How To
Discover Medshop Australia’s comprehensive how to guides and learn more about a broad range of healthcare and medical industry topics. From using a ventilator and defibrillator to finding your nearest AED in an emergency, we have all the information you need. Subscribe to the blog or contact us today for more information.
October 15, 2024
Carolyn Cumper
Gloves and Masks — Who Should Wear Them and Why
Over the past few months, as the coronavirus crisis has unfolded around the globe, one usually uncontentious element of viral protection has become highly controversial. The subject of personal protective equipment (PPE), in particular masks, gloves, gowns, and face shields in healthcare settings, is now hotly debated by health authorities, hospitals, medical professionals, and politicians alike. No one seems able to come to a definitive conclusion on who should wear them and for which reasons. Today, depending on your particular location, you might be mandated by law to wear masks whenever you leave the house. On the other hand, in certain places, you might be advised not to purchase PPE in order to ensure healthcare facilities do not run short of stock. People are confused, and with good reason. So, who should wear PPE? And what is the current guidance for Australia? Here, we take a look at the subject of personal protective equipment in healthcare and why there is so much confusion on when and where it should be used. Who Should Wear Masks? There are a number of issues surrounding the subject of protective masks, and to make matters more complicated, two of the most recognisable global health bodies, the WHO and the CDC, disagree. The WHO currently states that: “If you are healthy, you only need to wear a mask if you are taking care of a person with COVID-19.” and that you should “wear a mask if you are coughing or sneezing.” However, the CDC has recently revised its guidance on mask wearing, now suggesting: “…wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.” Among the reasons for the conflicting advice, from both these two bodies and various other outlets, is the types of mask used and their efficacy. The use of N95 respirators is now widely recommended for healthcare workers in high-risk environments, with proper fit testing and fit checking required to ensure a tight seal, as these masks are proven to protect against airborne particles. Fit tests should be performed yearly or when facial features change. Additionally, when it comes to more advanced masks such as N95 respirators used in healthcare, not only are fit tests required to ensure a proper seal is formed, but supply/demand issues mean that this type of mask should be reserved for healthcare professionals. The use of PPE such as safety face shields may be seen in supermarkets and other customer-facing environments, such as pharmacies, but again, these should be reserved for frontline and healthcare workers. Currently, there is no official guidance from the Australian government on wearing masks in public, however, this doesn’t rule out a u-turn in the coming weeks, with many other countries changing their advice as the crisis grows. If you want to err on the side of caution, then you can make a perfectly serviceable mask at home, or purchase one here. Who Should Wear Gloves? When it comes to protective gloves, the advice is a little clearer. Gloves do not, and never should, replace comprehensive hand hygiene. In fact, in most cases, washing your hands regularly and thoroughly is preferable to wearing any kind of sanitary glove, since wearing them may lead to people becoming less prudent with hand hygiene. In hospitals and healthcare environments, gloves are used for specific purposes and then disposed of immediately. The potential for the misuse of gloves by the general public, is one of the reasons that they are unlikely to be mandatory, and over reliance on this type of PPE can lead to shortages elsewhere. Exceptions include those in food preparation, or for anyone who has any kind of open wound. Again, there is no advice from the Australian government on glove wearing outside of the healthcare sector, and stockpiling gloves could have a knock-on effect on the healthcare sector’s ability to effectively equip those most at risk. The bottom line is, unless you are obligated to wear masks and gloves by law or according to health & safety advice, then its probably better not to. However, for more information on whether this advice changes in Australia, stay tuned to the Medshop blog. Author: Carolyn Cumper's career spans from being a Patrol Officer in Rhodesia to a Paediatric Nurse in the UK, and later a Deputy Hospice Manager in Australia. Her diverse journey includes roles in law enforcement, healthcare, and business, culminating in her significant contributions to Medshop.
August 20, 2024
Steven Cumper
What is Doppler Ultrasonography? A Guide
Doppler ultrasonography is a type of ultrasound imaging that healthcare professionals use to get a closer look at your blood flow. As a businessman with a strong foundation in biomedical science and osteopathic medicine, I've seen first-hand how essential this technology has become across multiple healthcare settings. Non-invasive, painless, and completely safe, Doppler ultrasonography produces results almost instantly, helping healthcare professionals diagnose and monitor a range of conditions related to the direction of blood flow and blood pressure. Ultrasonography has been widely used by doctors since the 1960s to assess a range of conditions and diseases. The technique uses high-frequency sound waves to create a picture of internal body structures like tendons, muscles, and organs. It’s also commonly used in pregnancy to assess the condition of the baby and spot any abnormalities. Doppler technology has continued to evolve, and now there are specialized devices that cater to specific clinical needs. At Medshop, we provide an extensive selection of advanced Dopplers that enhance diagnostic capabilities for practitioners. Normal types of ultrasound imaging, although incredibly useful in the diagnostic process, don’t show blood flow. If doctors want to assess the condition of blood vessels, and the rate of blood flow in the body, they need to use Doppler ultrasonography, especially to assess the direction of blood flow and identify potential blockage in the blood vessels. A Doppler ultrasound test can be used by healthcare professionals to identify a number of conditions and to aid diagnoses. Incredibly useful, this quick, non-invasive technique can save lives and help doctors to provide top-level care. The advancements in handheld Doppler devices have empowered many general practitioners and specialists alike to make on-the-spot assessments that can be critical for patient outcomes. What is the Difference Between a Doppler and an Ultrasound? A Doppler is a type of ultrasound imaging that’s used to measure or assess the flow of blood in the body. Doppler ultrasonography uses high-frequency sound waves to build a picture of how blood cells are moving in a patient’s vessels. The technique can be used to measure the speed and direction of blood flow in the body and is a valuable technique for diagnosing and monitoring a range of diseases and conditions, such as blockage or arterial occlusion. At Medshop, we offer a variety of Doppler devices, such as the Huntleigh FD1+ Fetal Doppler, which provides clear and reliable readings to assist in both prenatal care and general vascular assessments. These devices are designed to be easy to use, portable, and accurate, which makes them a staple in many healthcare professionals' toolkits. Doppler ultrasound tests are carried out using small, handheld devices called transducers. These are simply placed against the patient’s skin and then adjusted until the person carrying out the scan gets a satisfactory reading. The patient shouldn’t experience any pain or discomfort during a Doppler ultrasound test. What is the Doppler in an Ultrasound? The ‘Doppler’ in a Doppler ultrasound test refers to the Doppler Effect, or Doppler shift. This was first identified in the mid-19th century by Austrian physicist Christian Doppler. It describes the increase or decrease in the frequency of sound, light, or other waves as the source of the waves and the observer move towards or away from each other. A Doppler ultrasound test bounces sound waves off of the blood cells circulating in a patient’s body. This allows the doctor or sonographer carrying out the test to build up a detailed and informative picture of the patient’s vessels. This core technology is the basis for many of the Doppler devices available today, including the popular Edan SD3 Vascular Doppler, which provides a cost-effective yet highly reliable solution for clinics. What is Doppler Flow? Doppler flow is a type of Doppler imaging. Like other types of Doppler imaging, it uses high-frequency sound waves to measure the flow of blood through a vessel. Waveforms of the blood flow are shown on the ultrasound imaging screen, allowing the professional carrying out the scan to assess the patient’s circulation. Color Doppler, a more advanced form of Doppler imaging, provides color-coded visuals that show the speed and direction of blood flow in real time. Doppler flow studies are often used to assess the blood flow in a baby’s umbilical vein and arteries. It can also be used to check the foetal brain, foetal heart, and other internal organs. Doppler flow is sometimes called Doppler velocimetry. What is A Doppler Ultrasound Used For? Doppler ultrasound tests are commonly used to assess patients suffering from symptoms that indicate there is an issue with the circulatory system. For example, if a doctor believes a patient is experiencing reduced blood flow, blockage, or heart disease, they may use a Doppler to get more information about the patient’s blood vessels and flow. Doppler imaging allows doctors to make quick and accurate assessments and help them to decide if further treatment is needed. Whether you're dealing with vascular complications or prenatal monitoring, devices like the Edan SD5 and the Summit LifeDop 150 from Medshop are perfect examples of how modern Doppler technology is improving diagnostic capabilities. Symptoms that may result in a Doppler ultrasound test include: Numbness or weakness in the legs Painful cramping in the hips or leg muscles when walking or climbing stairs Cold feeling in the lower leg or foot Change in colour and/or shiny skin on your leg Shortness of breath Swelling in the legs, feet, and/or abdomen Fatigue Patients may also require a Doppler if: They’ve had a stroke - Transcranial Dopplers can be used to check blood flow to the brain They have injured their blood vessels They are being treated for a known blood flow disorder If they are pregnant and their doctor believes there may be a blood flow problem with mother or baby. What Can a Doppler Ultrasound Detect? A Doppler ultrasound can be used to detect and diagnose a range of conditions and diseases related to the circulatory system. These include: A blocked artery (arterial occlusion) Decreased blood circulation into the legs (peripheral artery disease) Bulging arteries (aneurysms) Narrowing of an artery (carotid artery stenosis) Deep vein thrombosis (DVT) Blood clots Poorly functioning valves in leg veins. These can cause blood and other fluids to pool in the legs (venous insufficiency) Heart valve defects and congenital heart disease How to Perform a Doppler Ultrasound Sonographers and most doctors will learn how to do a Doppler ultrasound test as part of their training. Some specialist nurses will also be taught how to use Doppler imaging and read the results. From my experience, having access to quality Doppler devices during training and clinical practice is crucial. This is why Medshop’s extensive range caters to both new learners and experienced professionals. The process is simple and usually involves applying gel to the patient’s skin to ensure the best transmission of sound waves. The handheld transducer is then applied to the affected area, and the sonographer moves it around to capture the correct readings. How to Read a Doppler Ultrasound The way a Doppler is read will depend on the exam being carried out. For example, a lot of foetal Dopplers are mostly used to check the baby’s heartbeat. In this instance, a simple heart rate reading will probably be sufficient to give the doctor or sonographer the information they need. If the doctor or sonographer is checking for an aneurysm, DVT or another circulatory condition, they may use another type of Doppler. Common types of Doppler ultrasonography include: Colour Doppler - This uses a computer to change sound waves into different colours which show the speed and direction of blood flow in real time. Power Doppler – This is a type of colour Doppler that can provide more detail about blood flow than a standard colour Doppler. However, it can’t show the direction of blood flow. Spectral Doppler – This type of Doppler shows blood flow data on a graph, rather than colour images. It’s often used to see how much of a blood vessel is blocked. Continuous wave Doppler – When this type of Doppler is carried out, sound waves are sent and received continuously. This provides a more accurate measurement of blood when it is flowing quickly. How to Interpret a Doppler Ultrasound Again, the way a Doppler is interpreted will depend on what the doctor is looking for and which type of Doppler has been carried out. If your readings fall outside normal parameters, your doctor will talk you through the results and what they mean for your diagnosis. How to do a Doppler Ultrasound in Pregnancy Because they are small, easy to use, and accurate, Dopplers are commonly used to check a baby’s heart rate during pregnancy. In many cases, family doctors will learn how to read a Doppler ultrasound test in pregnancy to allow them to monitor mother and baby without the need for a hospital visit. From my experience, devices like the Huntleigh FD3 provide essential insight for practitioners caring for expecting mothers, and are trusted in both clinical and home settings. When a Doppler ultrasound test is carried out in pregnancy, gel will be placed on the mother’s belly and a specially designed foetal doppler applied to the skin. The doctor or sonographer will then move the transducer around until they get a clear reading of the baby’s heartbeat. This process should be painless and non-invasive. Doppler ultrasonography is an incredible medical tool that provides valuable information on a range of conditions. Learn more about Doppler ultrasonography, and about the Dopplers in our collection of high-quality medical devices by exploring the Medshop store today or contacting one of our advisors. Author: Steven John Cumper, B.App.SC. (Osteo.), M.Ost., is a businessman with a strong foundation in biomedical science and osteopathic medicine, who founded and led Medshop to international success, culminating in its acquisition by the Bunzl Group in September 2021, where he continues to serve as Managing Director (Medshop Group).
August 09, 2024
Steven Cumper
CPR vs. AED — What Sets Them Apart
This information is not intended to be a substitute for professional medical advice.To understand the latest medical guidance on using CPR or an AED please consult Australian Resuscitation Council or the American Heart Association. In a medical emergency, every second counts. Whether it's a sudden cardiac arrest or a critical respiratory event, having the knowledge and skills to respond effectively can meanthe difference between life and death. Two crucial tools in such situations are Cardio-Pulmonary Resuscitation (CPR) and the use of an Automated External Defibrillator (AED). Understanding when to administer CPR versus employing an AED is important knowledge that can save lives—whatever your background. Both techniques are designed to support a failing heart, but they serve distinct roles when caring for a patient. This article explains the critical differences between CPR and AED, delving into when to employ each technique and how they can work together to save lives. Read on to learn more. The Importance of Immediate Response in Cardiac Emergencies Cardiac emergencies, such as heart attacks and sudden cardiac arrest, are critical and time-sensitive situations that require immediate and effective response. The importance of immediate action cannot be overstated, as it can significantly impact the outcome and increase the chances of saving a person's life. When the heart's blood supply is compromised, either due to a blockage in the arteries (heart attack) or a sudden malfunction of the heart's electrical system (cardiac arrest), every passing moment can lead to irreversible damage to the heart muscle and vital organs. Immediate response can help minimise the extent of damage and increase a person's chances of survival. What Is CPR? Cardiopulmonary resuscitation (CPR) is a life-saving technique performed by first responders in emergencies when a person's heartbeat or breathing has stopped. CPR aims to manually circulate blood and oxygen throughout the body to maintain essential organ function until professional medical help arrives. CPR is a critical intervention during cardiac arrests, drowning incidents, suffocation, and other situations where the normal circulation of blood is disrupted. How Does It Work Check Responsiveness: Gently shake the person and shout to check if they are responsive. If there is no response, it indicates an emergency. Call for Help: Dial emergency services or ask someone nearby to do so. Open the Airway: Tilt the person's head back slightly and lift the chin to open the airway. Check for Breathing: Look, listen, and feel for normal breathing. If the person is not breathing or is breathing abnormally, CPR should be initiated. Chest Compressions: Place the heel of one hand on the centre of the person's chest, just below the nipple line. Place the other hand on top and interlock the fingers. Deliver chest compressions by pushing hard and fast at a rate of about 100-120 compressions per minute. Allow the chest to fully recoil between compressions. Rescue Breaths: After 30 compressions, give two rescue breaths. Pinch the person's nose shut, cover their mouth with yours, and give breaths until the chest rises. Continue Compressions and Breaths: Alternate between 30 compressions and 2 rescue breaths until the person starts breathing on their own, emergency personnel arrive, or you are too exhausted to continue. CPR helps maintain blood circulation, delivering oxygen to the brain and other vital organs. It can buy valuable time until more advanced medical interventions, such as defibrillation, can be administered. Automated external defibrillators (AEDs) are often used in conjunction with CPR to restore the heart's normal rhythm. When to Use CPR — Situations and Indications Cardiopulmonary resuscitation (CPR) is a critical technique used to revive a person whose heart has stopped beating or is beating irregularly, and who is not breathing or not breathing normally. Knowing when to use CPR is essential for providing timely and effective assistance in life-threatening situations. Here are some key situations and indications for performing CPR: Cardiac Arrest — CPR is most commonly used during cardiac arrest. Cardiac arrest occurs when the heart suddenly stops pumping blood effectively. This can result from various causes, such as a heart attack, arrhythmias, drowning, electrocution, or severe trauma. If a person is unresponsive, not breathing, and has no pulse, CPR should be initiated immediately. Unresponsiveness — If an individual is unresponsive and not breathing normally, CPR should be started. Gently tap the person and shout loudly to check for responsiveness. If there is no response, begin CPR. No Normal Breathing — If a person is not breathing or is only gasping, CPR should be initiated. Gasping is not considered normal breathing and requires immediate action. Choking — If a person becomes unresponsive due to choking and is not breathing, CPR should be started after attempting to clear the airway with back blows and abdominal thrusts (Heimlich manoeuvre). If the person regains responsiveness, CPR is not needed. Drowning — Individuals who have experienced near-drowning incidents and are unresponsive with no normal breathing require CPR to restore breathing and circulation. Drug Overdose or Poisoning — In cases of severe drug overdose or poisoning leading to unconsciousness and no normal breathing, CPR is necessary to maintain blood flow and oxygen delivery. Sudden Collapse — If a person collapses suddenly and is unresponsive, CPR should be started to provide immediate life support while awaiting medical help. Unknown Cause of Unresponsiveness — If the cause of unresponsiveness is unknown and the person is not breathing or not breathing normally, CPR should be initiated to address potential cardiac arrest. It's important to note that CPR is not typically performed in situations where the person has a pulse and is breathing normally, even if they are unconscious. In such cases, placing the person in the recovery position and monitoring them until medical help arrives may be appropriate. Remember, early initiation of CPR significantly improves survival rates and reduces the risk of brain damage. If you are unsure whether CPR is needed, it's safer to begin chest compressions until professional medical assistance arrives. Proper CPR technique and training are crucial to ensure the best possible outcomes in these critical situations. What is an AED? The acronym AED stands for Automated External Defibrillator, and they are placed in public places, often as part of a broader first aid kit, to provide emergency care in the event of cardiac arrest. Defibrillator AEDs, like the ones produced by Laerdal, Zoll, and HeartSine allow untrained people to administer ventricular fibrillation (VF) to a human body that has suffered a cardiovascular event such as a heart attack. The AED has changed the fate of cardiac arrest victims forever. Before their introduction, without medical attention, standard CPR was the only chance someone had of surviving a cardiac event. Today, in cities where CPR is widely practised and AEDs are readily available, success rates range from 25 to better than 60 percent. The high end of the data comes from cases where the AED came into play. In the absence of CPR training and AEDs, success rates drop closer to 10 percent. It’s the AED units that improve these data the most. Unlike the hospital defibrillation machines, which predated AEDs and required specific training, these new consumer-friendly defibrillators are accessible to even the untrained. As stated by Defib First Australia, “Modern AEDs cannot be used inappropriately and it is not possible to do any further harm to a cardiac arrest victim who is, in effect, dead and will remain so unless defibrillated.” As far as the value of the AED on cardiac patients, the same site said it best: “An AED is the most vital piece of emergency first aid equipment and the only effective first aid treatment for cardiac arrest.” You can learn more about how to use an AED defibrillator here. Check HeartStart AED with FREE carry case* When should an AED be used? In short, whenever someone’s heart has stopped beating, that’s the best time to use the AED pads. When a heart stops beating, time is of the essence, because after six minutes of oxygen depletion, the brain begins to die. Damage can and will likely occur long before that point. That means you have minutes to get the oxygen moving through the body again. In the heat of such a moment, even though time seems to slow down, minutes slip away quickly. The good news about today’s AEDs is that they will not deliver a shock to a body with a beating heart. As such, there is no bad time to grab the AED if someone has fallen down. For this reason, most response training advises you to delegate retrieval of the nearest AED in the first moments of the incident. Key Differences Between CPR And AED Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) are both crucial components of cardiac arrest response, but they serve different roles in the effort to save a person's life. Here are the key differences between CPR and AED: CPR (Cardiopulmonary Resuscitation) Manual chest compressions and rescue breaths. Maintains minimal blood flow until normal heart activity is restored. Trained individuals perform CPR. Requires training for proper technique. No specialised equipment needed. AED (Automated External Defibrillator) Delivers electric shock to restore normal heart rhythm. Resets the heart's electrical activity during specific arrhythmias. Designed for use by laypeople. Minimal to no AED training required due to voice prompts. Specialised device that analyses and corrects heart rhythm. Combined Use CPR and AED are used together to maximise survival chances. CPR starts blood circulation, AED assesses and corrects heart rhythm. The Role of CPR and AED In Cardiac Arrest Response In a cardiac arrest emergency, CPR and AED work together to improve the chances of survival: CPR (First Step) Provides manual chest compressions and rescue breaths. Circulates oxygenated blood to vital organs. Buys time until professional medical help arrives. AED (Second Step) Analyzes the heart's rhythm. Delivers an electric shock if needed. Aims to restore a normal heart rhythm. The combination of immediate CPR followed by AED use is crucial for an effective cardiac arrest response, with each step enhancing the patient's chances of recovery. Common Misconceptions and Myths About CPR And AED There are several misconceptions and myths surrounding CPR and AED: Myth — Only medical professionals can perform CPR. Fact — Bystanders and laypeople can effectively perform CPR and should do so in emergencies. Myth — AEDs can cause harm. Fact — AEDs are designed to be safe and will only deliver a shock if a shockable rhythm is detected. Myth — AEDs can restart a stopped heart. Fact — AEDs aim to restore a normal rhythm in a heart that is still beating abnormally; they don't "restart" a stopped heart. Myth — CPR can restart the heart. Fact — CPR can help maintain blood flow and oxygenation but may not restart the heart. AED use is often necessary for rhythm correction. Myth — Only older adults need CPR and AED. Fact — Cardiac arrest can happen to people of all ages, including children and young adults. Myth — You need to be certified to use an AED. Fact — While training is helpful, AEDs are designed for use by anyone, even without formal certification. Myth — You should stop CPR when using an AED. Fact — Continue CPR until the AED is ready to analyse or deliver a shock. The AED will prompt you when to pause. FAQs — Clearing Doubts About CPR And AED Do you use an AED on someone with a pacemaker? The simple answer is yes, but there are a few caveats to AEDs used with pacemakers. Know that pacemakers of any sort should withstand external defibrillation without a problem. The problem with the pacemaker placement is that it usually coincides with the placement of one defibrillator pad. As such, you’ll have to get as close as possible to the correct location. Some AED units may assist with placement. Others may reject the placement. You may need to place the pad directly on the pacemaker, but try to avoid this. In any case, remember that any effort you make is better than none. This person only stands to improve their situation as they are essentially terminal without a heartbeat. Once the pads are in place, run the AED as normal and keep your hands off. After a successful resuscitation, their pacemaker may require attention from a professional, but that’s not a reason to avoid AED administration. Can you use an AED on an infant? If you find yourself in this spot, know that there are special pads and accompanying instructions with most AED units for delivering a shock to a child. The cutoff age is eight. Any human under eight years old will need specially sized defibrillation pads. You should NEVER use the adult pads on a child under the age of eight, even if you have no other options. The risk is not only to the child but to those in the near vicinity. Again, check with your accredited CPR/AED organisation for more details on that. When not to use an AED? Automated External Defibrillators (AEDs) are life-saving devices, but there are specific situations when their use should be avoided. Firstly, AEDs should not be used when the victim is breathing normally or has a detectable pulse. These devices are designed for cases of sudden cardiac arrest where the victim is unresponsive, not breathing, and lacks a pulse. Additionally, AEDs should not be used in environments with moisture or water present, as this can compromise their effectiveness. Moving the victim to a dry area or ensuring their chest is dry before attaching the AED pads is crucial. If the victim's chest is obstructed by medicinal patches or excessive hair, it's essential to clear the area quickly by wiping or shaving before applying the AED pads. Using an AED in areas with explosive or flammable materials is highly dangerous, as the electrical shock delivered by the device could potentially ignite a fire or cause an explosion. In cases of severe hypothermia where the victim's body temperature is extremely low, it's important to prioritize warming the victim before attempting defibrillation, as their heart's response to the shock can be significantly affected. Lastly, if there is a valid, visible Do Not Resuscitate (DNR) order for the victim, it indicates their explicit wish not to be resuscitated. In such cases, using an AED would be inappropriate. In summary, while AEDs are valuable tools for cardiac arrest situations, careful assessment of the circumstances and the victim's condition is essential to their appropriate use. Why is defibrillation important in CPR? Defibrillation is crucial in emergencies involving cardiac arrest for several reasons. Firstly, it delivers an electrical shock to the heart, momentarily stopping all electrical activity. This pause allows the heart's natural pacemaker to reset, potentially restoring a normal rhythm In addition, defibrillation complements CPR efforts. While CPR maintains minimal blood flow to vital organs, it cannot correct an irregular heart rhythm. Defibrillation steps in to potentially restore a normal rhythm, maximally boosting the odds of successful resuscitation. Certain abnormal heart rhythms, specifically ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT), respond well to defibrillation. These are categorised as "shockable" rhythms, and without swift intervention, they often lead to fatal outcomes. Finally, Automated External Defibrillators (AEDs) are designed to be portable and user-friendly. They offer clear voice and visual prompts, making them accessible in various settings, from homes to public spaces. They can be operated by individuals with minimal training, extending their potential life-saving reach. Can You Perform CPR While Using an AED? Yes, you can and should perform CPR while preparing to use an AED. When responding to a cardiac arrest, it's essential to start CPR immediately to maintain blood circulation to the vital organs. Once the AED arrives, continue CPR while the AED is being set up and the pads are being applied. However, when the AED is ready to analyze the heart's rhythm or deliver a shock, you must briefly stop CPR and ensure no one is touching the patient. After the shock is delivered (if needed), immediately resume CPR until the AED instructs you otherwise or professional medical help arrives. This combination of CPR and AED use is critical for increasing the chances of survival. How does CPR compare to Basic Life Support (BLS)? In short, CPR and BLS are similar as they share the same goal—to keep the airway open, the heart beating, and the circulation of oxygen to the body going without the use of advanced life support. However, understanding the difference between the two will allow you to know when to use CPR and when to use BLS. A BLS certification is a little more advanced, not so much as an Advanced Life Support (ALS) certification, but more than a standard CPR certification. That said, in practice, there is little daylight between these two. Some BLS certifications teach advanced methods like the administration of oxygen, team approaches, and in-hospital procedures, but the two certifications are close neighbours. In the case of someone seeking a certification for employment, it’s best to check with the employer if they consider the certifications as equivalent qualifiers. To someone suffering a catastrophic cardiovascular event, it will make little difference whether their attendant is CPR or BLS certified. Both are better than doing nothing when an AED is not available. Author: Steven John Cumper, B.App.SC. (Osteo.), M.Ost., is a businessman with a strong foundation in biomedical science and osteopathic medicine, who founded and led Medshop to international success, culminating in its acquisition by the Bunzl Group in September 2021, where he continues to serve as Managing Director (Medshop Group).
August 09, 2024
Steven Cumper
What is a Defibrillator? How AEDs Work and How to Use Them
Everyone knows what a defibrillator is. They’re a mainstay of Hollywood drama and a paramedic’s most recognisable tool. Here we look at how they work and when to use one.
July 22, 2024
Steven Cumper
Choosing the Best Sphygmomanometer for Everyday Use
Monitoring blood pressure is crucial for maintaining overall health and preventing serious conditions such as heart disease, stroke, and kidney failure. Regular monitoring allows individuals to detect hypertension early, manage existing conditions more effectively, and make informed decisions about their health. By keeping track of blood pressure readings, one can identify patterns and triggers, and work with healthcare providers to tailor treatment plans accordingly. The purpose of this guide is to help readers choose the best sphygmomanometer for everyday use. With so many options available on the market, it can be challenging to determine which device meets your specific needs in terms of accuracy, ease of use, and reliability. This guide will provide detailed information on various options of sphygmomanometers, key features to look for, and top recommendations based on personal experience and expert reviews. What is a Sphygmomanometer? A sphygmomanometer is a medical device used to measure blood pressure. It consists of an inflatable cuff, a measuring unit (either a mercury column, aneroid gauge, or digital display), and sometimes a stethoscope for manual types. There are several types of sphygmomanometers: Manual Sphygmomanometers: These include mercury and aneroid sphygmomanometers. They require the user to inflate the cuff manually and listen to blood flow sounds using a stethoscope. They are known for their accuracy but require training to use correctly. Digital Sphygmomanometers: These devices automatically inflate the cuff and display readings on a digital screen. They are user-friendly and ideal for home use, though their accuracy can vary based on the model. Wrist Sphygmomanometers: These are compact and convenient, wrapping around the wrist instead of the upper arm. They are easy to use but can be less accurate due to the sensitivity of wrist arteries to position and movement. The Best Sphygmomanometer for Nurses When it comes to choosing the best sphygmomanometer for nurses, there’s a few avenues you can take, and your choice will very much depend on the most common applications. There’s the traditional route or the more innovative route. Additionally, there’s your patients to consider, and there’s rarely a one sphygmomanometer fit all approach. Here then, we look at three types of sphygmomanometer that can be useful to you. Standard Aneroid Sphygmomanometer Standard aneroid sphygmomanometers, such as this one, are instantly recognizable and somewhat iconic. They offer great value for money and include everything you need in a handy carry case. This includes gauge, cuff, and the classic bulb pump. They are easy to use and maintain thanks to their simple design, and they can be quickly recalibrated after extended use. Standard aneroid sphygmomanometers are a great choice for student nurses, since they offer reliability and accuracy without breaking the bank. They also offer intuitive operation and, when referring to your study materials, it is likely that this type of sphygmomanometer will be referenced. Palm Style Aneroid Sphygmomanometer Palm style sphygmomanometers, like this, are a relatively new design that improves on the traditional bulb pump mechanism. These sphygmomanometers offer tactile pumping for both left and right handers using soft touch casing and a low-profile pump. They also include features such as improved air release valves and no pins stop. This type of sphygmomanometer is great for nurses who must take the blood pressure of lots of patients in a short space of time, reducing hand fatigue and improving comfort. Infant and Paediatric Sphygmomanometer For nurses who regularly work with children, a specialist infant and paediatric sphygmomanometer is the best choice. This type of equipment offers the same kind of functionality as other sphygmomanometers; however, they are presented in a range of colourful and playful finishes that can help to distract anxious children. For nurses studying or entering paediatric wards, this type of sphygmomanometer is a vital addition to your existing tools and equipment, allowing you to easily take the blood pressure of infants and children. Best Sphygmomanometer Brands When it comes to finding the best sphygmomanometer brands, there are two names that stand out. Here, we take a look at Welch Allyn and Prestige to see what they have to offer when it comes to high-quality sphygmomanometers Welch Allyn Welch Allyn is a highly respected name in the world of medical equipment, and it is no surprise that their sphygmomanometers are among the best around. The Welch Allyn DS66, for example, maintains highly accurate readings while improving durability through its DuraShock technology. This major innovation removes the need for gears within the equipment, ensuring that regular calibration is a thing of the past. They are lightweight, include comfort grips, and offer other practical features such as latex free materials and one-finger deflation triggers. They are also certified to an accuracy of +/- 3mmHg, ensuring the DS66 is the best sphygmomanometer for nurses who require the highest quality professional tools. Additionally, a broad range of accessories and spares, such as these reusable blood pressure cuffs, ensure your Welch Allyn sphygmomanometer is always up to the task—however often it is used and in whatever conditions. Prestige Prestige aneroid sphygmomanometers, while sitting at the budget end of the market, still offer superb functionality and usability. Ideal for student nurses looking for the best entry level sphygmomanometer to use during their studies, they provide great value for money without compromising on accuracy or reliability. Spare cuffs suitable for children, adults, and large adults are included within the specially designed carry case, while latex-free design improves comfort and safety. Available in a range of colours, Prestige also offer sphygmomanometers designed with eye-catching patterns made specifically for children. Finally, with a lifetime calibration warranty on Prestige products, you can rest assured that your sphygmomanometer will outlast your studies and serve you for many years to come. Author: Steven John Cumper, B.App.SC. (Osteo.), M.Ost., is a businessman with a strong foundation in biomedical science and osteopathic medicine, who founded and led Medshop to international success, culminating in its acquisition by the Bunzl Group in September 2021, where he continues to serve as Managing Director (Medshop Group).
July 22, 2024
Steven Cumper
What to Do if You Break a Mercury Thermometer
The evolution of the thermometer begins with the Greeks, with Hero of Alexandria recognising that certain substances expand and contract dependant on temperature. At that time, it was simply a water/air interface that was more of a scientific curiosity than a piece of practical equipment. It took another 1600 years for the first device that we might recognise to be invented, however this type of thermometer designed by Giuseppe Biancani in 1617, was actually called a thermoscope. Fast-forward another century and Dutch inventor and scientist Daniel Gabriel Fahrenheit introduces the world to the first reliable thermometer. This was the first type of thermometer to use mercury instead of water/alcohol mixtures, and it was this design that would remain in use until after the Second World War. Today, that iconic mercury-based design has all but been replaced by other types of thermometer, however, while digital now rules, in Australia, they are more prevalent than in most other western countries. Australia does not allow the sale and use of mercury thermometers for medical purposes. The Australian Therapeutic Goods Administration (TGA) has issued guidance aligned with the Minamata Convention on Mercury, which aims to phase out mercury-containing medical devices, including thermometers, due to their potential health risks and environmental impact. This initiative, supported by WHO and other global health organizations, seeks to eliminate the use of mercury in medical devices by promoting safer and more environmentally friendly alternatives, such as digital thermometers. Today, in many cases, alternative types of thermometer are used either alongside mercury-based devices or as replacements. Here, we take a look at the different types of thermometer used today and what to do if your toxic mercury thermometer breaks. Types of Thermometer Available Today Digital Thermometers – Digital thermometers are among the fastest and most accurate. Readings can be taken from under the tongue, the rectum, or the armpit in the same way as a traditional thermometer. Ear Thermometers – Otherwise known as tympanic thermometers, this type of thermometer uses infrared light to make temperature reading. Non-contact Thermometers – Non-contact thermometers also work with infrared to provide readings without contacting the body. They are probably the least accurate but can be useful for children. Glass Thermometers – Traditional glass thermometers using mercury or alcohol for readings are still used by individuals who already possess these thermometers. Mercury thermometers are heavily regulated and generally phased out for medical use due to their significant health and environmental risks. Alcohol thermometers, on the other hand, are considered safer and are still permitted. They are widely used as alternatives to mercury thermometers in various settings, including homes, schools, and laboratories, because they pose less risk and are environmentally friendly. Alcohol thermometers are mostly used for non-medical purposes. Using a Mercury Thermometer? Here’s What to do if it Breaks The first thing to remember if you break a mercury thermometer is that the silvery substance contained within those glass tubes has the potential to be highly toxic. Of course, identifying whether it is really mercury in your thermometer is an important step, however, it is always better to be safe than sorry. To help you identify whether the type of thermometer you are using is, in fact, mercury-based, ask yourself: Is the liquid silver? If it is not, then it is most likely to be an alcohol-based thermometer. If it is, then it may be either a mercury or a non-mercury thermometer. Does the thermometer contain any warnings? Sometimes, the paper calibration strip inside the thermometer will tell you which substance has been used. If there is no writing or warning, assume that it is mercury. Cleaning up Mercury Spills If your mercury thermometer breaks, then you can also identify whether the substance contained is mercury by observing its behaviour. Mercury is a liquid metal that has properties quite unique from other substances. Smaller droplets will pool together into a large sphere shape, which will break again into smaller droplets when pressure is applied. However, never touch mercury and take care not to scatter smaller droplets into hard-to-reach areas. When cleaning up after a mercury spill, you should be careful to NEVER do the following: • NEVER use a vacuum cleaner. This will disperse the mercury into the air • NEVER use a broom. This will break the mercury into smaller droplets and disperse them. • NEVER pour mercury down the drain. This can either damage plumbing, septic tanks, or sewage treatment plants while polluting at the same time. • NEVER walk around with mercury on your shoes of clothing. Additionally, you should prep the area where the mercury has been spilled by doing the following: • Ask people to leave the area ensuring no one walks through the mercury as they do so. Remove any pets from the area. Open all windows and doors to the outside and close doors to other parts of the building. • For absorbent surfaces, the contaminated items must be disposed of according to the guidelines below • For non-absorbent surfaces, clean-up is easier • Do not allow children or elderly people to help you clean up Instructions on How to Clean up Mercury Spills Put on rubber or nitrile gloves. Cover the affected areas with powdered sulphur, this will make the mercury easier to see and suppress any vapours. Pick up any broken glass or other debris, fold within a paper towel and place in a labelled, Ziplock bag. Use a piece of cardboard or plastic to gather mercury beads. Use slow sweeping motions. Darken the room and hold a torch at the low angle to check for any other mercury. Inspect the entire room. Use an eyedropper to draw up the mercury. Dispense onto a damp paper towel. Place the paper towel in a labelled, Ziplock bag. Place all items, including gloves, into a trash bag. Label the bag as hazardous and containing mercury. Author: Steven John Cumper, B.App.SC. (Osteo.), M.Ost., is a businessman with a strong foundation in biomedical science and osteopathic medicine, who founded and led Medshop to international success, culminating in its acquisition by the Bunzl Group in September 2021, where he continues to serve as Managing Director (Medshop Group).
June 21, 2024
Carolyn Cumper
Cleaning and Maintaining Your Scrubs
Easily the most recognisable item of clothing in the industry, the humble medical scrub is exposed to all sorts of fluids and discharges on a nurse’s routine shift—which as everyone knows could see them end up getting rather dirty. Your scrubs may well be the first thing a patient sees, and it’s always great to make a good first impression. However, not only is it essential to keep your scrubs clean for a professional appearance, it is also vitally important that they are safe to use on your next shift. As many experienced nurses know, this means you will probably find yourself standing over the washing machine on a regular basis—and in case you were wondering how best to clean your scrubs, we’re here to help! As the healthcare industry has moved beyond standard green scrubs, nurses can now choose from a wide variety of colours when it comes to their most essential piece of workwear from black scrubs to blue or pink. Despite this leap forward in style, no one has yet created a set of scrubs that are totally safe from the traditional stains you will likely pick up on the job. That is why we wanted to share with you a few tips to keep your scrubs clean and safe. Before Washing Your Scrubs Scrubs are quite different to the rest of your laundry, so you’ll need to take special care in how you prepare them for cleaning. The most important information you need for scrub care is printed on the care label. Following the care instructions on this label is critical to maintaining your scrubs as well as possible for both functionality and longevity. When you wash medical uniforms, you have to sanitize them as well as clean them, so it’s not as simple as tossing everything into the wash and forgetting about it. Don’t forget to separate your colors before washing to avoid any dye bleeding. Wash like colors together, and always separate white scrubs from all others. It’s also highly recommended to launder your scrubs separately from your regular clothes. This helps prevent pathogens (and bodily fluids) from spreading to other garments. It also keeps them separate from materials like denim or other rough fabric types that can cause damage to your scrubs. Scrubs Wash Procedure Now that you’re ready to wash your scrubs, there are a few steps to keep in mind. As always, refer to the directions on the care tag if you have questions about your specific pair of scrubs. 1. The Pre-Treatment Soak The first step in the washing process is to pre-treat your scrubs by soaking them in a cold water solution containing half a cup of white vinegar. The scrubs should be turned inside out to protect the fabric, especially if they are cotton scrubs, as this will reduce the fading of their colour and increase the lifespan of your garments. Vinegar is a more eco-friendly way of treating the fabric compared to using traditional conditioners, and it also acts as a mild disinfectant at this stage that will help sanitize your scrubs. 2. The Washing Process Once your scrubs have been soaked, they are ready for the first washing machine cycle. Depending on how soiled the items are, or if there are particularly stubborn stains on the scrubs, you can use a colour safe stain remover before washing your scrubs for the first time. This first cycle should be done with cold water and regular laundry detergent. You can use a regular wash setting on your washer. Before the second washing cycle, check the scrubs for stains before adding a colour-safe bleach for a more thorough disinfecting action. Always add bleach separately to your washing machine’s dispenser, and never pour directly onto clothing. An alternative to regular bleach is pine oil disinfectant. Although these are not as strong as normal bleach, pine oil is an effective natural product for those who are more environmentally conscious. At this stage, the washing cycle should be done with warm water and include regular detergent again in addition to the bleach products and stain removers mentioned previously. Fabric softeners are not recommended, as these liquids can coat the fibers in your scrubs and affect the integrity of the material. 3. Drying After this final wash, your scrubs should now be ready for drying. In most cases, you can put them in a tumble dryer on the lowest heat setting for at least 30 minutes. High heat can cause shrinkage in some fabrics, so it’s important to use low heat to protect your items. Generally, the lowest setting on your dryer is safe. You can also air dry your scrubs on a line or flat on a drying rack. After drying, you may wish to take out your scrubs and iron them. This is purely cosmetic and will ensure you keep up that all-important professional appearance on the job. Note that all scrubs do not require ironing — many modern options are made from high-quality wrinkle-resistant materials that can save you this tedious step. Treating Stains on Medical Scrubs Due to the nature of your job, you’re likely to run into stains on your scrubs from various contaminants. These tips can help you remove stubborn stains from your dirty scrubs so that you don’t have to replace them as often. Blood Always soak blood stains in cold water. The water temperature is very important, as hot water can cause the proteins in the blood to set deeper into the fabric. Depending on the colour of your scrubs, you can dab hydrogen peroxide on the stain to break it up. This is only recommended on white or very light colors since peroxide can have a bleaching effect. Vomit, Urine or Faeces Unfortunately, vomit, urine, and faeces stains on your nursing scrubs are a regular hazard of the profession. Much like blood stains, these bodily fluids are protein-based, and should be soaked in cold water before washing. You can then use a heavy-duty detergent on a normal wash cycle while adding in half a cup of baking soda to take care of any odors. Ointments These oil-based stains require hot water to remove. Never rub the stain directly as this will only make it worse. Apply a bit of strong detergent, leave for 10 minutes, and then wash as normal. Iodine Medical professionals know that iodine creates some of the toughest stains in the business. Start by soaking the affected area in warm water with an enzyme-based pre-soak product or heavy-duty detergent. After 20 minutes, you can wash in the machine with an oxygen-based bleach to remove the last decolourisation. But please take care with the colour of your garment—get it wrong and you’ll be buying new scrubs! Why Scrub Care Is Important Your medical uniforms are critical to your job, so taking care of them properly isn’t optional. While there are excellent affordable options on the market, no one wants to have to unnecessarily replace scrubs as a result of poor care and maintenance. Healthcare workers have enough on their plates without worrying about constantly purchasing new workwear. How to Wash Scrubs: FAQ Let’s take a look at a few common questions we see from professionals who want to make sure they’re giving their scrubs the best possible care. How Often Should You Wash Your Scrubs? You may have some clothing items that you can rewear a few times between washes, but scrubs are not in that category. In fact, you should wash your scrubs after every single wear to remove contaminants, reduce the risk of spreading pathogens, and keep your scrubs in tip-top shape. Do Scrubs Shrink After Wash? Shrinkage is certainly possible any time you do laundry, especially when you wash scrubs made from cotton. But you can prevent this issue by using the lowest possible heat setting for your washer and dryer. Air drying scrubs is also a great way to avoid shrinkage. Why Do My Scrubs Smell After Washing? Sometimes, you may notice a sour or mildew-like smell from your scrubs even after they’ve been properly washed. When that happens, it’s usually an easy fix. First, make sure you’ve followed all the washing directions correctly. Second, never leave your scrubs in the washing machine for long periods after they’re done washing. You should always transfer them to the dryer or a drying rack or line right away to prevent mildew. Lastly, double check that you’re using the right amount of detergent for the size of the load you are washing. White vinegar can be used to neutralize odors, so if you run into this problem, you may need to wash your scrubs again, starting with the pre-soak step. Author: Carolyn Cumper's career spans from being a Patrol Officer in Rhodesia to a Paediatric Nurse in the UK, and later a Deputy Hospice Manager in Australia. Her diverse journey includes roles in law enforcement, healthcare, and business, culminating in her significant contributions to Medshop.
May 08, 2024
Steven Cumper
What is a Welch Allyn Ophthalmoscope and How to Use One
In order to carry out accurate and useful physical examinations, doctors need access to high quality tools and diagnostic equipment. Welch Allyn has been producing precise, reliable medical products for over 100 years. Founded in 1915, the manufacturer has grown to be one of the most trusted in the ophthalmology industry. Today, it supplies its high-quality tools, parts, and accessories to healthcare professionals and research centres around the world. Covering everything from traditional stethoscopes to iPhone-enabled ophthalmoscopes like this PanOptic+ enabled direct ophthalmoscope, Welch Allyn has a plethora of excellent options. Welch Allyn was founded when Dr. Francis Welch and William Noah Allyn developed the world's first handheld, direct illuminating ophthalmoscope. The tool has been a big part of the company’s identity since the beginning and continues to be one of its most recognisable products. It's also among its biggest sellers, with hospitals and healthcare facilities around the world placing their trust in the Welch Allyn name. To help you choose the correct ophthalmoscope for your needs, we take a closer look at the Welch Allyn ophthalmoscope range, how you use it, and what value it can add to your medical practice. What is a Welch Allyn Ophthalmoscope? A Welch Allyn ophthalmoscope is an ophthalmoscope produced by specialist medical manufacturer Welch Allyn. It’s one of the brand’s signature products and is sold in countries around the world—either as a standalone tool or part of a complete diagnostic set that may also include an otoscope and aneroid sphygmomanometer. An ophthalmoscope is an instrument used to examine the retina. If you’ve ever been for an eye test or visited an ophthalmologist, there’s a good chance they would have taken a look at your retina with an ophthalmoscope. There are two main types of ophthalmoscope: direct and indirect. Direct ophthalmoscopes are used to examine the centre of the retina whereas indirect ophthalmoscopes check the entire retina. Welch Allyn ophthalmoscopes use either halogen illuminators or SureColor LED technology. This ensures excellent illumination and allows medical professionals to see all elements of the retina. Welch Allyn ophthalmoscopes come in a range of different sizes and designs. The Welch Allyn pocketscope LED ophthalmoscope is light, compact and easy to transport. The Welch Allyn 3.5 V ophthalmoscope is an advanced instrument with a range of specialist features, while the Welch Allyn Pocket Junior ophthalmoscope is the brand’s most basic model. Other features include: Rechargeable lithium-ion power handles for increased running time when compared to standard devices A range of diopter configurations Digital connectivity through the Welch Allyn iExaminer platform Advanced coaxial ophthalmoscopes designed to enable easy entry to the eye for increased field of view, true tissue colour, and reduced glare. How Do Ophthalmoscopes Work? Ophthalmoscopes work by illuminating either a dilated or undilated eye with an LED or halogen light. This allows the medical professional to see the various elements that make up the back of the eye and check for a number of injuries and conditions. The part of the eye that ophthalmoscopes focus on is called the fundus. It’s made up of the retina, the optic disc and a collection of blood vessels. Ophthalmologists will check the fundus when screening for diseases and conditions that affect the eye. It’s also often included in standard eye examinations. An ophthalmoscope can be used to check for: Damage to the optic nerve Retinal detachment or tear Glaucoma Macular degenerations Melanoma Diabetic retinopathy Hypertension Infection Cataracts More advanced ophthalmoscopes offer doctors the ability to alter the aperture, lens and aperture/filter combinations to gain a larger view of the fundus. This can help specialists to make a more accurate diagnosis. Instrument Parts Ophthalmoscopes may look straightforward, but these instruments are very complex, with several important parts that make them work. Brow Rest: The brow rest is at the top of the instrument. It assists with proper placement by sitting against the brow of the user, reducing movement and making it easier to see through the ophthalmoscope. Lens Wheel: This adjustment tool allows the instrument to be focused. The number of lenses varies based on the type of ophthalmoscope you’re using, but the more lenses there are, the more focus options you’ll have. Viewing Port: This is the most important part of an ophthalmoscope – it’s the part you look through. Lens Viewing Window: The viewing window shows the user which lens is currently in use. Diopter Adjustment: This wheel helps with focus and helps adjust the strength of the lens. Head: The head of the ophthalmoscope is the name for the entire top portion, which is usually interchangeable. On/Off Switch: This button turns the device on or off and, in some models, controls the light. Batter Handle: The handle of the ophthalmoscope is used to hold the instrument, but it also contains the battery. Aperture Selection Wheel: This is an additional wheel on the device that controls aperture settings. Aperture Settings Aperture refers to a small opening that can control how much light is able to move through a lens. The aperture settings on an ophthalmoscope change the size of that opening, allowing more or less light through. Each aperture setting allows a different view: Small aperture is used to see the fundus while the pupil is undilated. This setting is used in a room with dim lighting. When the small aperture is used, the user has better visibility and depth perception. Issues like subtle microaneurysms, intraretinal microvascular abnormalities (IRMA), or areas of capillary nonperfusion are easier to see using a small aperture. Large aperture is used for dilated pupils, typically after mydriatic eyedrops have been given. The large aperture is more likely to be used during standard eye examinations. With this setting, the user gets plenty of light with which to look at the eyeball and its structures, providing a broad view. It is generally used when the room is dimly lit. Micro spot aperture is used when the pupil is undilated and constricted and when the room is well-lit. Micro spot aperture is perfect for when the light from the small aperture isn’t quite narrow and focused enough. This setting is used specifically for procedures and imaging procedures where there is a need for extreme precision. It offers a high resolution that is beneficial for retinal microsurgery, laser photocoagulation, and advanced imaging modalities like optical coherence tomography (OCT). Other aperture settings may be included with your ophthalmoscope depending on the model, including slit aperture, cobalt blue filters, and red-free filters. Dioptre Settings The dioptre settings on an ophthalmoscope are the device’s way of adjusting which lens is being used. The higher the number, the more convex the lens is. The lower the number, the more concave the lens. This is controlled with a focusing wheel. The patient’s focal point will determine the dioptre setting you should choose. Different conditions of the eyeball cause variations in the focal point, so your examination will be customized for each patient. For example, if your patient has hypermetropia, you will need to use a more convex lens for the examination. On the other hand, patients with myopia should be checked using a concave lens. Red Reflex The red reflex refers to the reddish-orange reflection of light from the back of the eye that can be seen during an ophthalmoscopy. Checking the red reflex is important as abnormalities in the reflex can point to a more serious issue. When using an ophthalmoscope for red reflex, it’s important the lights in the room are turned down low. Doctors should use a direct ophthalmoscope, and the lens power should be set to ‘0’. The doctor should sit around 50cm from the patient and place the ophthalmoscope close to the eye. The patient should then be asked to look straight into the ophthalmoscope. When the doctor looks through the ophthalmoscope into the eye, they should see the bright red reflex. The colour and brightness of the red reflex should be identical in both eyes. If it isn’t, this may indicate a problem, and further tests should be carried out. How to Use a Standard Ophthalmoscope from Welch Allyn Ophthalmoscopes should always be used by trained professionals. While the instruments are non-invasive, incorrect use can still potentially cause damage to the eye. When using an ophthalmoscope, it’s essential the patient is seated and still and the correct working distance maintained. Exam lights in the room need to be turned down low, or switched off completely, to optimise the view of the fundus. Welch Allyn ophthalmoscopes are very intuitive to use. Adjustments can be made to the lens, lighting and filter simply by moving switches and dials on the ophthalmoscope head. Most of these adjustments can be made without removing the ophthalmoscope from the eye, allowing doctors to fine tune their examination quickly and easily. Filters can be applied to the ophthalmoscope to check different parts of the eye. Red filters are used to look closely at the blood vessels and a red-free filter or cobalt blue filter can be used to check for corneal abrasions or ulcers with fluorescein dye. Slit apertures allow doctors to look at contour abnormalities of the cornea, lens or retina and grids can be used to approximate the relative distance between any retinal lesions found during the examination. Let’s look at a step-by-step guide for using the direct ophthalmoscope during an eye exam. We recommend this for medical students to supplement your favorite OSCE guide like Geeky Medics! First, make sure the patient is seated, and the ophthalmoscope can be comfortably held at eye level. Adjust the aperture settings on the instrument. Inform the patient that you will be using a bright light to look at their eye. Ask the patient to look straight ahead at the wall and focus their vision. When you’re examining the patient’s right eye, you should use your right hand to hold the ophthalmoscope and look through it with your right eye. To view their left eye, use your left hand to hold the instrument and look with your left eye. Use the hand that is not holding the device to hold the patient’s head still. It’s easiest to put your thumb on their eyebrow to help reduce movement. For placement, make sure to keep the ophthalmoscope approximately 15 centimetres from the patient’s eyeball. You’ll also want to hold it slightly to the right of their head. Now, look for the red reflex. Gradually get closer to the patient until the optic nerve comes into view. Take the necessary measurements, such as the cup-to-disc ratio. Slowly, move in every direction to examine the vasculature. Back up again so that you can locate the macula and fovea. Understanding the difference between direct ophthalmoscopy and indirect ophthalmoscopy is important during your exam. Direct ophthalmoscopy is used for stereoscopic vision. You’ll get an upright image with roughly 15 times magnification. Indirect ophthalmoscopy will give a wider view, and it’s done by mounting the ophthalmoscope to the examiner’s head, who will then put about an arm’s length distance between themselves and the patient. What is the Difference Between Retinoscope and Ophthalmoscope? A retinoscope is an instrument used to carry out retinoscopies. A retinoscopy is an exam that’s used to determine the refractive error of the eye. This allows medical professionals to diagnose patients that are farsighted, nearsighted or have astigmatism by examining the field of view. During the retinoscopy, light needs to be moved quickly from side to side. From the speed and direction that light moves across the eye, opticians and ophthalmologists can estimate the level of refractive error. Ophthalmoscopes are unable to provide this type of fast moving illumination. The existing Welch Allyn catalogue also includes a range of retinoscopes. These are often sold in conjunction with ophthalmoscopes. What is The Meaning of Fundoscopy? A fundoscopy is an exam that looks in detail at the fundus of the eye. It’s also known as a fundoscopic exam. An ophthalmoscope is generally used to carry out fundoscopies as they provide doctors with excellent visuals and a choice of useful tools and filters. Investing in a high quality Welch Allyn ophthalmoscope is an excellent way for ophthalmologists and other medical professionals to provide their patients with high quality care. Find out more, and learn about the Welch Allyn ophthalmoscopes we offer, by exploring the Medshop store today. Additionally, stay tuned to the Medshop blog for more information on healthcare equipment and supplies. Author: Steven John Cumper, B.App.SC. (Osteo.), M.Ost., is a businessman with a strong foundation in biomedical science and osteopathic medicine, who founded and led Medshop to international success, culminating in its acquisition by the Bunzl Group in September 2021, where he continues to serve as Managing Director (Medshop Group).
April 02, 2024
Steven Cumper
What is a Ventilator? How Does it Work and How to Use It
A ventilator is one of the most important pieces of equipment doctors have at their disposal. You've probably heard a lot about ventilators recently, as they have been used extensively during the coronavirus pandemic to treat patients with severe cases of COVID-19. In essence, they are used as life support to help patients in ICU who are struggling to breathe and those who have lost the ability to breathe, ventilators have saved hundreds of thousands of lives over the years. Understanding the basic principles of artificial ventilation, and learning what happens when someone is on a ventilator, will help to prepare you for going on a ventilator yourself. If you’re supporting a loved one who’s on ventilation or about to go on ventilation, getting an idea of what a ventilator is used for can be even more important. What is a Ventilator? A ventilator is a medical device designed to support or replace the breathing process when a patient is unable to breathe adequately on their own. Modern ventilators are precisely engineered pieces of medical equipment. Used in virtually every major hospital in the world, they can help patients through severe illness, surgery and paralysis. The primary function of a ventilator is to breathe - or support breathing – for patients who have lost the ability to respirate themselves. Ventilator support helps patients to breathe by gently forcing air into their lungs using a breathing tube inserted into the windpipe. The patient’s body then expels the air naturally. Some ventilators help patients to exhale as well as inhale like the Neopuff T-Piece Resuscitator RD900. Patients going into surgery under general anesthesia are often put on mechanical ventilators because surgical drugs and procedures can interfere with the breathing process. Being on a ventilator will ensure that the patient is able to get enough oxygen into their system throughout the operation. In intensive care units, ventilators are used to help patients who are struggling to breathe because of an illness or accident that causes acute respiratory distress syndrome (ARDS) or pneumothorax (collapsed lung). Taking over the breathing function for a patient can give their body time to rest and help them along the road to recovery. It can also give doctors time to try new medications, assess the condition of the patient and create effective treatment plans. How Does a Ventilator Work? A ventilator works by mechanically assisting or taking over the breathing process for a patient who is unable to breathe adequately on their own. For many years, ventilators and breathing machines used negative pressure to help a patient breathe. When the body is exposed to negative pressure, it causes the thorax to expand and air to be drawn into the lungs. The most famous example of negative pressure ventilation is probably the Iron Lung, a groundbreaking machine that saved the lives of thousands of children affected by polio. Today, most ventilators use positive pressure to help patients breathe. These ventilators push oxygen into a patient’s airway via a mask or endotracheal or tracheostomy tube. The positive pressure causes air to flow into the lungs until the ventilator breath ends. Often, oxygen is added to the air supply to ensure the patient’s levels of oxygen in the blood reach the correct level. With a Face Mask Using a face mask to aid oxygen intake is called non-invasive ventilation. In this approach, a well-fitted plastic face mask covers both the nose and mouth. A tube links the mask to the ventilator, delivering air into the lungs. This method is usually preferred for less severe respiratory issues. With a Breathing Tube For more severe cases, endotracheal and tracheostomy tubes are inserted while the patient is under general anaesthetic. Endotracheal tubes enter the patient’s airway via the mouth while tracheostomy tubes are inserted into the throat or trachea. Tracheostomy tubes are generally used when a patient requires long periods of ventilation. Both endotracheal and tracheostomy tubes are a type of invasive ventilation. In some cases, a non-invasive method of ventilation will be more appropriate. This delivers positive pressure to the airway via a mask. This type of ventilation increases gas exchange and reduces the amount of effort it takes for a patient to breathe. How is Ventilation Measured? In a clinical setting, minute ventilation (MV) is measured by multiplying the respiratory rate (RR) - the number of breaths delivered by the ventilator per minute - by the tidal volume (Vt) which refers to the amount of air delivered to the lungs with each breath. This calculation shows how regularly a patient is breathing and how much air they are able to inhale with each breath. Doctors will monitor both the respiratory rate and tidal volume of a patient's lungs while they are on a ventilator. They will also monitor the oxygen levels and carbon dioxide saturation of the patient’s blood in order to ensure they are breathing as they should. Types of Ventilators There are various types of ventilators available to treat patients with different needs. Medical professionals will assess a patient, their condition, prognosis and treatment plan before deciding which type of ventilation is most suitable. · Invasive Ventilation Invasive ventilation is when a tube is inserted into a patient’s mouth (endotracheal) or throat (tracheostomy) to help them breathe. This tube is attached to the ventilator which uses intermittent positive pressure to gently force air into the patient's lungs. · Non-invasive Ventilation - CPAP and BiPAP CPAP and BiPAP are both forms of non-invasive ventilation commonly used to treat sleep apnea and other respiratory conditions. CPAP ventilators use continuous positive pressure to help patients maintain their breathing. CPAP machines administer pressure via a mask rather than an endotracheal or tracheostomy tube. This makes them a non-invasive ventilation option. BiPAP machines offer patients pressure relief between breaths to help them exhale. · Nasal Ventilation Nasal ventilation is a type of non-invasive ventilation. It is often used to provide domiciliary nocturnal ventilatory support in patients with chest wall disorders, neuromuscular disease and chronic obstructive lung disease (COPD). Like a CPAP machine, nasal ventilation works by the delivery of positive pressure to the airway. Nasal ventilation generally uses intermittent pressure to allow the patient to exhale naturally. Ventilator FAQs What is the Difference Between a Medical Respirator and a Ventilator? A respirator is a masklike device, usually made of gauze, worn over the nose and mouth to prevent the inhalation of noxious substances. Health professionals wear respirator face masks to filter out virus particles so they aren’t exposed to infection when treating patients. Respirators also help to prevent the wearer from passing on any infections they may have to their patients. Unlike ventilators, respirations don’t push air into the lungs or aid breathing. They are purely used as personal protective equipment to prevent infection and injury. What is the Difference Between a Medical Ventilator and a CPAP Machine? Medical ventilators work via a tube inserted into the neck or mouth of the patient, usually for critical care in ICU settings. They use short ‘breaths’ of positive pressure to gently force air into the lungs and effectively breathe for the patient. CPAP machines, while a type of ventilator, work very differently. CPAP stands for Continuous Positive Airway Pressure. When a patient is using a CPAP machine, they will have a face mask like the Philips Pico Nasal over their nose and mouth. The machine then applies continuous pressure to their airway via the mask in order to help them breathe. CPAP machines are used by individuals to treat conditions such as obstructive sleep apnea as prescribed by a respiratory therapist. Using a CPAP machine at night prevents patients with obstructive sleep apnea from experiencing breathing difficulties as they sleep. How Long Can You Be on a Ventilator? Mechanical ventilation is used as a last resort, and medical professionals will try to discontinue ventilation as soon as is safely possible. This is because there are a number of health risks associated with long term ventilation. These include: Ventilator-associated pneumonia Sinus infection Blood clots Lung injury Damage to vocal cords The process of taking a patient off of ventilation is called weaning. With expertise developed over years in the field, our products have been enabled to offer invaluable support and resources to medical teams. When a patient is being weaned, doctors will carry out spontaneous breathing trials. During these trials, the patient will attempt to breathe with reduced or no ventilator support. Patients undergoing breathing trials are closely monitored by a team of medical professionals. For patients who have been on a ventilator for an extended period, successful weaning may require multiple attempts. Can a Person Recover From a Ventilator? As an expert in the field, it's crucial to understand that while many individuals placed on a ventilator will indeed recover from their underlying illness, injury, or surgical procedure, it's important to recognize that the process of recovery can vary significantly from person to person. Ventilators provide essential breathing support, allowing the body time to rest and heal. However, it's essential to approach each case with a realistic understanding that not all patients will recover following ventilation. Some individuals may have pre-existing conditions or severe underlying illnesses that make recovery more challenging. It's important for healthcare providers to closely monitor patients on ventilators, adjusting treatment plans as needed and providing comprehensive care to support the healing process. This may include physical therapy, nutritional support, and ongoing medical management. Furthermore, for patients and their families, it's essential to maintain open communication with healthcare professionals, ask questions, and participate actively in decision-making processes regarding care and treatment options. Is it Painful Being on a Ventilator? In most cases, the endotracheal or tracheostomy tubes used for ventilation are inserted when a patient is under general anaesthetic. This means the patient won’t experience any pain during the procedure. Once the tube is in place, it may cause a little discomfort. Patients will often be prescribed sedative and analgesic medications in order to make them more comfortable. Patients who are on invasive ventilation can’t talk and their movement is very restricted. They also can’t eat and so receive nutrients via an IV or through nasogastric feeding. Some patients who require long term ventilation may be able to use a portable machine. This will give them more freedom of movement and greater independence. What is the Price of a Medical Ventilator? The cost of a medical ventilator will vary depending on its make, model and capabilities. Good quality ventilators are available for around $8,500. A range of accessories and replacement parts are available for most ventilators to help equipment last longer and work efficiently. Where to Buy a Ventilator Ventilators are available to purchase from recognised medical equipment supply stores. As ventilators are essential pieces of life-saving equipment, they should only ever be sourced from trusted retailers. Explore our range of ventilators or get in touch to find out more about the products we offer. You’ll find more information on other health topics and equipment in the Medshop blog. Author: Steven John Cumper, B.App.SC. (Osteo.), M.Ost., is a businessman with a strong foundation in biomedical science and osteopathic medicine, who founded and led Medshop to international success, culminating in its acquisition by the Bunzl Group in September 2021, where he continues to serve as Managing Director (Medshop Group).
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