smoke analyzermagbanua & mathews

8/8/2019 Smoke Analyzermagbanua & Mathews

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By Arianne Pearl

Magbanua


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A sequential 20-port automatic smokingmachine performing calibrated volume smoking

of cigarettes is disclosed. The machinesequentially smokes 20 cigarettes for thecollection and laboratory analysis of particulatematter and gas content of the cigarette smoke.Sequential smoking is accomplished by havingeach station take a 2-second puff every 3seconds, yielding a 60-second cycle of time

between puffs at each station. Control iselectronic, utilizing solid-stage counters.Smoking syringes are individually operated byhydraulic cylinders in an even/odd arrangementof master drive


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cylinders both served by a common fluidreservoir. The master cylinders are disposed

on opposite sides of the single crank systemsuch that two halves are driven 180 out of phase. Gas lines connecting individual

cigarette ports to the analyzers are purgedwith room air between each puff delivered tothe respective analyzers. By use of sequential techniques, real time carbonmonoxide (CO) measurements may bedetermined in addition to total particulatematter (TPM) collection.


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Fagerstrom Test for NicotineDependenceIndications: Assessment of Tobacco addictiony Tobacco Cessation counseling in Tobacco abusey Nicotine Replacement dosingH istory: Questions (abbreviated version)y H ow soon after waking do you smoke first Cigarette ?

Time less than 5 minutes: 3 points

Time 5 to 30 minutes: 2 pointsTime 31 to 60 minutes: 1 point

y H ow many Cigarette s do you smoke per day?Cigarette s more than 30 per day: 3 pointsCigarette s 21 to 30 per day: 2 pointsCigarette s 11 to 20 per day: 1 point

Interpretationy H eavy nicotine dependence: 5-6 points

Consider 21 mg Nicotine Patchy Moderate nicotine dependence: 3-4 points

Consider 14 mg Nicotine Patchy Light nicotine dependence: 0-2 points

Consider 7 mg Nicotine Patch or no patch


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B ronchoscopy

a procedure that allows your doctor to lookat your airway through a thin viewinginstrument called a bronchoscope. During a

bronchoscopy, your doctor will examine your throat, larynx , trachea , and lower airways.Bronchoscopy may be done to diagnose

problems with the airway, the lungs , or withthe lymph nodes in the chest, or to treatproblems such as an object or growth in the

airway.


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WHA T HAPPE NS DURING T HE P ROCE DURE?The bronchoscopy room has an x-ray machine, a hear monitor, an oxygen monitor and a blood pressuremonitor. There, a specialist called respiratory therapistwill explain the procedure and will assist the doctor

with the bronchoscopy. You are encouraged to ask anyquestions that will help you understand what is aboutto happen. You will be asked to remove glasses, all

jewelry, dentures or other dental appliances. Next, youwill be given a breathing treatment that contains a localanesthetic called Xylocaine to numb the airways andmake you more comfortable. When the doctor arrives,you will be given Versed in your I.V. to help you relaxand sleep. The bronchoscope is guided through your

nose and into your lungs by your doctor.


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Thoracoscopy is the insertion of anendoscope, a narrowdiameter tubewith a viewing mirror or camera

attachment, through a very smallincision (cut) in the chest wall.


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Pu rposeThoracoscopy makes it possible for a physician to examine thelungs or other structures in the chest cavity, without making alarge incision. It is an alternative to thoracotomy (opening thechest cavity with a large incision). Many surgical procedures,especially taking tissue samples (biopsies), can also be

accomplished with thoracoscopy. The procedure is done to:assess lung cancer take a biopsy for studydetermine the cause of fluid in the chest cavity

introduce medications or other treatments directly into the lungstreat accumulated fluid, pus ( empyema ), or blood in the spacearound the lungsFor many patients, thoracoscopy replaces thoracotomy. It avoidsmany of the complications of open chest surgery andreduces pain , hospital stay, and recovery time.


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Technique After adequate sedation is achieved, the patient ispositioned in the full lateral decubitus with thehemithorax up, padded comfortably, and secured to thetable. The site for pleuroscope entry into the pleuralspace is determined by surface anatomy landmarks,preoperative imaging studies, and physical examinationto maximize visualization of the expected pathology.Standard sterile skin preparation and draping to createan adequate field are performed while the skin isanesthetized with local infiltration anesthesia. After ensuring adequate sedation, the hemithorax is enteredbluntly with a clamp passed over the rib and through thepleura (see chest tube insertion technique). With anadequate access space created, the pleural spaceimmediately subjacent to the entry site is digitally.


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inspected to ensure an adequate pleural space(freedom from pleural adhesions) to safely insertthe pleuroscope. The pleuroscope is insertedunder direct vision into the pleural space. Oncethe surveillance panoramic examination iscompleted, the specific purpose of the procedure(eg, evacuation of pleural fluid, pleural biopsy, or pleurodesis) is addressed. Fluid is evacuatedusing suction catheters passed through theworking channel under direct vision. Parietalpleural biopsy is performed with biopsy forceps

passed through the working channel under directvision. Once the examination and procedure arecompleted, the pleuroscope is withdrawn, a chestdrain is placed, and the pneumothorax is

evacuated


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By Mathews, Sherylane Rose


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also known as thoracocentesis or pleuraltap . The procedure was first described in1852.It is an invasive procedure to removefluid or air from the pleural space for diagnostic or therapeutic purposes. Acannula , or hollow needle, is carefullyintroduced into the thorax, generally after administration of local anesthesia .


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The recommended location variesdepending upon the source. It iscritical that the patient holds their breath, do not cough, or moveduring the test to avoid injury or

piercing the lung. Some sourcesrecommend the midaxillary line , inthe ninth intercostal space .


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Indications:This procedure is indicated when unexplained fluidaccumulates in the chest cavity outside the lung.In more than 90% of cases analysis of pleural fluidyields clinically useful information. If a large

amount of fluid is present, then this procedure canalso be used therapeutically to remove that fluidand improve patient comfort and lung function.The most common causes of pleural effusions arecancer , congestive heart failure , pneumonia , andrecent surgery . In countries where tuberculosis iscommon, this is also a common cause of pleural

effusions.


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P roced u re:The patient will sit on a bed or on the edge of a chair or bed while

the head and arms will rest on a table.The skin around the procedure site is cleaned and the area isdraped. A local numbing medicine (anesthetic) is injected into theskin. The thoracentesis needle is inserted above the rib into thepleural space.The patient will feel a stinging sensation when the local anestheticis injected and may feel pressure when the needle is inserted intothe pleural space.

Advise patient to inform health care provider if theres a feeling of

shortness of breath or chest pain.When cardiopulmonary status is compromised (i.e. when the fluidor air has its repercussions on the function of heart and lungs),due to air (significant pneumothorax ), fluid ( pleural fluid ) or blood(hemothorax ) outside the lung, then this procedure is usuallyreplaced with tube thoracostomy , the placement of a large tube in


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A biopsy is a medical test involving

the removal of cells or tissues for examination. It is the medical removalof tissue or cells from the pharynx,

larynx, and nasal passages from aliving subject to determine thepresence or extent of a disease.


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PLE URAL NEE DLE B IOP SY A pleural biopsy is a procedure toremove a sample of the tissue liningthe lungs and the inside of the chestwall to check for disease or infection


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P roced u re:

The patient will be sitting up for thebiopsy. The health care provider willcleanse the skin at the biopsy site, and

inject a local numbing drug (anesthetic)through the skin and into the lining of thelungs and chest wall (pleural membrane).The patient may feel a brief prick and aburning sensation.

A larger, hollow needle is then placed


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through the skin and into the chest cavity. Thedoctor rotates the needle. At various times duringthe procedure, the patient will be asked to sing,hum, or say "eee." This helps prevent air fromgetting into the chest cavity, which can cause alung collapse pneumothorax.The doctor removes the needle to collect tissuesamples. Usually, 3 biopsy samples are taken.When the test is completed, a bandage is placedover the biopsy site.Pleural biopsy is usually done to determine thecause of a collection of fluid around the lung(persistent pleural effusion) or other abnormality of the pleural membrane. Pleural biopsy candiagnose tuberculosis


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Indications: A lung biopsy is usually performed to determine thecause of abnormalities, such as nodules that appear on chest x rays. It can confirm a diagnosis of cancer,

especially if malignant cells are detected in thepatient's sputum or bronchial washing. In addition toevaluating lung tumors and their associatedsymptoms, lung biopsies may be used to diagnose

lung infections, especially tuberculosis andPneumocystis pneumonia, drug reactions, andchronic diseases of the lungs such as sarcoidosis andpulmonary fibrosis. A lung biopsy can be used for

treatment as well as diagnosis.


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Lymph node biopsy is a test in which a lymphnode or a piece of a lymph node is removed for examination under a microscope.The lymphatic system is made up of lymph nodesconnected by lymph vessels. The nodes producewhite blood cells (lymphocytes) that fightinfections. When an infection is present, the lymph

nodes swell, produce more white blood cells, andattempt to trap the organisms that are causing theinfection. The lymph nodes also try to trap cancer cells.


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Indications:The test is used to help determine the cause of swollen

glands. It may be done to find out if a lymph node tumor is cancerous (malignant) or non-cancerous (benign).


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P roced u re:The test is done in an operating room in a hospital,or at an outpatient surgical facility. There are twoways the sample may be obtained:Needle biopsy

Open biopsy A needle biopsy involves inserting a needle into alymph node. The patient will lie on the examinationtable. The biopsy site will be cleansed, and thehealth care provider will inject a local anesthetic(numbing medication) into the area. The biopsyneedle is then inserted into the node, and asample is removed. Pressure is applied to the siteto stop the bleeding, and a bandage is applied.


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An open biopsy is surgery to remove all or part of thelymph node. The patient will lie on the examinationtable. The biopsy site will be cleansed, and the health

care provider will inject a local anesthetic (numbingmedication) into the area. (Occasionally, generalanesthesia is used, which means the patient is asleepand pain-free.) A small surgical cut is made, and thelymph node or part of the node is removed. The area isclosed with stitches and a bandage is applied.Mediastinoscopy . This procedure is performed under general anesthesia. A 23 in (58 cm) incision is madeat the base of the neck. A thin, hollow, lighted tube,

called a mediastinoscope, is inserted through theincision into the space between the right and the leftlungs. The surgeon removes any lymph nodes or tissues that look abnormal. The mediastinoscope is thenremoved, and the incision is sutured and bandaged. Amediastinoscopy takes about an hour.


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P ULM ONARY FUNCTION TE STS

Pulmonary function tests are agroup of tests that measure how

well the lungs take in and releaseair and how well they move gasessuch as oxygen from the

atmosphere into the body'scirculation.


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P roced u re:Do not eat a heavy meal before the test. Do notsmoke for 4 - 6 hours before the test. You'll getspecific instructions if you need to stop usingbronchodilators or inhaler medications. You mayhave to breathe in medication before the test.In a spirometry test, you breathe into a mouthpiecethat is connected to an instrument called aspirometer. The spirometer records the amount

and the rate of air that you breathe in and out over a period of time.For some of the test measurements, you canbreathe normally and quietly. Other tests require

forced inhalation or exhalation after a deep breath.


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Indications:Pulmonary function tests are done to:Diagnose certain types of lung disease(especially asthma asthma,bronchitis bronchitis, and emphysema)Find the cause of shortness of breath shortness of breathMeasure whether exposure to contaminants atwork affects lung functionIt also can be done to:

Assess the effect of medicationMeasure progress in disease treatment


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P URIFIE D P ROTE IN DE RIVATIVEThe PPD skin test is a method used to diagnosetuberculosis tuberculosis (TB). PPD stands for purifiedprotein derivative.P rocedure:The test site (usually the forearm) is cleansed withrubbing alcohol. The PPD extract is then injected under the top layer of skin, causing a welt to form on the skin.This welt usually goes away in a few hours.The reaction will take 48 - 72 hours to develop. You mustreturn to your health care provider within that time to havethe area checked. This test will determine whether youhave had a significant reaction to the PPD test. Thereaction is measured in millimeters of firm swelling(induration), not redness, at the site


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Indications:

The PPD test is done to find out if youhave been infected with Mycobact eriumt uber c ul os i s , the bacteria that causesTB.

smoke analyzermagbanua & mathews

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