Page 47 - Norco Patient Orientation Handbook e-book
P. 47
IPPB (Intermittent Positive Pressure Breathing)
Education
Discuss the goals of IPPB therapy: 1) to treat/prevent airway closure (atelectasis), 2) to mobilize secretions,
3) to promote a cough, 4) to deliver aerosolized medication.
Review the physician Rx and the need to use the equipment as prescribed.
Discuss the length and frequency of treatments via physician prescription. (15-20 min./ Q4 (every 4 hours),
QID (four times a day), Q3 (every 3 hours) , TID (3 times a day), Q2 (every 2 hours), BID (twice a day), or
PRN (as needed).
Discuss contraindications/potential side effects which include: 1) Hyperventilation [fast breathing],
2) Barotrauma (lung damage due to extreme pressure) or airway collapse, 3) Fatigue, 4) Tremors or shakes,
5) Tachycardia (from nebulizer medication) [fast heartbeat; normal heart rate for adults: 60 – 100, children:
100-140, infants: 120-160 bpm], 6) allergies.
Discuss safe medication storage (refer patient to specific medication instruction).
Demonstration
Plug power cord into properly grounded AC electrical outlet. Do not use an extension cord.
Fill nebulizer cup on the Vortran™ IPPB circuit with the medication vial and the balance with saline
solution (15-20ml total). The Vortran™ will nebulize at a rate of 1ml/minute.
Attach one end of the plastic tubing to the air outlet on the compressor and the other end to Vortran™ IPPB
nebulizer reservoir.
Adjust pressure on the high flow compressor to 40-50 psi.
Adjust the IPPB pressure and sensitivity on the modulator piece to
tolerance. 15-20cmH20 is a conservative starting pressure. Increase
pressure according to physician’s guidelines. (See Vortran™ IPPB
kit instructions.
Use mouthpiece or inflatable mask to deliver therapy. Sit upright
with back straight. Take 10-15 slow deep breaths. Rest for 1-2 minutes and repeat. The treatment should
last 15-20 minutes. If using a mouthpiece, nose plugs are recommended to prevent air escaping from the
nose.
It is extremely important to cough and spit out mucous from the central airways. Cough as frequently as
prescribed.
Ways to detect and correct low aerosol levels: 1) listen for a crackling sound or change in pitch from the
nebulizer cup, 2) tap the nebulizer lightly until aerosol mist appears.
Disconnect tubing from the IPPB kit. Clean and store the IPPB with tubing in a clean plastic bag.
A clinician will follow up with you every day for the first 3 days of therapy.
Cleaning/Maintenance/Troubleshooting
Discuss equipment malfunction procedures: 1) power failure, 2) compressor wear/ failure.
Clean compressor filters weekly in warm soapy water. Rinse and allow to air dry.
Daily, disassemble IPPB unit and wash in hot soapy water (7 ft. tubing excluded). Rinse to remove soapy
residue.
Three times per week, soak IPPB circuit (excluding the modulator adapter) in a 1:3 white vinegar/water,
70% alcohol or hydrogen peroxide solution for 30 minutes. Remove items from solution, rinse and allow to
air dry. Discard cleaning solution after each use. Do not towel dry or clean in dishwasher.
If using a medical disinfectant, follow the manufacturer’s guidelines and safety precautions carefully. The
high flow compressor can be sprayed with cleaner and wiped with a clean paper towel.
If the compressor does not power up: 1) Check the outlet 2) Unplug the machine and check the fuses.
If the Vortran™ IPPB kit doesn’t pressurize/create a mist: 1) Check hose connections. 2) Check all
connections on kit. 3) Check nebulizer cup to ensure that clear adapter is not cracked or damaged.
Replace the Vortran™ IPPB kits every 6 months.
