Self-Assessment Checklist Airway Management
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paraPAC plus™ Ventilator P310 Self-Assessment Checklist
AIRWAY MANAGEMENT
Section 1: ParaPAC Plus™ external features I can...
Achieved Date or Not
a)
Define the patients for whom the par aPAC plus ™ is suitable.
b)
Identify the controls, indicators and alarm module on the front of the ventilator.
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 1
I can... c)
Achieved Date or Not
Describe the function of each mode.
Off Mode - Manual operation –
Demand Oxygen -
Position I – Controlled Mandatory Ventilation
Position II – Oxygen therapy position
d)
Explain the use of Relief Alarm Pressure Control.
e)
Explain the function of the Oxygen Concentration control.
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 2
I can...
Achieved Date or Not
f)
Describe each of the alarms below.
g)
Identify the silence button on the alarm module.
h) Describe the correct action when presented with a High Pressure alarm.
i)
Describe the correct action when presented with a Low Pressure alarm.
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 3
I can...
Achieved Date or Not
j)
Describe the label on the side of the ventilator.
k)
Insert the battery with correct polarity in the battery compartment.
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 4
I can... l)
Achieved Date or Not
Identify the inlets and outlets on the side of the ventilator.
Comments
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 5
Section 2: The patient circuit, CPAP circuit and hyperinflation system I can...
Achieved Date or Not
a) Identify the circuit below and the parts A, B & C.
A C
B
A. B. C.
Demonstrate/describe how to attach it to the ventilator:-
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 6
I can...
Achieved Date or Not
b) Identify the circuit below and the parts A, B, C & D.
A C
B
D
A. B. C. D.
Demonstrate/describe how to attach it to the ventilator:-
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 7
I can...
Achieved Date or Not
c) Identify the device below and the parts A, B, C, D & E.
C
A B
D
E
A. B. C. D. E.
Demonstrate/describe how to attach it to the ventilator:-
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 8
Section 3: Setting up the ventilator I can... a)
Achieved Date or Not
Set up the ventilator for use.
Comments
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 9
paraPAC plus™ VENTILATOR SELF ASSESSMENT CHECKLIST
ANSWERS SECTION
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
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Section 1: paraPAC plus™ external features Performance criteria. I can… Intended Answer/Outcome ... ® a)
Define the patients for whom the par aPAC plus ™ is suitable.
b)
Identify the controls, indicators and alarm module on the front of the ventilator.
The Pneupac par aPAC plus ™ ventilator is suitable for ventilation of Infants above 10kg, Children and Adults.
Pressure relief valve and alarm
Inflation Pressure Manometer
Oxygen Oxygen supply concentration indicator control
c) Describe the function of each mode.
CPAP therapy through dedicated accessory (model 310)
Integrated PEEP control (model 310)
Mode selection and function button
Frequency – breaths per minute
Tidal Volume
Off Mode - Manual operation - Delivering manual breaths at the selected Tidal volume settings via the manual push button. Demand Oxygen - Oxygen on demand is available to a spontaneous breathing patient. Position I – Controlled Mandatory Ventilation The par aPAC plus ™ delivers automatic ventilation at the selected frequency and tidal volume selected on the controls. Position II – Oxygen therapy position The par aPAC plus ™ delivers automatic oxygen at the selected flow to the oxygen outlet of the par aPA C plus ™. This mode is used for CPAP and driving other oxygen driven accessories.
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 11
Performance criteria. I can… Intended Answer/Outcome ... d) Explain the use of Relief Alarm Pressure Control.
This is set to limit the over-inflation of the patient.
e) Explain the function of the Oxygen Concentration control.
The oxygen control allows either 50% FiO2 or 100% FiO2.
f)
Describe each of the alarms below.
High pressure Indicator (Red)
Normal Cycle Indicator (Green)
Low Pressure (Disconnect) Indicator (Amber)
Silence button Patient Inflation Indicator
Low Battery Indicator (Amber)
Silence Indicator (Amber) Will blink when patient takes a spontaneous breath
g) Identify the silence button.
Black button on the bottom right of the Patient Inflation Indicator.
h) Describe the correct action when presented with a High Pressure alarm.
Check the Patient circuit for a blockage then check for excessive Tidal Volume and if PEEP is set above 13cm H2O after correction and then check the patient is ventilated correctly again.
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 12
i)
Describe the correct action when presented with a Low Pressure Alarm.
Check the patient circuit for disconnection or leakage, after correction check the patient is ventilated correctly again.
j)
Describe the label on the side of the ventilator.
The label on the side of the ventilator shows the alarms that the ventilator may sound.
k) Insert the correct battery in the battery compartment.
l)
Identify the inlets and outlets on the side of the ventilator.
Correctly inserts the battery into the compartment on the side of the ventilator. Demonstrates an understanding that the ventilator must be fitted with an MRI compatible battery if it is to be used in a MRI environment.
Oxygen supply gas inlet connection
Flow/CPAP connection/Oxygen therapy outlet
Patient outlet connection
Pressure monitoring connection manometer luer connection
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 13
Section 2: The patient circuit, CPAP circuit and hyperinflation system Performance criteria. I can ... Intended Answer/Outcome a) Identify the criteria. correct circuit Performance I can ... below and the parts A, B & C. Demonstrate how to attach to the ventilator.
This is the standard circuit for use with the par aP AC plus ™ 300 Intended Answer/Outcome and p ar aP AC p lus ™ 310 but if PEEP is needed with the P300, then a separate PEEP valve will need to be attached or 100/905/341 will need to be used.
C
A
B
A. Single limb Breathing Circuit B. Patient
Valve
(containing
a
non-return
valve)
C. Monitoring line with in-line filter (inside circuit) To attach circuit to the ventilator:1. Ensure that the circuit is undamaged, complete and assembled. 2. Ensure that all connections are secure. 3. Connect the in-line filter to the luer port on the ventilator. 4. Connect the circuit to the patient outlet connection (22mm) male on to the ventilator. 5. Pressure test the circuit before use to verify leak resistance. 6. If using the p ar aPA C p lus ™ P300 and a circuit with a mechanical PEEP valve is used, make sure that it is set to its lowest setting before connecting the circuit to the patient.
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
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b) Identify the correct circuit below and the parts A, B, C & D. Demonstrate how to attach to the ventilator.
This is the CPAP circuit, for use with the par aPAC p lus ™ 310, which has the CPAP feature.
A C
B
D
A. CPAP air entrainment device B. Pre-attached, 7ft oxygen line to connect to the par aPA C plus ™ 310, via the CPAP/oxygen outlet port. C. Pre-attached pressure monitoring line (fitted with a filter) D. Face Mask. To Attach CPAP circuit to the ventilator:1. Ensure all components are present and visually undamaged. 2. Confirm size of face mask; there are 2 options medium or large. 3. Connect the CPAP accessory device to the facemask. 4. Connect the monitoring line to the luer port on the par aPA C plus ™ 310. 5. Place the face mask on the patient’s face; fit it as snuggle as possible; secure the straps. 6. On the ventilator, turn the function switch to CPAP. 7. Gradually rotate the CPAP/oxygen to a maximum of 15L/min to detect leakage. Where leakage is detected adjust the mask in that area by tightening the straps. Adjust the CPAP flow until the required pressure is indicated on the patient pressure gauge.
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 15
c) Identify the correct circuit below and the parts A, B, C, D & E. Demonstrate how to attach to the ventilator.
This is the hyperinflation system.
C
A B
D
E
A. Disposable pressure manometer B. Slide bleed valve C. Latex-free bag D. Oxygen Tubing E. Right-angled elbow To attach the hyperinflation system to the ventilator:1. Connect the oxygen tubing (D) to the CPAP/Oxygen outlet on the ventilator. 2. On the ventilator, set the oxygen therapy/CPAP control to between 5 and 8 litres/min. 3. Adjust the slide bleed valve to desired PEEP level. 4. Squeeze the latex-free bag 3-4 times to relax the disposable pressure manometer spring. 5. Squeeze the latex-free bag to ventilate the patient using the manometer to monitor PEEP. Observe patient’s chest rise and fall during breath-delivery.
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 16
Section 3: Setting up the ventilator Performance criteria. I can ... Intended Answer/Outcome a) Set up the ventilator for use.
Smiths Medical
1. Connect supply hose probe to dry filtered gas supply. 2. Turn on gas supply (if relevant). 3. Check that the visual alarm for supply gas failure has changed from red to white. 4. Turn function switch to I VENTILATE CMV. 5. Check that the alarm indicators flash in sequence, to indicate correct function. 6. Set ventilation parameters to suit the patient. 7. Briefly occlude the patient connection port of the patient valve with the thumb. Check that the peak inflation pressure reading on the manometer is appropriate for the patient and that the pneumatic audible alarm sounds and the high inflation pressure indicator shows red. 8. Connect face mask or endotracheal (ET tube) to patient valve. 9. Check chest movement and Inflation Pressure Manometer to ensure correct ventilation. 10. Check that the green cycle indicator light flashes when inflation pressure rises above 10cmH2O. 11. Make adjustments to the ventilator based upon clinical observation and measurement of expired CO2 and pulse oximetry.
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
Page 17
Smiths Medical - Pneupac® paraPAC plus™ ventilator: A Framework for Reflection What is reflection? Reflection is a generic term for those intellectual and emotional activities in which an individual engages to explore their experiences to lead to new understanding and appreciations. It is a highly personal process and the outcome is a changed perspective and/or learning. Schon (1991) describes two types of reflection: Reflection during practice, which takes place during the activity of practice Reflection on practice, where the person looks back on their practice.
Why reflect? Schon* (1988) suggests that reflection provides the means to review and think about an experience, exploring what happened in context, linking it to past experiences, together with recognising previous and present knowledge. This way, meaning can be extracted and the incident
evaluated
in
terms
of
what
is
being
combined
into
current
practice.
How to reflect This framework is designed to guide you to reflect on the knowledge gained and provide evidence of learning. Summarise your learning in your own words following the suggested headings on the pages provided.
*Reference: Schonn D. A. (1988) Educating the Reflective Practioner, San Francisco : Jossey-Bass.
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Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
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Suggested headings
What have I learnt from this training programme that maintains or develops my professional knowledge and competence?
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What can I apply immediately to my practice and client care?
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What else do I need to do/know to extend my professional development in this area?
_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________
Smiths Medical
Pneupac ® p a r a P A C p l u s ™ Ventilator - Self-Assessment Checklist
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