Inhaler:​ An ​inhaler​ or ​puffer​ is a medical device used for delivering medication into the body via the lungs.

It is
mainly used in the treatment of ​asthma​ and ​Chronic Obstructive Pulmonary Disease​ (COPD).

Types

1. Metered-dose inhalers
MDI​ — ​the most common type of inhaler is the pressurized ​metered-dose inhaler​ (MDI). In MDIs, medication is
most commonly stored in solution in a pressurized canister. On activation, the metered-dose inhaler releases a fixed
dose of medication in ​aerosol​ form. The correct procedure for using an MDI is to first fully exhale, place the
mouth-piece of the device into the mouth, and having just started to inhale at a moderate rate, depress the canister to
release the medicine. The aerosolized medication is drawn into the lungs by continuing to inhale deeply before
holding the breath for 10 seconds to allow the aerosol to settle onto the walls of the ​bronchial​ and other airways of the
lung.

2. Dry powder inhalers

DPI​ ​Dry powder inhalers​ release a metered or device-measured dose of powdered medication that is inhaled
through a DPI device.
3. Analgesic inhalers
The Analogizes was found to be safe, effective, and simple to administer in ​obstetric​ patients during childbirth, as well
as for patients with ​bone fractures​ and ​joint dislocations​,[3]​
​ and for dressing changes on ​burn​ patients
4. Soft Mist Inhaler​
The analogize inhaler was withdrawn in 1974.

Nebulizers
Nebulizers​ — supply the medication as an aerosol created from an aqueous formulation.
Nebulizer
In ​medicine​, a ​nebulizer​ ​is a device used to administer medication in the form of a mist inhaled into the lungs.

Nebulizers are commonly used for the treatment of ​cystic fibrosis​, ​asthma​, ​COPD​ and other ​respiratory diseases​.

Types
1. Jet nebulizers.​ The most commonly used nebulizers are ​Jet nebulizers

2. Ultrasonic wave nebulizers​ were invented in 1964 as a new more portable nebulizer

3. Vibrating Mesh nebulizers

Respirator
A ​respirator​ is a device designed to protect the wearer from inhaling harmful ​dusts​, fumes, vapors, or ​gases​.
A half face particulate (air-purifying) mask is generally worn to protect the wearer from dust and paint fumes.

1. Air-purifying respirators
Protective filter mask worn by NYPD officer. Air-purifying respirators are used against particulates (such as smoke or
fumes), gases, and vapors that are at atmospheric concentrations less than immediately dangerous to life and health.
The air-purifying respirator class includes:

▪ negative-pressure​ ​respirators, using mechanical filters and chemical media

▪ positive-pressure​ ​units such as powered air-purifying respirators (PAPRs)

▪ Escape only​ ​respirators or hoods such as Air-Purifying Escape Respirators (APER) for use ​by the general
public for ​Chemical, Biological, Radiological, and Nuclear (CBRN)​ terrorism incidents.
1.1. Mechanical filter respirators
Mechanical filter respirators retain particulate matter when contaminated air is passed through the filter material.

1.2. Chemical cartridge respirators

Chemical cartridge respirators use a cartridge to remove ​gases​, ​volatile organic compounds​ (VOCs), and other
vapors from breathing ​air
1.3. Powered air-purifying respirators
The purpose of this type of respirator is to take ​air​ that is ​contaminated​ with one or more types of ​pollutants​, remove
a sufficient quantity of those ​pollutants​ and then supply the air to the user.
2. Self-contained breathing apparatus

Ventilators

Definition
A ventilator is a device used to provide assisted respiration and positive-pressure breathing.

Purpose
Ventilators are used to provide mechanical ventilation for patients with ​respiratory failure​ who cannot breathe
effectively on their own.

Description
Different types of ventilators can be programmed to provide several modes of mechanical ventilation. A brief overview
of each type and mode follows.

Types of Mechanical ventilators

Negative-pressure ventilators
The original ventilators used negative pressure to remove and replace gas from the ventilator chamber. Examples of
these include the iron lung, the Drinker respirator, and the chest shell. Rather than connecting to an artificial airway,
these ventilators enclosed the body from the outside. As gas was pulled out of the ventilator chamber, the resulting
negative pressure caused the chest wall to expand, which pulled air into the ​lungs​. The cessation of the negative
pressure caused the chest wall to fall and exhalation to occur. While an advantage of these ventilators was that they
did not require insertion of an artificial airway, they were noisy, made nursing care difficult, and the patient was not
able to ambulate.
Positive-pressure ventilators
Postive-pressure ventilators require an artificial airway (endotracheal or tracheostomy tube) and use positive
pressure to force gas into a patient's lungs. Inspiration can be triggered either by the patient or the machine. There
are four types of positive-pressure ventilators: ​volume-cycled​, ​pressure-cycled, flow-cycled, and time-cycled.

VOLUME-CYCLED VENTILATORS.​
PRESSURE-CYCLED VENTILATORS.​
FLOW-CYCLED VENTILATORSTIME-CYCLED VENTILATORS.​
Modes of ventilation
Mode refers to how the machine will ventilate the patient in relation to the patient's own respiratory efforts. There is a
mode for nearly every patient situation; plus, many different types can be used in conjunction with each other.

CONTROL VENTILATION (CV).​ ​CV delivers the preset volume or pressure regardless of the patient's own
inspiratory efforts. This mode is used for patients who are unable to initiate a breath. If it is used with spontaneously
breathing patients, they must be sedated and/or pharmacologically paralyzed so they don't breathe out of synchrony
with the ventilator.
ASSIST-CONTROL VENTILATION (A/C) OR CONTINUOUS MANDATORY VENTILATION
(CMV).​A/C or CMV delivers the preset volume or pressure in response to the patient's inspiratory effort, but will
initiate the breath if the patient does not do so within a preset amount of time. This mode is used for patients who can
initiate a breath but who have weakened respiratory muscles. The patient may need to be sedated to limit the number
of spontaneous breaths, as hyperventilation can occur in patients with high respiratory rates.
SYNCHRONOUS INTERMITTENT MANDATORY VENTILATION (SIMV).​ ​SIMV delivers the preset
volume or pressure and preset respiratory rate while allowing the patient to breathe ​spontaneously. The vent
initiates each breath in synchrony with the patient's breaths. SIMV is used as a primary mode of ventilation as well as
a weaning mode. (During weaning, the preset rate is gradually reduced, allowing the patient to slowly regain
breathing on their own.) The disadvantage of this mode is that it may increase the effort of breathing and cause
respiratory muscle fatigue. (Breathing spontaneously through ventilator tubing has been compared to breathing
through a straw.)
POSITIVE-END EXPIRATORY PRESSURE (PEEP).​ PEEP is positive pressure that is applied
by the ventilator at the end of expiration. This mode does not deliver breaths but is used as an adjunct to CV, A/C,
and SIMV to improve oxygenation by opening collapsed alveoli at the end of expiration. Complications from the
increased pressure can include decreased cardiac output, lung rupture, and increased intracranial pressure.
CONSTANT POSITIVE AIRWAY PRESSURE (CPAP).​ ​CPAP is similar to PEEP, except that it works
only for patients who are breathing spontaneously. The effect of CPAP (and PEEP) is compared to inflating a balloon
but not letting it completely deflate before inflating it again. The second inflation is easier to perform because
resistance is decreased. CPAP can also be administered using a mask and CPAP machine for patients who do not
require mechanical ventilation but who need respiratory support (for example, patients with sleep apnea).
PRESSURE SUPPORT VENTILATION (PSV​).​ PS is preset pressure which augments the patient's
spontaneous inspiration effort and decreases the work of breathing. The patient completely controls the respiratory
rate and tidal volume. PS is used for patients with a stable respiratory status and is often used with SIMV during
weaning.
INDEPENDENT LUNG VENTILATION (ILV).​ ​This method is used to ventilate each lung separately in
patients with unilateral lung disease or a different disease process in each lung. It requires a double-lumen
endotracheal tube and two ventilators. Sedation and pharmacologic ​paralysis​ are used to facilitate optimal ventilation
and increase comfort for the patient on whom this method is used.
HIGH FREQUENCY VENTILATION (HFV).​ ​HFV delivers a small amount of gas at a rapid rate (as much as
60-100 breaths per minute). This is used when conventional mechanical ventilation would compromise hemodynamic
stability, during short-term procedures, or for patients who are at high risk for lung rupture. Sedation and/or
pharmacologic paralysis are required.
INVERSE RATIO VENTILATION (IRV).​ ​The normal inspiratory: expiratory ratio is 1:2, but this is reversed
during IRV to 2:1 or greater (the maximum is 4:1). This method is used for patients who are still hypoxic, even with
the use of PEEP. Longer inspiratory time increases
The amount of air in the lungs at the end of expiration (the functional residual capacity) and improves oxygenation by
responding collapsed alveoli. The shorter expiratory time prevents the alveoli from collapsing again. This method
requires sedation and therapeutic paralysis because it is very uncomfortable for the patient.

Anesthesia  Machine​.  ​A  biotechnical  device  used  to  deliver  anesthetic  gases  or  volatile  liquids  and  provide  physiological 
monitoring​.

Defibrillator.​
An electrical device used to counteract fibrillation of the heart muscle and restore normal heartbeat
by applying a brief electric shock​.
P​acemaker.

An artificial device for stimulating the heart muscle and regulating its contractions.

Asynchronous pacemaker.
Cardiac pacing a pacemaker which fires at a fixed, preset rate, independent of the heart's intrinsic electrical and/or
mechanical activity.

Demand pacemaker​. ​A form of artificial pacemaker usually implanted into cardiac tissue because it’s output of
electrical stimuli can be inhibited by endogenous cardiac electrical activity.

External pacemaker
Cardiac pacing a pulse generator intended to be worn outside the body, used for temporary pacing.
Internal ​pacemaker​:

A device that uses electrical impulses to regulate the ​heart​ rhythm or to reproduce that rhythm. An
internal ​pacemaker​ is one in which the electrodes into the heart, the electronic circuitry and the power supply are
implanted (internally) within the body.

OXYGENATOR
An ​oxygenator​ is a medical device that is capable of exchanging ​oxygen​ and ​carbon dioxide​ in the blood of human
patient in surgical procedures that may necessitate the interruption or cessation of blood flow in the body, a critical
organ or great blood vessel. These organs can be the ​heart​, ​lungs​ or ​liver​, while the great vessels can be the ​aorta,
pulmonary​, ​pulmonary veins​ or ​vena cava​. An oxygenator is typically utilized by a ​percussionists​ in ​cardiac surgery​ in
conjunction with the ​heart-lung machine​. However, oxygenators can also be utilized in ​extracorporeal membrane
oxygenation​ in neonatal intensive care units by ​nurses​.
For most cardiac operations such as ​coronary artery bypass​ grafting, the cardiopulmonary bypass is performed using
a heart-lung machine (or cardiopulmonary bypass machine). The ​heart-lung machine​ serves to replace the work of
the heart during the open bypass surgery. The machine replaces both the heart's pumping action and the lungs' gas
exchange function. Since the heart is stopped during the operation, this permits the surgeon to operate on a
bloodless, stationary heart.
One component of the heart-lung machine is the oxygenator. The oxygenator component serves as the lung, and is
designed to expose the blood to oxygen and remove carbon dioxide. It is disposable and contains about 2–4 m² of a
membrane permeable to gas but impermeable to ​blood​, in the form of hollow fibers. Blood flows on the outside of the
hollow fibers, while oxygen flows in the opposite direction on the inside of the fibers. As the blood passes through the
oxygenator, the blood comes into intimate contact with the fine surfaces of the device itself. Gas containing oxygen
and medical air is delivered to the interface between the blood and the device, permitting the blood cells to absorb
oxygen molecules directly.