Nebulizer

Using the Nebulizer:

• Place aerosol into grounded outlet. Make sure power on compressor is in the “OFF” position.
• Add medication to nebulizer and connect tubing to the compressor air outlet.
• Switch the compressor “ON”, the medication will begin to mist.
• Breath slowly and deeply, holding the mist in your lungs every few minutes. Continue until medication is gone.
• Once completed, switch “OFF” the compressor and disassemble nebulizer.

Cleaning the Nebulizer Kit:

• Disassemble nebulizer kit. DO NOT CLEAN THE TUBING
• Wash pieces with warm water and detergent or soak in three part water one part vinegar solution for 30 minutes.
• Rinse with warm water and let pieces air dry on absorbant piece of paper. Do not use any volatile fluids like alcohol or benzene

50 PSI Compressor

Warning: Explosion hazard. Do not operate in the presence of flammable anesthetics.

• The aerosol delivered by the 50 psi compressor travels through the large bore tubing to an aerosol mask, tracheotomy collar, or similar device.
• There is an adjustable ring on the top of 50 psi compressors marked in percentages.
• Only use sterile distilled water when filling the humidifier bottle. Never use tap water to fill the humidifier bottle.
• The flow rate used to power the 50 psi compressor is adjusted to provide a constant flow of mist.
• The aerosol mist must be constant during inhaling and exhaling.
• If the aerosol mist disappears when the patient is taking a breath, contact your nurse.
• A good habit is to check the mist after adding sterile water to the humidifier bottle.
• Make sure the power cord is unplugged from wall-outlet power source.
• Place the compressor on a flat surface and positioned six to twelve inches away from a wall.
• Before plugging in the power cord, make sure the power switch is in the “Off” position by pressing on the bottom half of the switch.
• Plug the power cord into a properly grounded wall-outlet power source.

Trapeze Bars

There are many different brands of trapezes, but generally only two basic types. There are the freestanding types that are mounted on a base and are not secured to any objects. This model has increased flexibility in that it can be transferred to different parts of the house where it is needed. It also has less security in that it is not mounted to any fixture and can move or shift if not used correctly. The other type is the clamp-on trapeze. The clamp-on trapeze is the most durable and is clamped onto an adjustable hospital bed. These models have the added security of better attachment, but lack the flexibility of moving around.

Safety:

• The grab bar and chain should be adjusted so the user can effectively transfer or change positions.
• The elbow is usually bent at a 20-30 degree angle when extended.
• For freestanding models, make sure the trapeze and base are securely fastened to each other daily.
• Always have the center of weight directly under the grab bar. This will help stabilize the base and aid in the prevention of shifting of the base.
• Always check connections and attachments daily. Do not over tighten
• Do not attach a clamp-on trapeze to any other bed except the hospital bed that was provided by your medical equipment provider.

• Check mattress for tears and pitting of mattress.
• Check hand control and motor cords for signs of wear and tear and proper function.
• Check for general wear and tear of bed and head and foot boards.
• Check that side rails are secured to bed properly.
• General cleaning and dusting of equipment, use of normal household cleaner is acceptable.
• Call your hospice nurse if bed needs servicing.

Hospital Bed

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​Maintenance and inspection checklist:

• Check mattress for tears and pitting of mattress.
• Check hand control and motor cords for signs of wear and tear and proper function.
• Check for general wear and tear of bed and head and foot boards.
• Check that side rails are secured to bed properly.
• General cleaning and dusting of equipment, use of normal household cleaner is acceptable.
• Call your hospice nurse if bed needs servicing.

Safety Issues:

• ​Keep all moving parts, including the bed frame, and drive shafts free of obstruction i.e. blankets, sheets tubing and other types of products that may get tangled around the bed.
• When getting in/out of bed always make sure the wheel locks are engaged.
• Always test the side rails to ensure that they are securely in place before using the bed.
• If a trapeze is being used, never use the trapeze as a total individual weight support.
• Never operate bed if cord or plug should get pinched or damaged.
• If using bedside rails, be cautious of gaps between mattress and rails where bodily harm may occur.

Over Bed Table

​​Maintenance:​​

• Periodically clean the table with warm water and a soft cloth.
• Dishwashing detergent (rinsing required) or a mild disinfectant 1-part bleach or 10 parts water may be used.
• If casters begin to squeak check to ensure there isn’t hair, string, or other objects twisted in caster. Remove items and spray with WD-40.

​​​​​​Safety Issues:​

• Be sure adjustable parts are locked and secured before use.
• Keep hand and feet (or any body parts) away from moving parts.
• Weight limit- Place no more than 20 lbs. on over bed table.
• Do not sit or lean on the table.
• Do not use to transport patient weight or to assist in patient transport.

Maintenence​​​:

• Warning: Disconnect the power cord from the outlet before attempting to clean the blower unit.
• The mattress itself may be wiped down with a disinfectant solution or mild detergent and damp cloth. Wipe dry before placing patient back on mattress.
• Mattress cover can be generally laundered on the “gentle cycle” and dried on the “fluff cycle”.

Using your low air loss/alternating pressure mattress​:

• Inspect mattress and make sure that the mattress is fully inflated to maximum if the patient is to be transferred after inflation.
• Adjust firmness for patient comfort. Check to be sure the patient isn’t bottoming out on the mattress; there should be a minimu of “1” clearance below the patient’s pelvic region.
• Place patient on top cover of low air loss/alternating pressure mattress. There is not a need for a sheet or padding as this may reduce the effectiveness of the mattress.
• Check all tubing connections and CPR plug periodically to ensure they are securely in place.
• If CPR needs to be administered, pull the CPR plug so that mattress will debate.

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​​Safety Issues​:

• Do not spill food or liquids on the blower unit. If a spillage does occur, please contact hospice nurse to request service.
• Do not insert any items into the blower unit.
• Do not block airflow on blower unit.
• Do not puncture mattress with sharp object.
• Do not leave the patient unsupervised with the bedrails in the down position.
• Make sure the bed rail gaps and potential entrapment hazards of the patients head or body are adequately reduced.
• Keep away from smoking materials or open flame.
• If linens are used, do not pull linens too tight over mattress. This can cause “hammocking” and reduce the effectiveness of the mattress.

• Remember: Oxygen doesn’t burn: it supports combustion. This means that oxygen causes things to catch on fire easier, and to burn faster and hotter.
• Make sure you have a functioning smoke detector.
• No smoking or flames (including cigarettes or cigars) are allowed within 5-8 feet of any oxygen delivery device.
• Keep all flammable materials away from an oxygen source, especially oil, grease, solvents, creams, lotions, petroleum products, paper, clothes, aerosol containers, and alcohol of any kind. (This includes on your hands or clothes also).
• No smoking or flames (including cigarettes or cigars) are allowed within 5-8 feet of any oxygen delivery device.
• ​Keep all flammable materials away from an oxygen source, especially oil, grease, solvents, creams, lotions, petroleum products, paper, clothes, aerosol containers, and alcohol of any kind. (This includes on your hands or clothes also).
• Keep all devices that are powered by electricity or that can produce sparkes, at least 5-8 feet away from any oxygen delivery device.
• Do not try to fix, repair or lubricate any oxygen device or delivery equipment.
• Keep all tubing and equipment uncovered and tangle-free and stored in an uncluttered and unconfined space.
• Never allow any untrained person or child to touch or manipulate oxygen equipment.

Always plug a concentrator directly into a grounded outlet or approved extension cord.

• DO NOT oil or lubricate the regulator or the post valve on cylinder.
• Always secure oxygen cylinder while traveling.
• Bleed pressure from tank when not in use by turning tank off and leaving regulator flow on until the needle is on.
• Lay cylinders down in an area where the post valve will not create a hazard to feet and ankles.
• DO NOT use an oxygen mask with a humidifier on the oxygen cylinder. This may cause severe back pressure.
• DO NOT use an oxygen mask with flow rates that are under 4 LPM as this may cause CO2 retention.

The following is an estimate of how long these two tanks will last on different flow rates while on the continuous flow setting.

E Tank

23hrs

11hrs 30min

5hrs 45min

3hrs 50min

2hrs 52min

2hrs 18min

1hr 55min

1hr 39min

1hr 26min

1hr 16min

1hr 9min

M6 Tank

5hrs 36min

2hrs 50min

1hr 5min

57min

43min

34min

28min

24min

21min

19min

17min

There are two basic types of liquid systems: stationary and portable. Stationary units can deliver your home oxygen and fill your portable unit. Portable units are lightweight units with carrying straps or carts that allow the user to travel within the limits of the oxygen supply. Each portable unit has a maximum time limit it will provide oxygen and this is dependent upon the flow rate and breathing rate. Contact your medical equipment supplier if you have any questions about your unit’s time limits. The user can fill the portable unit, but your medical equipment provider’s personnel fill the stationary unit.

• When reading yor flowmeter, you must read the middle of the float not the top.
• If using a mask, a good seal on the face is needed to deliver accurate oxygen amounts.
• The holes on the side of the mask should never be obstructed.
• The minimum flowrate on an oxygen mask is 5 LPM.

Using the patient lift:

• Before lifting patient, spread base legs fully outward with lever next to mast.
• Adjust sling straps or chains to proper height.
• Slide into position near patient being careful of swing hanger.
• Once patient is in sling, lift just enough to clear surface & allow swivel.
• Engage wheel locks prior to transferring patient.

​To accommodate sling to patient: (patient lying down)​​​​​​​​​​​​​

• Roll patient away from you.
• Lay sling (patient side up) on surface where patient is lying.
• Adjust position of sling to line up with patient’s buttocks and torso.
• Roll patient back to lying position over sling.
• Roll lift into place, and then lower boom to attach straps or chain to sling.

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​​Special Procedures: Lifting from a seated position​

• Stand in front of a chair-facing patient
• Lean patient forward so your body supports their weight
• Hold sling by top. Allow remainder of sling material to drop behind patient to the top of the chair.

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To position the sling under the patient’s buttocks:

• Lean patient to one side.
• Reach underneath the patient’s raised buttocks.
• Firmly grasp sling material and pull toward patient’s leg.
• Repeat for other leg by switching the patient to lean in the opposite direction.
• Once sling is properly positioned, roll into position and attach chains or straps.

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Safety Issues
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Before use:

• Make sure patient’s head is clear of hanger at all times.
• Once raise boom high enough for patient in sling to clear the “transfer from” surface.
• Make sure all parts of lift are properly secured.
• Adjust chains or straps and sling prior to allowing patient to be lifted.
• Spread legs of lift base to ensure maximum stability.
• Engage or disengage wheel locks.

When raising patient weight:

• Ensure that release is locked into “lift” position.
• Check for pinch points on patient where the sling makes weight-bearing contact. Do this before rolling the lift away from the “transfer from” surface.
• When moving lift (occupied) push slowly and smoothly towards “transfer to” surface.

Oral Suction Machine

Maintenance:

• Clean collection unit (jar) daily with hot soapy water, rinsing in warm water
• Clean tubing using 1 part white vinegar and 2 parts water
• Rinse tubing with clean water
• Let parts air dry

Safety Issues:

• Do not use higher levels of suction than prescribed
• Be sure unit is plugged into a grounded outlet
• Contact hospice with any malfunction or faulty part on unit.

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Gastric Suction Machine

Maintenance:

• To clean the collection bottle remove the cap assembly from the botte.
• Remove the overflow membrane from the underside of the cap. (If this piece gets wet it will shut off the vacuum flow).
• Dispose of drainage fluids and materials in the bottle.
• Soak the bottle and cap assembly in a warm detergent solution. Wash all three parts and rinse thoroughly. Let air dry.
• Replace suction tubing as necessary.

Wheelchair

Maintenance:

• General cleaning of weelchair should be done weekly
• Wheels and tires should be checked for cracking, and wearing down of rubber wheels
• Check upholstery for snagging, rips, and tears
• Check the spokes and rims for cracking or broken pieces
• Keep front wheel casters free of string, hair and dirt

Special Procedures:

Unfolding Chair:

• Standing in front of the chair, push down on the top of the seat until chair is fully open.
• Open the footrest/elevated footrest to the side to transfer into wheelchair.
• Standing in back of chair, grasp the wheelchair push handles and fully open the wheelchair.
• Check to ensure that the seat is in the seat guides securely.
• Open the footrest/elevated footrest to the side to transfer into wheelchair.

Folding the Chair:

• With the wheel locks engaged, swing the footrest/elevated footrest to the front of the chair.
• Check Grabbing both the front and the back edges of the seat upholstery, lift up to close.​

Safety Issues:

• ​Always set the wheel locks when transferring to and from the chair.
• Never stand on footplates. The chair will tip forward and could cause injury.
• Always remove the footrest.elevated footrest when loading/unloading into car.
• Do not attempt to ride an escalator while in the wheelchair. Use the elevator.
• Do not reach beyond seat area, you could lose your balance and the wheelchair could tip over causing injury.
• If using a wheelchair oxygen cylinder holder; place on back of wheelchair so that the wheels move without any hindrance.
• Please notify your hospice nurse should the wheelchair need maintenance or servicing. The nurse will then contact WilBea Medical Equipment.

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Geri Chair

Assisted Recline:

• The ​position lock lever (long bar in back of chair) reclines the back and locks it into position.
• The user cannot recline the chair by pushing on the arms when the position lock lever is in use.
• Grasp position lock lever out.
• Pull up to remove the lock lever from the studs.
• Adjust the lock lever to a different position.
• Secure lock lever in place by engaging it in the notches on the studs.
• Ensure that the lock lever is in the locked positon when occupying the recliner. Bodily injury may occur to the occupant or to an individual standing behind the recliner.

Locking Rear Wheels:

• ​Push down on the wheel lock until it latches to engage the wheel locks.
• Release the wheel locks by pushing the middle button to unlock (dependent on the model)
• Do not push Geri chair while the wheels are in a locked position.

Safety Warnings: While using the geri chair, always:

• Lock the wheels when transferring an occupant.
• Before using the recliner, make sure the chair is stable and the patient is properly positioned before reclining.
• For larger users, always be safe and have additional assistant present.
• Make sure the recliner is stable BEFORE using the tilt and/or recliner option.
• Make sure the patient is properly positioned in the recliner before tilting, reclining, or inclining (reverse recline) to maintain maximum stability and safety.
• When returning the occupant to the full, upright position, more body strength will be required for approximately the last twenty degrees of incline.
• Make sure to use proper body mechanics (use your legs) or seek assistance to avoie injury.