Which of the following criteria should be met before considering use of a heat-moisture ex-changer (HME) for a patient being placed on ventilatory support?
1. There should be no problem with retained secretions.
2. The patient should not have fever (normothermic).
3. The patient should be adequately hydrated.
4. The support should be short term (24 to 48 hr).
a. 1, 2, and 3 only
b. 2 and 4 only
c. 1, 2, 3, and 4
d. 3 and 4 only
ANS: C
Use of HMEs should be avoided in the care of patients with secretion problems and those with low body temperature (<32° C), high spontaneous minute ventilation (>10 L/min), or air leaks in which exhaled tidal volume is less than 70% of delivered tidal volume.
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