Best Practices in Lung Management Experiences using Meta

Best Practices in Lung Management Experiences using Meta. Neb Paula Abbas, BSN, RN, CPTC Life. Source Donation Coordinator Region 7 Meeting February 13, 2015

Current options for CPT Vest therapy CPT Metaneb 4. 0 Manual CPT

Downfalls of manual and vest CPT • Time consuming (manual) • Often not performed correctly or frequently enough • Vest stays on patient, potentially interfering with other treatments • Disturbing to families/seen as violent (vest) • Limited to loosening secretions

The Meta. Neb® System Description The Meta. Neb® System is a therapeutic device that uses a systematic approach to enhance mucus clearance and resolve or prevent atelectasis. The Meta. Neb® System offers 3 therapies: 1. Continuous Positive Expiratory Pressure (CPEP) – Lung expansion therapy for the treatment and prevention of pulmonary atelectasis 2. Continuous High Frequency Oscillation (CHFO) – Secretions mobilization therapy 3. Aerosol Mode – Aerosol Therapy • Provides supplemental oxygen when used with compressed oxygen

The Meta. Neb® System Absolute Contraindications ‒ Untreated tension pneumothorax ‒ Untrained or unskilled operator

Life. Source’s Experience Device became available through Hill Rom in 2012/2013 and several hospitals in our region began using the device in 2013 Lifesource worked with Hill Rom rep and hospital RTTs to begin using the device on organ donors Noted decreased atelectasis and better secretion removal with use

Life. Source Experience cont. Hill Rom rep came to Life. Source skills day to demonstrate set up and use of Metaneb to clinical staff in 2014. Life. Soure worked with Hill-Rom legal rep to set up an exclusive rental program for use at 2 of our donor hospitals. (for use exclusively for organ donors) Unusual rental circumstances for organ donors requiring daily rental rate.

Life. Source Experiences cont. The 2 hospitals with the rental agreements LOVE the metaneb and are considering purchasing the equipment RTTs verbalize use of this device has prevented escalation of care to oscillators or other High frequency ventilator modes. Significant reduction of atelectasis and increase in secretion removal noted by staff, demonstrated by CXR improvement, better oxygenation, and decreased secretions.

Life. Source Experiences cont. Treatment not as violent as the vest. Families not bothered by treatment Easy to use RTTs with overwhelming positive feedback regarding device Research data available on Hill-Rom website

Life. Source Meta. Neb Protocol 10 minute treatment q 2 hrs Used with neb q 4 hrs, and q 2 hrs prn HOB up 30 degrees during treatment Used in conjunction with q 4 hr recruitment maneuvers and O 2 challenges Used also in non-lung donors to improve oxygenation and secretion clearance

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