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Information About Respiratory Therapy Equipment

The most important equipment utilized by respiratory therapists (RT) is the ventilator, as it sustains life. However, most RTs spend much more of their time involved in seemingly lesser tasks that are nevertheless very important to improving and/or maintaining the health of their patients. The list of RT equipment is a long one and includes oxygen tanks, regulators and flow meters as well as diagnostic tools and calibration equipment. However, most RTs spend the majority of their time dealing with ventilators, humidifiers, nebulizers, intermittent positive pressure breathing machines and incentive spirometers.

  1. Volume-Cycled Ventilators (VCV)

    • The most common type of ventilation used in American hospitals, volume-cycled ventilators (VCV) deliver a preset volume of oxygen-enriched air to the patient with each breath. Modern ventilators will monitor the delivered and exhaled volume of each breath and for each minute (minute volume); any discrepancy can indicate a physiological problem or a leak in the circuit. Many VCVs can convert to pressure-cycled mode.

    Pressure-Cycled Ventilators (PCV)

    • In this mode, the ventilator delivers a preset pressure of oxygen-enriched air into the patient’s lungs at a predetermined flow rate. In the Intensive Care Unit (ICU), doctors rarely prescribe this ventilator mode for patients unless they suffer from Adult Respiratory Distress Syndrome (ARDS), in which the lungs become very stiff and are vulnerable to lung trauma from excessive ventilation. In emergency room (ER) traumas requiring mechanical ventilation, respiratory therapists will often use intermittent positive pressure breathing (IPPB) machines to deliver pressure-cycled ventilation until the patient’s transfer to the ICU.

    Time-Cycled Ventilators (TCV)

    • Such ventilators see use rarely outside of the Neonatal Intensive Care (NIC) Unit. Perfect for use on delicate newborns, TCVs deliver a timed measurement of oxygen-enriched air to the newborn at a predetermined flow rate. This is useful especially when the patient has a very high respiratory rate, which is common for distressed neonates.

    Humidifiers

    • Long-term ventilators incorporate humidifiers, attached to the patient circuit between the ventilator output port and the ventilator tubing. Because the endotracheal tube (the tube running from the mouth or nose down into the mainstem bronchus just above both lungs) bypasses the airway’s mucosa, which normally humidifies inhaled air to protect the lungs and airways, you must humidify ventilator-generated breaths before they go into the patient’s lungs. Patients wearing oxygen cannulas in their noses or oxygen masks can benefit from humidification, as the medical oxygen contains no water vapor at all and can lead to dehydration with long use. Doctors will sometimes prescribe humidified room air as therapy for those with excess mucus production to loosen the phlegm.

    Nebulizers

    • The devices employed most frequently by all RTs other than those working in NIC units, nebulizers deliver aerosolized medications to patients with any number of lung diseases and/or conditions. “Smoked” like a pipe through a mouthpiece or attached to a loose-fitting mask, the patient inhales a bronchodilator (a drug that opens airways wider), a mucolytic (liquefies mucus, making it easier to expel) or antibiotic, treating the lung ailment topically and therefore more safely than with intravenous medications and more quickly than ingested meds.

    Intermittent Positive Pressure Breathing (IPPB) Machines

    • In addition to serving as temporary ventilators for emergency patients, IPPB machines deliver the same medications used in nebulizers to seriously ill patients not requiring mechanical ventilation. The machine, via a mouthpiece held by the patient or a ventilation mask (padded, airtight) held by the RT, delivers a predetermined pressure and flow of air into the patients lungs while simultaneously nebulizing the medication and delivering it into the lungs.

    Incentive Spirometers (IS)

    • Most often prescribed by surgeons for their postoperative patients, IS is a device that encourages the patient to take very deep spontaneous breaths to dampen the growth of bacteria in the lungs that may lead to pneumonia. Such bacteria are usually anaerobic (live in environments devoid of oxygen); therefore, patients who keep these areas of the lungs inflated regularly stand a much lower risk of developing pneumonia.

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