T-piece Resuscitator (TPR)
- Can also be referred to as NeoPuff. NeoPuff is a brand name t-piece resuscitator.
- Disposable t-piece resuscitators (TPR) are the most available resuscitator. If a NeoPuff is not available, disposable TPR should be used.
What it is used for
- To provide supplemental oxygen
- To provide manual breaths (PPV)
- To deliver CPAP
- Suggested use is to deliver manual resuscitation to infants up to 10 kg
Set ups
- T-piece Resuscitator Setup
- Connect O2 tubing end of TPR to an oxygen or blended oxygen/air supply
- Turn flow to 10 L/min.
- Occlude patient connection
- Turn the cap on the T-Piece to set PEEP at desired level
- Adjust pressure control knob clockwise or counterclockwise to set desired ventilating pressure
- Neopuff Setup
- Check manometer reads zero with no gas flow. If not, the manometer needs to be calibrated
- Connect O2 tubing from an oxygen or blended oxygen/air supply to the gas inlet port.
- Connect the T-Piece Circuit to the gas outlet port.
- Turn flow to 10 L/min.
Set Pressure Pop-off
- Occlude PEEP cap and turn PIP control clockwise until it is maxed out.
- Adjust max pressure control knob clockwise or counterclockwise to set desired max pressure.
- The max pressure control knobs job
- The Max Pressure Relief valve is as an overall limit on the amount of pressure you can reach in the cicuit.
- The factory setting of the Max Pressure Relief is 40 cmH20
To set the PIP
- Occlude PEEP cap and turn the inspiratory pressure control to set desired PIP
To set the PEEP
- Turn the cap on the T-Piece to set PEEP at desired level
To give PPV
- Place mask over the baby’s mouth and/nose (or fit patient T-piece to ETT)
- Resuscitate by placing and removing thumb over the PEEP cap to allow inspiration and expiration
- Inhalation occurs when you place thumb over the PEEP cap
- Exhalation occurs when you remove thumb from PEEP cap
How do you know PPV is working
- Heart rate increases
- Improved Color
- Spontaneous respirations
- Increased muscle tone
- Chest Rise
Troubleshooting
- Run through MR SOPA mnemonic
- Mask size appropriate
- Reposition/assure good seal on mask, check equipment and connections
- Does patient need suctioning
- Open patient’s mouth
- Make sure PIP is adequate
- Check respirations