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Priority for Everyone, and Even More So for Those with Chronic Illnesses
Mouth Care: Patient/Caregiver Training Hospice of Cincinnati Mouth Care is a high priority for everyone, and even more so for those with chronic illnesses. Proper mouth care has many benefits including: 1. Increasing appetite 2. Maintaining comfort 3. Clearer speech 4. Easier swallowing 5. Preventing sores and infection. General tips: Mouth care should be performed a minimum of twice daily and more frequently for dry mouth, if breathing through the mouth, or if you are not eating. Mouth care should always be performed after using an inhaler/nebulizer to prevent thrush. Thrush is slightly raised white patches or a rash typically seen on the tongue or inner cheeks. There may be pain with swallowing. Contact your hospice nurse immediately if you suspect thrush. Dentures may no longer fit well. You may consider using them only when eating or when visiting with friends and family. Questions or concerns? Call a hospice nurse at 513-891-7700. Training: Mouth Care. ©2017 Hospice of Cincinnati Hospice of Cincinnati Relieving dry mouth: 1. Increase frequency of mouth care. 2. Encourage sucking on candy, ice chips, popsicles or taking small sips of water to increase saliva. 3. Use of a mouthwash can increase dryness. Talk to your nurse about a proper mouth moisturizer/artificial saliva product. For those with difficulty swallowing: • Raise the head of the bed and support the head with pillows, turn head to one side. • Cover the upper body with a towel to keep the area clean and dry. • Remove dentures prior to mouth care and brush separately. • Use a toothette, which is a sponge-tipped oral swab, to clean the mouth and teeth using a small amount of toothpaste. -
Hydrogen Peroxide, and This Is the Same Substance That Can Be Purchased in a 32-Ounce Plastic Bottle at Walmart, for 88 Cents, Or at Walgreens for Under a $1.00
An At-Home Treatment That Can Cure Any Virus, Including Coronavirus Originally Conceptualized, circa 1990, by Charles Farr, MD Subsequently Researched and Prescribed by Frank Shallenberger, MD Current Protocol Created by Thomas Levy, MD, JD Although COVID-19, aka coronavirus, is deadly in some select cases, and it can spread rapidly, there is a simple, very inexpensive, and highly effective treatment that can treat and rapidly resolve coronavirus and virtually any other respiratory virus. While different individuals can be expected to have variable degrees of positive response, this intervention can be anticipated to eliminate eventual fatal disease outcomes in all but the most advanced cases. As I hope you will eventually experience, the treatment works for all acute viral infections, and especially well for flu viruses of any variety. In fact, although we are constantly conditioned to not believe in anything “too good to be true,” you will never have to worry about getting a cold or the flu again because you can cure it on your own. The key ingredient in this treatment is common household 3% hydrogen peroxide, and this is the same substance that can be purchased in a 32-ounce plastic bottle at Walmart, for 88 cents, or at Walgreens for under a $1.00. Perhaps you have never heard of hydrogen peroxide therapy, but since the treatment was first championed by Dr. Charles Farr in about 1990, thousands of doctors have used this therapy for decades to conquer infections in many thousands of patients throughout the world. How and Why Hydrogen Peroxide Works Because hydrogen peroxide consists of a water molecule (H2O) with an extra oxygen atom (H2O2), it is this extra oxygen atom that makes it so deadly for viruses. -
Smoking and Asthma
If you smoke and have asthma, the most important step you can take to improve your health and reduce asthma attacks is to QUIT SMOKING . Tobacco smoke is a major trigger for asthma attacks. Asthmatic breathing tube triggered by smoking Muscles tighten and squeeze tubes Extra mucus forms inside tubes Tubes swell and fill with fluid Asthmatic breathing tube Normal breathing tube Eight hours after your last cigarette, oxygen levels in your No matter blood return to normal. After 72 hours (3 days), breathing tubes relax, lung capacity how long increases, and breathing is easier. After 1 to 9 months, sinus congestion, coughing, fatigue, you smoked, and shortness of breath decrease. Your lungs’ ability to quitting helps clean themselves and handle mucus improves. Chances of lung infections are reduced. you b r e a t h e You’ll save trips to the doctor and ER and save money on asthma medication or possibly not buy it at all. more easily! You’ll save money from no longer buying cigarettes! TOBACCO CESSATION PROGRAM | 2600 TOWER DRIVE, SUITE 216, MONROE Tobacco smoke is the most toxic indoor Quitting smoking is difficult to do alone, air pollutant that triggers asthma. but support is available through your It is worse than dust mites, St. Francis Tobacco Cessation Program. cockroaches, and mold, and people with asthma should not smoke or be around secondhand smoke. Any time you need assistance WHAT HAPPENS WHEN with your cessation journey, need to ask questions YOU QUIT SMOKING or just need to talk, When a person who has asthma quits smok- call us at (318) 966-QUIT. -
Novel Therapeutic Approaches to Eosinophilic Esophagitis
Novel Therapeutic Approaches to Eosinophilic Esophagitis Claire Beveridge, MD, and Gary W. Falk, MD, MS Dr Beveridge is a gastroenterology Abstract: Eosinophilic esophagitis is a chronic inflammatory condi- and hepatology fellow and Dr Falk is a tion that requires treatment to improve symptoms and prevent professor of medicine in the Division complications of esophageal remodeling, such as strictures and of Gastroenterology and Hepatology narrow-caliber esophagus. First-line treatments include proton at the University of Pennsylvania Perelman School of Medicine in pump inhibitors, topical corticosteroids, elimination or elemental Philadelphia, Pennsylvania. diets, and esophageal dilation. Topical corticosteroids have typi- cally required repurposing inhaled asthma medications by swal- lowing an aerosolized medication or mixing a nebulizer solution Address correspondence to: into a slurry. New topical corticosteroid formulations undergoing Dr Gary W. Falk investigation include a premade budesonide oral suspension and Division of Gastroenterology and Hepatology disintegrating budesonide and fluticasone propionate tablets. The University of Pennsylvania Perelman approach to an elimination diet is also changing, with an emphasis School of Medicine on patient preference when considering a traditional 6-food elim- Perelman Center for Advanced ination diet compared with a step-up approach. This approach Medicine involves eliminating only 2 or 4 foods initially and expanding if 7th Floor South Pavilion 750 necessary. While this method can be initially less effective for some 3400 Civic Center Boulevard Philadelphia, PA 19104 patients, it generally involves fewer endoscopies and minimizes Tel: 215-615-4951 diet restriction. Beyond conventional therapies, a number of novel Fax: 215-349-5915 biologic agents are also under investigation. These include week- E-mail: gary.falk@pennmedicine. -
Using an Inhaler and Nebulizer
inhalercover.pdf 1 8/27/18 7:32 AM Using an Inhaler and Nebulizer C M Y CM MY CY CMY K Using an Inhaler and Nebulizer Inhalers An inhaler is a handheld device. It delivers medication directly into your airways. Inhalers are commonly used to treat problems that affect your ability to breathe. Your health care provider may recommend that you use an inhaler if you have: • Asthma. • Chronic obstructive pulmonary disease. • Other ongoing respiratory problems. The asthma medications delivered by the inhalers include: • Bronchodilators. • Steroids. • Combination of bronchodilators and steroids. Bronchodilators cause small airways in the lungs to open up. Steroids are used to relieve swelling and inflammation. Some inhalers are meant for limited use during an emergency situation. Others are used daily to prevent breathing problems. Using the right amount of medication is important in the treatment and prevention of ongoing respiratory problems. Medications can also decrease the sensitivity of the lungs to allergens. Inhalers are commonly used to deliver these medications directly into the airways. Inhaled medicine relieves symptoms faster than the same medicine given in pill form. Using an Inhaler and Nebulizer 1 Fewer side effects happen when medicine is delivered by an inhaler instead of taken in pill form. That’s because medicine from an inhaler goes directly into the airways. Very little medicine ends up in the bloodstream. Inhalers come in many different forms. The most commonly used inhalers are: • Metered dose inhalers. • Metered dose inhalers with a spacer. • Dry powder inhalers. A metered dose inhaler, or MDI, is a small aerosol canister that holds medicine. -
Medication Administration
MEDICATION ADMINISTRATION GENERAL CONSIDERATIONS A. Before administering any medication, the EMT should know: 1. What is the medication being used? 2. Does the patient have an allergy to this medication? 3. What is the safe and effective dose? 4. What is the correct administration route? 5. What are the indications? (Why are you using is?) 6. What are the contraindications? (Why or when would you NOT use this medication?) 7. What are the expected effects? 8. What are the adverse effects / side effects? 9. Is the medication expired? B. The “Six Rights” of medication administration: 1. Right patient – is the medication indicated for this patient; no contraindications; no allergies 2. Right drug – the correct name (trade name vs. generic name); correct concentration 3. Right dose 4. Right route 5. Right time – slow IVP vs. rapid IVP 6. Right documentation C. Correct documentation of medications administered and/or IV/IO placement will include: 1. Time of medication administration; IV/IO placement 2. Route of administration 3. Size of catheter (IV/IO) 4. Site location for IV/IO and SQ, IM medication (include unsuccessful IV/IO attempt locations) 5. Dose or volume infused 6. Time of infusion as indicated (e.g., rapid IVP, infused over 10 minutes, etc.) 7. Name of EMT responsible 8. Any complications and steps made to correct 9. Patient’s response to treatment D. Use of a medication simply because it is in the protocol is not an acceptable standard of medical care. When there are questions about medication administration, consult medical control. ORAL ADMINSTRATION To administer an oral (PO) medication ensure that the patient has an intact gag reflex and place the patient in a seated or semi-seated position. -
A Guide to Aerosol Delivery Devices for Respiratory Therapists 4Th Edition
A Guide To Aerosol Delivery Devices for Respiratory Therapists 4th Edition Douglas S. Gardenhire, EdD, RRT-NPS, FAARC Dave Burnett, PhD, RRT, AE-C Shawna Strickland, PhD, RRT-NPS, RRT-ACCS, AE-C, FAARC Timothy R. Myers, MBA, RRT-NPS, FAARC Platinum Sponsor Copyright ©2017 by the American Association for Respiratory Care A Guide to Aerosol Delivery Devices for Respiratory Therapists, 4th Edition Douglas S. Gardenhire, EdD, RRT-NPS, FAARC Dave Burnett, PhD, RRT, AE-C Shawna Strickland, PhD, RRT-NPS, RRT-ACCS, AE-C, FAARC Timothy R. Myers, MBA, RRT-NPS, FAARC With a Foreword by Timothy R. Myers, MBA, RRT-NPS, FAARC Chief Business Officer American Association for Respiratory Care DISCLOSURE Douglas S. Gardenhire, EdD, RRT-NPS, FAARC has served as a consultant for the following companies: Westmed, Inc. and Boehringer Ingelheim. Produced by the American Association for Respiratory Care 2 A Guide to Aerosol Delivery Devices for Respiratory Therapists, 4th Edition American Association for Respiratory Care, © 2017 Foreward Aerosol therapy is considered to be one of the corner- any) benefit from their prescribed metered-dose inhalers, stones of respiratory therapy that exemplifies the nuances dry-powder inhalers, and nebulizers simply because they are of both the art and science of 21st century medicine. As not adequately trained or evaluated on their proper use. respiratory therapists are the only health care providers The combination of the right medication and the most who receive extensive formal education and who are tested optimal delivery device with the patient’s cognitive and for competency in aerosol therapy, the ability to manage physical abilities is the critical juncture where science inter- patients with both acute and chronic respiratory disease as sects with art. -
Guide to Medication Administration in the School Setting
Guide to Medication Administration in the School Setting To Implement Texas Education Code Chapter 22 Section 22.052. Guidelines for Use by Local Boards of Trustees of School Districts and Governing Bodies of Open-Enrollment Charter Schools. Guide to Medication Administration in the School Setting To Implement Texas Education Code Chapter 22 Section 22.052. Table of Contents Introduction. 3 Laws Related to Medication Administration . 4 Civil Immunity . 5 Children with Food Allergies At-Risk for Anaphylaxis . 5 Policy and Administrative Regulation Development . 6 Special Considerations for Medication Administration . 11 General Procedures for Medication Administration . 14 Procedures for Various Routes of Medication Administration . 18 References . 25 Statutory Reference Guide . 30 Roles and Responsibilities . 31 Medication Administration Definitions . 34 Common Metric Measurements and Abbreviations . 36 Sample Requests, Medical Assessments, Letters, and Reports . 37 Eight Rights to Medication Administration . 48 Guide to Medication Administration in the School Setting 1 2 Guide to Medication Administration in the School Setting Introduction Each year, more students are attending schools with complex and chronic health conditions. According to the National Survey of Children with Special Healthcare Needs, 11.2 million children are at risk for chronic conditions that can affect their physical, emotional, and social well-being.1 Conditions such as asthma, diabetes, epilepsy, food allergies, obesity, and mental health issues can hinder academic achievement if not given proper attention. Schools can assist in managing these conditions by administering medications and treatments during the school day. Due to the variety of medications and treatments administered in schools, school nurses and trained school health staff can assist with administering medications, monitoring adherence to medication regimens, and providing recommendations to protect the health and safety of students. -
Table of Contents
TABLE OF CONTENTS Page No. Foreword . .2 Executive Summary . .3 1. Aerosol Drug Delivery . .9 2. Aerosol Drug Delivery: Small-Volume Nebulizers . .16 3. Inhalers . .25 4. Pressurized Metered-Dose Inhalers . .27 5. Metered-Dose Inhaler Accessory Devices . .37 6. Dry-Powder Inhalers . .40 7. Criteria for Selecting an Aerosol Delivery Device . .47 8. Neonatal and Pediatric Aerosol Drug Delivery . .49 9. Infection Control . .51 10. Educating Patients in Correct Use of Aerosol Devices . .54 References . .59 List of Acronyms and Terminology . .64 List of Figures, Tables, and Technique Boxes . .65 DISCLOSURE: Karen L. Gregory, is an advanced practice nurse at Oklahoma Allergy and Asthma Clinic in Oklahoma City, OK. She is an assistant professor at Georgetown University, Washington, DC. She provides lectures for Monaghan Medical Cor- poration, Genetech, Novartis, and GlaxcoSmithKlein. Deborah Elliott, MSN, NP-C, is a nurse practitioner in the department of surgery at Fairview Hospital in Cleveland, OH. She has no personal involvement with any of the products and companies in aerosol medicine. Patrick Dunne, MEd, RRT, FAARC, is president of HealthCare Productions in Fullerton, CA, and occasionally provides lectures for Monaghan Medical Corporation and Dey Pharma L.P. NOTE: You will find products that are registered or trademarked called out on first reference in the text, or listed in Figure 9. 1 ©2013 Guide to Aerosol Delivery Devices for Physicians, Nurses, Pharmacists, and Other Health Care Professionals American Association for Respiratory Care FOREWORD The American Association for Respiratory Care (AARC) is happy to release the second edition of “Guide to Aerosol Delivery Devices for Physicians, Nurses, Pharmacists, and Other Health Care Professionals.” This Guide should provide you with necessary informa- tion about currently available aerosol delivery devices in the U.S. -
NE-C803 (NE-C803-E) Instruction Manual
NE-C803-E_A_M09_140715.pdf EN Compressor Nebulizer NE-C803 (NE-C803-E) Instruction Manual IM-NE-C803-E-01-05/2014 8300641-7A 14G1762 Before using the device Contents Before using the device Introduction ................................................................................................................. 2 Intended use ............................................................................................................... 3 Important safety instructions .......................................................................................4 Know your unit ............................................................................................................7 Optional Medical Accessories ..................................................................................... 8 Other Optional/Replacement Parts .............................................................................8 Operating instructions How to use ..................................................................................................................9 Care and maintenance Cleaning and disinfecting.......................................................................................... 13 Removing condensation from the air tube ................................................................16 Changing the air filter................................................................................................ 16 Troubleshooting ....................................................................................................... -
A Patient's Guide To
A Patient’s Guide to Aerosol Medication Delivery 3rd Edition Prepared by: Tim Op’t Holt, EdD, RRT, AE-C, FAARC Kimberly Wiles, RRT, CPFT Ellen Becker, PhD, RRT-NPS, RPFT, AE-C, FAARC Edited by: Timothy Myers, MBA, RRT-NPS, FAARC Copyright ©2017 by the American Association for Respiratory Care A Patient’s Guide to Aerosol Medication Delivery, 3rd Edition Tim Op’t Holt, EdD, RRT, AE-C, FAARC Kimberly Wiles, RRT, CPFT Ellen Becker, PhD, RRT-NPS, RPFT, AE-C, FAARC Edited by: Timothy Myers, MBA, RRT-NPS, FAARC With a Foreword by Thomas Kallstrom, MBA, RRT, FAARC Executive Director/Chief Executive Officer American Association for Respiratory Care Produced by the American Association for Respiratory Care 1 A Patient’s Guide to Aerosol Medication Delivery, 3rd Edition American Association for Respiratory Care © 2017 Foreward Gaining as much information as possible about We hope that you find this Patient Guide your aerosol delivery devices is essential. You useful. The American Association for Respiratory have taken a positive first step by obtaining this Care invites you to learn more about better third edition of “A Patient’s Guide to Aerosol self-management of lung disease through other Medication Delivery.” The American Association online resources that, again, have been created for Respiratory Care (AARC) asked respiratory to help you and to allow you to practice a higher therapists who were noted aerosol delivery level of self-management. Simply go to www. experts to write this guide. This guide was written aarc.org or www.yourlunghealth.org. There you with you in mind. -
Standard Treatment Guidelines and Essential Drugs List
STANDARD TREATMENT GUIDELINES AND ESSENTIAL DRUGS LIST FOR THE MINISTRY OF HEALTH, TONGA- 2007. Standard Treatment Guidelines Tonga 2007 Standard Treatment Guidelines and Essential Drugs List: Ministry of Health. First Edition, 2007 Copyright © 2007, Ministry of Health, Tonga All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, scanned or transmitted in any form without the permission of the copyright owner. Ministry of Health PO Box 59 Nuku’alofa Tonga Phone: 676 23200 Fax: 676 24291 E-mail address: [email protected] Editors: Siale ‘Akau’ola & Siutaka Siua Cover design by: Owen Towle Formatted by: T. Nauna Paongo Printed by: Taulua Press STG 2 Ministry of Health Standard Treatment Guidelines Tonga 2007 TABLE OF CONTENTS 1. FOREWORD: 13 2. ABBREVIATIONS AND ACRONYMS: 14 3. ACKNOWLEDGEMENTS: 17 4. INTRODUCTION: 19 5. ACCIDENT AND EMERGENCY (A&E): 21 5.1. General Approach to A&E 21 5.2. Cardiac Arrest 26 5.3. Other Life Threatening Emergencies 30 5.4. Infectious Diseases 52 5.5. Severe Hypertension 58 5.6. Abdominal Pain 59 5.7. Surgical Problems 60 5.8. Red Eye 66 5.9. Dog Bite 67 6. CARDIOVASCULAR CONDITIONS. 68 6.1. Heart Failure 68 6.2. Myocardial Infarction 72 6.3. Cardiogenic Shock 77 6.4. Acute Coronary Syndrome (ACS) 79 6.5. Cardiac Arrythmias 80 6.6. Cardiac Arrest 87 6.7. Hypertension 89 6.8. Aortic Dissection 93 6.9. Bacterial Endocarditis 96 6.10. Infective Endocarditis Prophylaxis 97 7. CENTRAL NERVOUS SYSTEM (CNS) CONDITIONS 104 7.1 Headache 104 STG 3 Ministry of Health Standard Treatment Guidelines Tonga 2007 7.2 Seizures 107 7.3 Meningitis 108 7.4 Stroke 108 7.5 Involuntary Movement Disorders 110 7.6 Epilepsy 111 8 COMMON EAR, NOSE AND THROAT PROBLEMS.