Pediatric Mist Tent 6o583

Cardiopulmonary Services Gas Therapy Proc8.4

PEDIATRIC MIST TENTS Purpose: 1. 2. 3. 4.

Provide continuous cool mist with oxygen if needed. Relieve laryngeal, tracheal, or bronchial edema. Help promote and improve cough mechanism. Hydrate dried secretions.

Description: Mist tents have an electrically powered fan that circulates cool air and nebulized water particles inside a canopy which covers the entire child or infant. Indications: 1. Mist Tents are used for infant and pediatric patients with dried secretions. 2. Used especially for pediatric patients who have laryngotracheobronchitis (croup), bronchitis, bronchiolitis, inhalation burns, and other edematous airway processes. 3. Can give oxygen concentrations predictably up to 50% if canopy is adequately tucked under mattress. Contraindications/hazards/Complications: 1. Must have a working circulation unit. Malfunctions in this unit can cause excessive heat and C02 build-up inside the tent canopy. 2. Precautions for oxygen usage must be observed. 3: Water reservoir must be monitored. 4. Consistent oxygen concentrations cannot be maintained if the canopy is opened frequently. 5. Bed linen can become damp and need to be changed. 6. Large volume nebulizers are susceptible to contamination. 7. Potential for electric shock or fire exists from the electrical fan or static electricity from the plastic. Equipment: 1. 2. 3. 4. 5. 6.

A complete pediatric mist tent with nebulizer unit, a fan, and drain bottle. Mist tent canopy. High-pressure oxygen hose, about 6 feet in length. Oxygen or air flowmeter. Two liters of sterile water. Oxygen analyzer for monitoring oxygen concentrations.

Personnel: Respiratory Care Technician I & II; Respiratory Care Therapist I & II. Infection Control and Protocol for istration: 1. Instruction will be given to the patient and family upon initiation, including statement of precautions if oxygen will be in use and instructions for replacing canopy after opening for access to patient. 2. An oxygen analyzer should be made accessible to monitor concentrations inside the tent if oxygen is to be used. 3. Nebulizer units will be changed out every twenty-four hours. Canopies will be changed out every forty-eight hours. 4. The water reservoir will be filled once every eight hours with sterile water to insure that the cool mist is continuous. Fresh containers of water must be used and discarded after use. 5. The drain bottle, used for collecting excess water from the nebulizer unit and fan, will be emptied every eight hours.

Cardiopulmonary Services Gas Therapy Proc8.4 6. 7.

Pediatric tents will be discontinued on physician order or as per department protocol for continuous aerosol not in use for seventy-two hours. Orders for mist tent therapy must be re-evaluated and updated every seventy-two to ninety-six hours.

Procedure for Therapy: 1. written physician order. 2. Review patient's chart for the following: a. itting or most recent updated diagnosis. b. Progress notes. c. Nursing notes d. Review lab and x-ray findings. 3. Approach and inform patient and family of the purpose of visit: a. Identify self and department b. Identify patient by comparing hospital and billing numbers on the armband to those on the physicians’ orders for therapy. c. Inform patient and family of therapy procedure and answer all questions pertinent to therapy. 4. Obtain personal protective equipment, wash and dry hands. 5. Remove canopy from sterile package. Extend canopy arm and rails. Attach canopy to rails utilizing the rubber bands. Make sure the canopy fan opening faces the fan unit. 6. Stretch the canopy fan opening over the unit's fan cover. 7. Place mist tent at head of bed with canopy draped over the bed. 8. Attach large bore nebulizer hoses to the canopy openings located on each side of the fan opening. 9. Fill the nebulizer unit with sterile water to fill line. Discard any opened bottles of sterile water. 10. Attach the high pressure hose from the outlet on the nebulizer unit inlet to a flowmeter on a blender. Turn the flowmeter to 15 lpm and adjust the FIO2 as ordered. 11. Open the damper on the nebulizer unit inlet. 12. Electrically power the mist tent unit. 13. Turn on the circulation unit switch to "COOL". 14. Note: Check that the fan is activated and mist is being generated. If mist is not produced, check the nebulizer body for placement of the metal diff on the body tip. If the body assembly is intact and no mist is generated, check the nebulizer body sphere for obstruction using a cleaning tip. If the tent continues to malfunction, return it to the department for repair. 15. Place the canopy over the bed, place patient under canopy, and tuck canopy securely under the mattress. If high concentration of oxygen s desired, placing a blanket or sheet over the canopy end may seal the untucked end of the canopy. 16. Allow sufficient time to have the oxygen concentration build up before trying to analyze. 17. Reassure patient if placement in the tent frightens the patient.

Cardiopulmonary Services Gas Therapy Proc8.4 18. Discard personal protective equipment and wash hands. 19. Document as per department guidelines: Written: Revised: Revised: Reviewed: Revised: Reviewed: Revised: Revised: Reviewed: Revised: References: AARC Clinical Practice Guidelines

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