A50095-1 Direct To Artificial Airway Procedure

IPV®/IMPULSATOR®
THERAPY PROCEDURE 
(Artificial airway) 

1. Introduce yourself and explain procedure to patient. 
2. Connect to proper power source: 
   A. IPV®: 50 psi/3.2 bar gas source. Make sure master switch is in off position. 
   B.IMPULSATOR®: 115Vac/60Hz USA, 220Vac/50Hz Foreign. Make sure rocker  switch is in off position.
3. Patient should be in an upright comfortable position if possible. 
   A. Patient should be assessed for a minimum of breath sounds, heart rate, respiratory  rate or follow institution guidelines. 
4. Short end of harness assembly should be connected to IPV®/IMPULSATOR® unit using correct color-coding. 
5. Long end of harness assembly should be connected to Phasitron® and nebulizer using correct color-coding., (green line may be left disconnected if patient is unable to depress remote switch - an open green line will allow the device to cycle continuously).
6. Fill nebulizer with prescribed medications and dilute to 15 to 20 ccs. Assemble Phasitron® to nebulizer.   
7. Rotate frequency control knob full counterclockwise to the easy position. 
8. Rotate source pressure knob for an operating pressure of 30-35 psi. 
   A.  IPV®: Source/Operational pressure control knob is located on front of unit.
   B.  IMPULSATOR®: Source pressure control knob is located at the bottom left of unit as it is facing you.
   NOTE: The IMPULSATOR® must be switched on in the rear of the unit before pressure can be adjusted.
9. Attach Phasitron® to artificial airway making sure of patient comfort.
   A. Initiate percussion immediately: observe chest wiggle. Percussions will begin either when the silver button on the nebulizer is pressed (by patient or clinician), or when the green hose is disconnected (at either end).
10. Patient is instructed to inhale and exhale through the percussions, this is the beginning of the "active breathing" cycle. 
    A. This "active breathing" cycle should last at least 10-15 seconds to allow for equilibration of pressures.
    B. If applicable the patient's cuff should be partially deflated for the facilitation of  secretions  into the oral airway.
    C. Observe SpO2 throughout, if a drop occurs increase rate by rotating  percussion knob counterclockwise toward easy.
11. If the patient cannot understand instructions the therapist must deliver treatment. 
    A. Suction as needed. 
12. During the treatment, which should be about 15-20 minutes in length, the entire percussion frequency should be scanned (easy-hard) in order to mobilize secretions in the different time constants of the lung.
    A. Source Pressure should be adjusted for effective internal percussions by assessing "chest wiggle"/chest wall movement, auscultation and patient comfort.
13. Treatment should continue until all medication is delivered.
    A. Additional diluents may be added if necessary.
14. When treatment is complete unit should be turned off (bleed off internal pressure in IPV®) breathing head should be dismantled and stored/cleaned for future use.
    A. Re-inflate cuff to pre treatment level.
    B. Reassess patient, this procedure may result in mobilization of copious secretions, suction and evaluate.

A patient cannot breathe through an obstructed airway.
See Clinical Manuals for complete Instructions.