At school.

Hi everyone.

I am here with my teacher, at her place, and I am taking a practice ACT. Its hard, but I finished the english part of it. Next will be the reading. I had a good dream about a cough assist machine. It was that I had one, and that I tried it out. I was able to cough stuff up better, and I got some snot out of my nose. Man. I tell you. From what i have heard, the cough assist machine is awwwwwwsome!!!!!!!!!!!!!!!!!!!! I'm gonna save my money up for an IPV machine. lol. Those machines are cool. I love the noise. lol. the thud thud of the machine as it puffs liquid into the patient's lungs. You know, IPV stands for Intra pulmonary Percussive Ventilation. Its a machine, that is used for people who need a little extra or a LOT of extra help getting secretions out of their lungs. For SMA Patients its used, to help get secretions out to where, they are able to be coughed up with the cough assist machine. Or, if the patient can, they can manually cough them up. The cough assist machine simulates a cough by putting positive pressure on the airways, and then shifting to negative pressure on the airways which is the same thing a cough does. ONLY the cough assist is used when a cough is not suffecient enough to do that. The cough asist might be used for someone who had a disorder called SMA, inwhich the muscles atrophy. SMA stands for 9Spinal Muscular Atrophy), and there are I think Three types. Type one is usually Always fatal. The cough assist is a painless machine, but it does kinda feel weird from what i have heard. A mask is put on the face, or a mouth piece is used. For children who have a trach, or an ET tube, an endotracheal/tracheostomy tube adapter is hooked up to the tube. The machine should already be turned and the pressures should be made sure that they are in the correct ammount. The machine then goes onto the right interface, and the machine puts posotive air into the lungs. Kinda like a BIPAP, or a CPAP machine. then the machine puts NEGATIVE pressure and sucks all the air out thus simulating a cough. Now, I've heard that when the cough assist is used, it kinda feels like the machine is sucking the air out when it swiches to the negative pressure phaise. Each cycle is equaled to one cough. A series of 4 to 6 cycles is used to help bring out all the junk, and if necessary, the patient is suctioned. IPV is used first if an IPV machine is uused. Then the cough assist machine. What the IPV machine brings up out of the lungs, the Cough assist or the in/exhuflater brings out along with the suction machine.

I have been studying this for several years, so this is how i know this. hahaha. It just takes A LOT of practice, and listening, writing, playing around with, and other things that I have donee sence I was about four. Its tons of fun for me. I love it when I see a new machine. Well, anyhow, i'll be writing more to you when I get back, and we'll talk about ECMO.

Have a good day.

much love and respect Peter Johann

p.S. ECMO will be a big long one, but we'll get through it.