View source for ResQGuard Impedance Threshold Device

==Procedure Guidelines==
===9.31 ResQGUARD Impedance Threshold Device===

====DEFINITION:====
* The ResQGARD is an impedance threshold device (ITD) that provides therapeutic resistance to inspiration in spontaneously breathing patients. During inspiration, a negative pressure (created from expansion of the thorax) draws air into the lungs.
* When inspiratory impedance is added to the ventilation circuit, it enhances the negative pressure (vacuum) in the chest, which pulls more blood back to the heart, resulting in increased preload and thus, enhanced cardiac output on the subsequent cardiac contraction.

====INDICATIONS:====
* Patients over 12 years old or over 50 Kg.
* Patients experiencing symptoms of low blood circulation or hypotension (Systolic Blood pressure of less than 100 mmHg), which can be secondary to a variety of causes such as dialysis, hypovolemia, dehydration, sepsis and orthostatic intolerance.

====CONTRAINDICATIONS:====
* Known dilated cardiomyopathy
* Left-sided congestive heart failure
* Pulmonary hypertension and/or aortic stenosis
* Flail chest
* Chest pain and/or shortness of breath
* On-going, uncontrolled blood loss with penetrating thoracic (chest) injury

====PRECAUTIONS:====
* The ResQGARD may benefit patients who suffer from non-thoracic penetrating injury and ongoing blood loss once a clinical decision has been made to treat the patient with fluid resuscitation, but the safety and effectiveness of the ResQGARD in this clinical setting has not been established.
* The safety and effectiveness in persons suffering from arterial stenosis or asthma has not been established.
* Prolonged use for more than 30 minutes has not been clinically evaluated.
* If respiratory distress develops during use of the ResQGARD, immediately discontinue use.

====PROCEDURE:====
* Using the ResQGARD on a facemask:
** Connect the ResQGARD to the vented facemask provided; be sure pieces fit together snugly.
** Explain to the patient that the device will make it slightly more difficult to take a breath but that the resistance is what may make them feel better.
** Gently (but firmly) hold the ResQGARD over the nose and mouth (or have the patient hold), establishing and maintaining a tight face seal with facemask. A head strap (e.g. ResQStrap) may be used if the patient does not want to hold the ResQGARD in place.
** Breathe in slowly (over 2 – 3 secs) and deeply; exhale normally. Breathe at a rate of 10 – 16/minute.
** If supplemental oxygen is used, attach the tubing to the oxygen port on the ResQGARD and deliver up to fifteen (15) lpm but do not exceed 15 lpm.
* Using the ResQGARD with a mouthpiece:
** Connect the ResQGARD to the mouthpiece provided; be sure pieces fit together snugly.
** Explain to the patient that the device will make it slightly more difficult to take a breath but that the resistance is what may make them feel better.
** Place the mouthpiece into the patient’s mouth and establish and maintain a tight seal with the lips.
** Breathe in slowly (over 2 – 3 secs) and deeply through the mouth only; exhale normally. Breathe at a rate of 10 – 16/minute.
** A nose clip may be helpful if the patient has trouble inspiring only through their mouth.
** If supplemental oxygen is used, attach the tubing to the oxygen port on the ResQGARD and deliver up to fifteen (15) lpm but do not exceed 15 lpm.
* Use the application device (mask or mouthpiece) that is best suited for the patient’s condition, compliance tolerance.

[[Category:Procedure Guidelines|0931]]