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MH CI (7)
Haemodynamic Instability
Suspected or undrained pneuomothorax
Large bullae
Severe bronchospasm or asthma
Obstructive lung disease
High positive end expiratory pressure (PEEP>10cmH2o on ventilator)
Severe head injury with ICP < 20 mmHg
Why is Haemodynamic Instability a CI for MH
Decreases in cardiac output and blood pressure put patient at risk if already hypotensive
Why should you be careful with a treated pneuomothorax when preforming MH
Why is large bullae a CI for MH
Reduce risk of rupture
Why is severe bronchospasm and asthma a CI for MH
Delivery of un humidified gas may worsen bronchospasm and incerase risk of barotrauma
Obstructive lung disease eg COPD - why CI for MH
Patients with COPD are at risk of gas trapping - need sufficient expiratory time
Why is high PEEP and CI for MH
Patient may not tolerate discconecting from ventilator
Indications for MH (3)
Mobilise and facilitate clearance of secretions
Recruit/ Reinflate atelectaic areas of lung
Improve lung compliance
Suction CI (6)
Unexplained haemoptysis
Severe coagulopathies
Severe bronchospasm
Laryngeal spasm
Compromised cardiovascular system
Head injuries with CSF leak into nasal passage - if done via nasopharyngeal
Suction Indications
Stimulation of cough (ineffective cough)
Removal of secretions (Retention clearance)
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