1、霧化水和大容量噴霧器霧化的概念霧化吸入療法的原理是利用氣體射流原理，將水滴撞擊的微小霧滴懸浮于氣體中，形成氣霧劑而輸入呼吸道，以進行呼吸道濕化或藥物吸入的治療方法。霧化吸入有消炎、化痰、解除氣管平滑肌痙攣、減輕喉頭水腫的效果.尤其是對于氣管切開且長期臥床患者效果明顯。產生的微粒為215 m,平均6 m ，能到達各級氣道。什么是大容量霧化治療A type of respiratory therapy used in the hospital, long-term care and home environments.一種用于醫(yī)院,長期護理和家居護理的呼吸治療方式Provides visible

2、particles of water to the respiratory tract to thin mucus and assist in the mobilization of secretions. 向呼吸道提供可見的霧化水顆粒，以便稀釋呼吸道分泌物，使其易于排出A bland aerosol (water or saline) is created by a nebulizer and carried to the patient via 22mm corrugated tubing. 霧化器產生純凈的霧氣(蒸餾水或生理鹽水),由22mm直徑的螺紋管連接輸送霧氣給患者Delivere

3、d via mask, face tent or trach mask 霧化氣體可通過面罩、氧氣面帳或氣切面罩送達患者LVN Therapy專有名詞LVN - Large Volume Nebulizer 大容量噴霧器Nebulizer A device that transforms a liquid into an aerosol 噴霧器 一種將液體轉換成噴霧劑（霧氣）的裝置Aerosol - Suspension of fine liquid particles噴霧劑、霧化顆粒懸浮著的細小液體微粒Bland aerosol - Soothing or non-irritating, no

4、 pharmacologic action, usually water or saline solution 純凈的霧化治療-不添加藥物，舒緩、無刺激，通常用無菌水或生理鹽水Rain Out - Aerosol particles that drop out of suspension and collect in the 22mm tubing 凝水- 氣霧顆粒沉積在22mm的螺紋管內LVN Therapy Definitions Who Benefits from Aerosol Therapy?霧化治療適用與哪些病人 ？Patients with artificial airways:

5、 endotracheal or tracheostomy tube 使用氣管插管或氣切插管建立人工氣道的病人Patients with thick secretions acute infection or underlying pulmonary disease 急性感染或器質性肺部疾病引起呼吸道分泌物濃稠的患者Post-extubation during a recovery period拔管后處于恢復期的病人Patients who have had fiberoptic bronchoscopy 使用纖維支氣管鏡的病人Patients with inflammatory obstru

6、ction, croup or laryngitis炎癥喉阻塞，義膜性喉炎或喉炎的患者。LVN Therapy Benefits LVN大容量噴霧器治療特點使用無菌蒸餾水或生理鹽水氣動式，須連接流量表氣霧粒子大小2-20m氣霧輸出量3050 mg/liter28%-100%氧氣濃度可供選擇濕化治療和大容量噴霧器的區(qū)別Humidifiers: add invisible water vapor (molecular humidity) to a gas mixture. Molecular humidity cannot carry bacterial or viral pathogens濕化治

7、療：令不可見的水蒸氣并與空氣混合。濕化分子不能攜帶細菌和病毒Nebulizers: add visible water particles to the gas mixture in the form of an aerosol. Aerosol particles are large enough to carry bacterial and viral pathogens 霧化器：使可見的水滴與氣體混合形成懸浮顆粒。氣溶膠顆粒足夠大可攜帶細菌和病毒LVN Therapy Humidification vs. NebulizationAQUAPAK Prefilled Large Volum

8、e NebulizersAQUAPAK預裝水大容量噴霧器Convenient 方便Cost effective 經濟Sterile 無菌Aseptic technique 無菌技術Closed system密閉系統(tǒng)Infection control感染控制Variety of options多種選擇LVN Therapy Delivery Options AquaPakEquipment Requirements 需要的配件Aerosol generator (nebulizer) including a variable oxygen concentration feature 可以調節(jié)氧濃

9、度的霧化發(fā)生器Patients needing aerosol therapy often need supplemental oxygen需要霧化治療的病人往往需要供氧Always verify delivered oxygen levels 可控制氧氣供給水平Corrugated tubing 螺紋管Aerosol drainage bag 霧化排水袋Patient interface: face mask, trach mask, face tent 連接病人端：面罩、氣切面罩、面帳External heater can be added as needed 根據(jù)需要添加加熱器Great

10、ly increases the aerosol output 大幅度提高霧化輸出量Always verify aerosol temperature at the patient可控制病人端的霧化溫度LVN Therapy Equipment RequirementsEquipment Requirements需要的配件LVN Therapy Equipment RequirementsTemperature Monitor 溫度監(jiān)測器Aerosol Mask霧化面罩 Corrugated Tubing螺紋管 Reservoir 霧化瓶 Heater加熱器 Adapter霧化接頭 AquaP

11、ak 霧化水容量選擇Three sizes, 440ml, 760ml, 1070ml to meet every clinical situation三種規(guī)格針對每種臨床的情況2200mL discontinued/2200ml不再提供Three bland solutions, sterile water, .45% NaCl, .9% NaCL 三種不同配方：無菌水、0.45%NaCl、0.9%生理鹽水Color coded labels by solution 不同配方有不同顏色的標簽Available separately or packaged with 028 or 033 ad

12、apter 有單獨包裝和與028/033接頭一起的包裝供應LVN Therapy Delivery Options AquaPak Reservoir OptionsTwo Nebulizer Adaptor Options兩種接頭選擇Adjustable air entrainment 可調節(jié)空氣入口Full range of oxygen concentrations: 28 to 98% (yellow) 黃色接頭有28-98%的氧氣濃度可選擇33 to 98% (blue) more silent, more rain out 藍色接頭氧濃度選擇為33-98%，更安靜，出霧更多Easy

13、 to use self-sealing puncture pins 簡單實用的封口穿刺針Closed system: recycles large particles back to the reservoir, infection control 全密閉系統(tǒng)：回收多余的霧化粒子，便于感控Ideal particle size for optimal nebulization 理想霧化顆粒達到最佳霧化效果Special baffling system provides quiet nebulization 安靜霧化Compatible with all AQUAPAK reservoirs

14、可與各種型號AQUAPAK霧化儲水瓶相接Sterile assembly, covered puncture pins 部件都是消毒包裝，穿刺針有針尖帽覆蓋LVN Therapy Delivery Options AquaPak Adapters031-33 (033) Nebulizer Adaptor 霧化接頭Quieter than the 028 adaptor, due to different internal baffle 不同的內部調節(jié)口設計，使它比028接口更靜音Mist more visible than 028 due to slightly larger particl

15、e size 霧化顆粒略大于028接頭，霧氣可視性更好Consumes more water than 028 比028接頭更費水More rainout than 028 比028接頭水汽沉積更多33% - 98% oxygen settings/ 33-98%氧濃度設置Bright blue entrainment collar 接頭為亮藍色LVN Therapy Delivery Options AquaPak AdaptersRain Out in Aerosol Tubing在霧化管道中的沉積LVN Therapy Delivery Options AquaPak Rain OutV

16、ariable Oxygen Concentration: 不同的氧氣濃度Venturi Effect 文丘里效應Oxygen from gas source is forced through a restricted orifice inside adaptor氧氣從接頭中的小孔通過Vacuum is created and room air is entrained through openings on adaptor 產生真空，使空氣從接頭的開口處進入Combination of oxygen flow and room air entrainment = total flow an

17、d FIO2氧氣和空氣的總和=總流量和總氧氣濃度Total Flow Data 總流量數(shù)據(jù)LVN Therapy Delivery Options AquaPak Venturi Effect霧化裝置設置（LPM/FLO2)總流量 LPMHudson RCI #0285 LPM/28%10 LPM/60%10 LPM/98%49.420.810.8Hudson RCI #0338 LPM/33%10 LPM/60%10 LPM/98%4919.710.5Large volume nebulizers can be heated to provide a heated mist to the p

18、atient. 大容量霧化裝置可用加熱方法向患者提供加熱的霧氣Heating the solution to be aerosolized raises the temperature of the gas leaving the nebulizer and increases its capacity to carry humidity. 對霧化水加熱，使霧化氣體溫度提高，增加其攜帶濕氣的能力Heat also increases the water output from the nebulizer by raising the temperature of the water. 加熱可增

19、加霧化器的出霧量Indicated for patient needing excessive amounts of aerosol / hyperactive airways (i.e. Asthma) 用于需要大劑量霧化的病人或氣道亢進的患者（如哮喘）Heated Aerosol 加熱霧化LVN Therapy Delivery Options Heated AerosolAquatherm III Heater, Cat. No. 050-12/050-14加熱器Push-to-turn temperature knob prevents accidental adjustment 溫度

20、調控旋鈕，防止意外觸碰改變溫度Self cleaning internal heater 有自動凈化功能Output temperature and temperature at patient depends upon heater setting, room temperature, length of tubing and oxygen setting輸出溫度和到達病人端的溫度取決于加熱器溫度設定、 房間溫度、 管道的長度和氧氣設置。Note: Always monitor temperature of aerosol delivered to patient 注意：不斷監(jiān)測到達病人端的

21、霧氣溫度LVN Therapy Delivery Options Aquatherm HeatersAerosol Output: Unheated vs. Heated霧氣輸出：加熱和不加熱的比較接頭霧氣輸出數(shù)據(jù)LVN Therapy Delivery Options Aquatherm HeatersHudson RCI #028 接頭設置總液體輸出（ML/小時）病人端濕度mg/L不加熱加熱不加熱加熱5 LPM/28%10 LPM/60%10 LPM/98%2320.814.784.2101.687.615.721.123.231.150.761.8Hudson RCI #033 接頭設置總液體輸出（ML/小時）病人端濕度mg/L不加熱加