CN113577489B - Mask fastening system and anesthesia airway auxiliary management instrument with same - Google Patents

Mask fastening system and anesthesia airway auxiliary management instrument with same Download PDF

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Publication number
CN113577489B
CN113577489B CN202110863357.2A CN202110863357A CN113577489B CN 113577489 B CN113577489 B CN 113577489B CN 202110863357 A CN202110863357 A CN 202110863357A CN 113577489 B CN113577489 B CN 113577489B
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wire
central
wheel
mask
rope
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CN113577489A (en
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潘博
马雪松
付宜利
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Harbin Institute of Technology
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Harbin Institute of Technology
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/06Respiratory or anaesthetic masks
    • A61M16/0605Means for improving the adaptation of the mask to the patient
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022Control means therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08Bellows; Connecting tubes ; Water traps; Patient circuits

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  • Health & Medical Sciences (AREA)
  • Emergency Medicine (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Respiratory Apparatuses And Protective Means (AREA)

Abstract

Mask fastening system and have its anesthesia air flue auxiliary management apparatus, it relates to a mask fastening system. The invention aims to solve the problem that the left and right symmetric force of an oxygen mask cannot be ensured to cause air leakage in the conventional mask fastening mode. The driving system (1) and the transmission system are arranged in the shell (C), the driving system (1) is connected with the transmission system, the tensioning rope (3) is arranged on the mask (2), the end part of the tensioning rope (3) is connected with the transmission system, and the displacement of the tail end of the transmission system is converted into the force for simultaneously fastening the mask (2) by the tensioning rope (3). The motor output force can be regulated through the regulating knob, then the fastening force can be regulated through the transmission system, and the fastening force can be directly read according to the scales on the knob. The problem of air leakage of the mask is avoided by accurately determining the fastening force of four ends of the mask. The invention is used in the anesthesia airway auxiliary management apparatus.

Description

Mask fastening system and anesthesia airway auxiliary management instrument with same
Technical Field
The invention relates to a mask fastening system and an anesthetic airway auxiliary management device, in particular to a mask fastening system and an anesthetic airway auxiliary management device with the same, and belongs to the field of anesthetic medicine.
Background
Mask ventilation is a non-invasive positive pressure ventilation (NPPV), and the advantages of mask NPPV include: the airway management method has lighter stimulation to the patient and is more comfortable for the patient; can avoid the complications of damage to the normal barrier function of the upper respiratory tract, upper respiratory tract injury, respiratory tract infection and the like caused by establishing an artificial airway. Research shows that the mask NPPV can be used for acute and chronic respiratory failure caused by various reasons, effectively relieving dyspnea, enhancing gas exchange, improving oxygenation function, reducing the proportion of trachea cannula, shortening ICU and total hospitalization time, reducing death rate and improving life quality. However, the stability and reliability of mask NPPV technology are not as good as those of invasive positive pressure ventilation technology, and the defects of air leakage, airway obstruction, local skin compression injury, flatulence, aspiration and sputum excretion disorder, large airway dead space and the like exist.
Bulletin number CN109646774a, patent name: the invention discloses an invention patent of an airway management manipulator for assisting positive pressure ventilation of a mask, and particularly discloses two symmetrically arranged multi-joint snakelike mechanisms, wherein four tentacles are arranged on the two multi-joint snakelike mechanisms, two tentacles are used for pressing the mask, and the other two tentacles are used for supporting the chin of a patient. The pressing degree of the mask cannot be adjusted at any time by the mask pressing mode, the mask pressing and the chin supporting are controlled through the same snake-shaped mechanism, if the tightness of the snake-shaped mechanism is adjusted, the using effect of the other pair of tentacles can be possibly affected, and meanwhile, as the two snake-shaped mechanisms are respectively controlled by the two motors, the driving force cannot be identical, and the left and right stress of the mask is asymmetric.
In summary, the fastening manner of the existing mask cannot ensure that the oxygen mask is symmetrically stressed left and right, so that the problem of air leakage is caused.
Disclosure of Invention
The invention aims to solve the problem that the left and right symmetric force of an oxygen mask cannot be guaranteed in the conventional mask fastening mode, so that air leakage is caused. Further provides a mask fastening system and an anesthesia airway auxiliary management apparatus with the same.
The technical scheme of the invention is as follows: the mask fastening system and the anesthesia airway auxiliary management instrument with the same comprise a driving system, a transmission system, a mask and two tensioning ropes, wherein the driving system is connected with the transmission system, the two tensioning ropes are arranged on the mask, the end parts of the two tensioning ropes are respectively connected with the transmission system, and the displacement of the tail end of the transmission system is converted into the force for simultaneously fastening the mask by the two tensioning ropes.
The invention also provides an anesthetic airway auxiliary management apparatus with a mask fastening system, comprising the mask fastening system.
Compared with the prior art, the invention has the following effects:
1. according to the invention, the output force of the motor can be regulated through the regulating knob, the fastening force can be regulated through the transmission system, and the fastening force can be directly read according to the scales on the knob. The problem of air leakage of the mask is avoided by accurately determining the fastening force of four ends of the mask.
2. The force on the left side and the right side of the fastening face mask is consistent, and the risk of air leakage of the face mask caused by uneven left and right force is reduced.
Drawings
FIG. 1 is a top view of the present invention; fig. 2 is a front view of the central wire guide wheel assembly 4; FIG. 3 is a side view of FIG. 2;
fig. 4 is a schematic view of the structure of the present invention mounted on an anesthetic airway auxiliary management apparatus.
Detailed Description
The technical scheme of the invention is not limited to the specific embodiments listed below, and also comprises any reasonable combination of the specific embodiments.
The first embodiment is as follows: the present embodiment is described with reference to fig. 1 to 3, and includes a driving system 1, a transmission system, a mask 2, a tension string 3, and a housing C, wherein the driving system 1 and the transmission system are installed in the housing C, the driving system 1 is connected with the transmission system, the tension string 3 is installed on the mask 2, an end portion of the tension string 3 is connected with the transmission system, and displacement of an end of the transmission system is converted into a force for simultaneously fastening the mask 2 by the tension string 3.
The drive system of the present embodiment is for outputting power; providing power to the drive train.
The transmission system of the embodiment is used for converting the displacement of the steel wire rope output by the wire guide wheel into synchronous displacement of the 4 steel wire rope ports at the tail end; the mask and the wire rope are used for converting the displacement of the 4 wire rope ports at the tail end of the transmission system into the force for fastening the mask by the wire rope, so that the fastening force of the mask at four points is ensured, and the fastening forces of the four points are identical.
The second embodiment is as follows: referring to fig. 1, a driving system 1 of the present embodiment includes a motor 1-1, a motor mount 1-2, a driving wheel 1-3, and a driving rope 1-4, wherein the motor 1-1 is mounted on the motor mount 1-2, the driving wheel 1-3 is mounted on an output shaft of the motor 1-1, one end of the driving rope 1-4 is fixedly mounted on the driving wheel 1-3, and the other end of the driving rope 1-4 is connected with a transmission system. So set up, be convenient for provide power to the transmission system, simultaneously, the degree of winding of drive rope 1-4 is realized through the degree of rotation of motor 1-1. Other components and connection relationships are the same as those of the first embodiment.
And a third specific embodiment: the transmission system of the present embodiment includes a left wire guide wheel assembly 5, a central wire guide wheel assembly 4 and a right wire guide wheel assembly 6, which are sequentially connected by wire ropes and installed in a housing C in a T shape, the other ends of the driving ropes 1 to 4 are connected with the lower end of the central wire guide wheel assembly 4, and the ends of the left wire guide wheel assembly 5 and the right wire guide wheel assembly 6 are respectively connected with the ends of the two tensioning ropes 3 and drive the four ends of the two tensioning ropes 3 to act simultaneously, as described in connection with fig. 1. So set up, drive left side wire wheel subassembly 5 and right side wire wheel subassembly 6 action simultaneously and symmetrically through central wire wheel subassembly 4, be convenient for guarantee that the atress of face guard both sides is the same. Other components and connection relationships are the same as those of the first or second embodiment.
The specific embodiment IV is as follows: the central wire wheel assembly 4 of the present embodiment includes a central wire wheel chute 4-1, a central wire wheel carriage 4-2, a central compression spring 4-3, a central wire wheel 4-4 and a central output wire rope 4-5, wherein an elongated vertical sliding hole 4-1-1 is formed in the central wire wheel chute 4-1, the central wire wheel carriage 4-2 is mounted in the central wire wheel chute 4-1, a sliding shaft outside the central wire wheel carriage 4-2 is mounted in the elongated vertical sliding hole 4-1, an upper end of the central compression spring 4-3 is connected with a lower end of the central wire wheel carriage 4-2, a lower end of the central compression spring 4-3 is connected with the other end of the driving wire rope 1-4, the central wire wheel 4-4 is rotatably mounted in the central wire wheel carriage 4-2, the central output wire rope 4-5 is wound on the central wire wheel 4-4, and both ends of the central output wire rope 4-5 are respectively connected with the left wire wheel assembly 5 and the right wire wheel assembly 6. The device has simple structure and stable and reliable operation. Other compositions and connection relationships are the same as any one of the first to third embodiments.
Fifth embodiment: referring to fig. 1, in the present embodiment, the left wire wheel assembly 5 and the right wire wheel assembly 6 have the same structure, the left wire wheel assembly 5 includes a wire wheel chute 5-1, a wire wheel sliding frame 5-2, a pressure spring 5-3, a wire wheel 5-4, and a wire rope 5-5 for output, the wire wheel chute 5-1 is provided with a horizontal sliding hole 5-1, the wire wheel sliding frame 5-2 is mounted in the wire wheel chute 5-1, a sliding shaft outside the wire wheel sliding frame 5-2 is mounted in the horizontal sliding hole 5-1, the upper end of the pressure spring 5-3 is connected with the lower end of the wire wheel sliding frame 5-2, the lower end of the pressure spring 5-3 is connected with one output end of the central output wire rope 4-5 after passing through the wire wheel sliding frame 5-1, the wire wheel 5-4 is rotatably mounted on the wire wheel sliding frame 5-2, the wire rope 5-5 for output is wound on the wire wheel 5-4, and both ends of the wire rope 5-5 are respectively connected with both ends of the wire rope 3 for tensioning. The arrangement is convenient for batch production, in addition, in the use process, as the steel wire rope does not wind and rotate on the wire guide wheel, only displacement is generated, the use precision is improved, the four-point fastening synchronization of the mask is convenient to ensure, and the problem of slipping of the wire guide wheel is avoided. Other compositions and connection relationships are the same as those in any one of the first to fourth embodiments.
Specific embodiment six: the left-side wire guide wheel assembly 5 of the present embodiment further includes a steering sleeve 5-6 rotatably mounted in the housing C of the anesthesia airway auxiliary management apparatus, and the steering sleeve 5-6 is located on the upper left side of the central wire guide wheel 4-4, as described in connection with fig. 1. The arrangement is convenient for guiding and tensioning the steel wire ropes at the two sides of the central output steel wire rope 4-5, and ensures that the left wire guide wheel assembly 5 and the right wire guide wheel assembly 6 are synchronously carried out. Other compositions and connection relationships are the same as those in any one of the first to fifth embodiments.
Seventh embodiment: the left wire guide wheel assembly 5 of the present embodiment further includes two copper wire guide pipes 5-7, the two copper wire guide pipes 5-7 are installed parallel to the central wire guide wheel chute 4-1, and both ends of the split output wire rope 5-5 are respectively penetrated in one copper wire guide pipe 5-7. So set up, be convenient for protect wire rope, carry out spacingly to wire rope's mounted position simultaneously. Other compositions and connection relationships are the same as those in any one of the first to sixth embodiments.
Eighth embodiment: in the present embodiment, a description will be given of a case where one ring 5-5-1 is provided at each end of the split output wire rope 5-5 according to the present embodiment, with reference to fig. 1. So set up, be convenient for with the cotton rope connection. Other compositions and connection relationships are the same as those in any one of the first to seventh embodiments.
Detailed description nine: the present embodiment is described with reference to fig. 1, in which a motor 1-1 of the present embodiment employs torque control. The mask is convenient to rapidly remove and buckle on the face of a patient in an emergency, and the mask is more flexible to use. Other compositions and connection relationships are the same as in any one of the first to ninth embodiments.
Detailed description ten: this embodiment is described with reference to fig. 4, which illustrates an anesthetic airway supplemental management apparatus including a mask fastening system as described in embodiments one through nine.
The working principle of the invention is as follows:
as shown in fig. 1 to 3, after the motor 1-1 of the present invention drives the driving wheel 1-3 to rotate, the wire rope connected to the driving wheel 1-3 by the central wire guide wheel assembly 4 is stretched or retracted accordingly, when the force of the central compression spring 4-3 in the central wire guide wheel assembly 4 is greater than the acting force of the motor, the wire rope is retracted, and when the force of the central compression spring 4-3 in the central wire guide wheel assembly 4 is less than the acting force of the motor, the wire rope is stretched. The central wire guide wheel 4-4 of the central wire guide wheel assembly 4 is wound with a central output wire rope 4-5, and the central output wire rope 4-5 is connected with the left wire guide wheel assembly 5 and the right wire guide wheel assembly 6 on the left side and the right side.
The motor of the invention adopts torque control, and is convenient for rapidly removing the mask pressed on the face of the patient in emergency.
When the central wire guide wheel 4-4 is stretched, the output wire ropes 5-5 output by the left wire guide wheel assembly 5 and the right wire guide wheel assembly 6 are stretched, and the left and right layout is symmetrical about the central wire guide wheel assembly 4, so that the movement distances of the left and right wire guide wheel assemblies are consistent; similarly, when the central wire guide wheel 4-4 is retracted, the wire guide dividing wheels 5-4 on the left and right sides and the central output wire rope 4-5 are also retracted by the same distance. At this time, the output steel wire ropes 5-5 wound on the wire wheels on the left side and the right side are correspondingly pulled back or loosened by the same distance, so that the pressure consistency of the left side and the right side of the oxygen mask is ensured.
The wire wheel assembly of the mask fastening system comprises a central wire wheel assembly 4, a left wire wheel assembly 5 and a right wire wheel assembly 6, all of which are identical in construction, as shown in fig. 1. The center wire guide wheel assembly 4 is illustrated as an example. When the tension applied to the central output wire rope 4-5 is greater than the pressure of the central pressure spring 4-3, the central wire guide wheel carriage 4-2 is pulled towards the side of the central pressure spring 4-3, driving the central wire guide wheel 4-4 to be pulled towards the side of the central pressure spring 4-3, and then driving the central output wire rope 4-5 wound on the central wire guide wheel 4-4 to approach towards the side of the central pressure spring 4-3 along with the central wire guide wheel 4-4. When the tension applied to the central output wire rope 4-5 is smaller than the pressure of the central pressure spring 4-3, the wire wheel carriage 3-4 is pushed out by the central pressure spring 4-3 in a direction away from the central pressure spring 4-3, the central wire wheel 4-4 is also pushed to a side away from the central pressure spring 4-3, and the output central output wire rope 4-5 wound on the central wire wheel 4-4 is then driven to move along with the wire wheel in a direction away from the central pressure spring 4-3.
As shown in fig. 4, 4 cable interfaces are output from the drive portion of the mask fastening system. 1 steel wire rope of the left wire guide wheel assembly 5 is wound in the left wire guide wheel 5-4, and two ends of the steel wire rope are respectively output from a left front hole and a left rear hole of the anesthesia airway auxiliary management instrument shell; similarly, the 1 steel wire rope on the right side is wound in the wire dividing wheel 5-4 on the right side, and two ends of the steel wire rope are respectively output from the right front hole and the right rear hole of the anesthesia airway auxiliary management instrument shell. The 4 steel wire rope interfaces are respectively provided with a circular ring connected with the steel wire rope, the circular rings are respectively connected with the circular rings at the tail ends of the ropes hung on the oxygen mask, when the steel wire rope is tensioned, the rope hung on the oxygen mask is also driven to tension the mask, and when the steel wire rope is loosened, the rope hung on the oxygen mask is also driven to loosen the mask.

Claims (7)

1. A mask fastening system, characterized by: comprises a driving system (1), a transmission system, a mask (2), a tensioning rope (3) and a shell (C), wherein the driving system (1) and the transmission system are arranged in the shell (C),
the driving system (1) is connected with the transmission system, the tensioning rope (3) is arranged on the mask (2), the end part of the tensioning rope (3) is connected with the transmission system, and the displacement change of the tail end of the transmission system is converted into the force for simultaneously fastening the tensioning rope (3) and the mask (2);
the transmission system comprises a left wire guide wheel assembly (5), a central wire guide wheel assembly (4) and a right wire guide wheel assembly (6), wherein the central output wire ropes (4-5) of the central wire guide wheel assembly (4) are sequentially connected and are installed in a shell (C) in a T shape, the other ends of the driving ropes (1-4) are connected with the lower ends of the central wire guide wheel assembly (4), and the tail ends of the left wire guide wheel assembly (5) and the right wire guide wheel assembly (6) are respectively connected with the end parts of the two tensioning ropes (3) and drive the four end parts of the two tensioning ropes (3) to act simultaneously;
the central wire guiding wheel assembly (4) comprises a central wire guiding wheel sliding groove (4-1), a central wire guiding wheel sliding frame (4-2), a central pressure spring (4-3), a central wire guiding wheel (4-4) and a central output steel wire rope (4-5),
a strip-shaped vertical sliding hole (4-1-1) is formed in the central wire wheel sliding groove (4-1), a central wire wheel sliding frame (4-2) is installed in the central wire wheel sliding groove (4-1), a sliding shaft at the outer side of the central wire wheel sliding frame (4-2) is installed in the strip-shaped vertical sliding hole (4-1-1), the upper end of a central pressure spring (4-3) is connected with the lower end of the central wire wheel sliding frame (4-2), the lower end of the central pressure spring (4-3) is connected with the other end of a driving rope (1-4), a central wire wheel (4-4) is rotatably installed in the central wire wheel sliding frame (4-2), a central output wire rope (4-5) is wound on the central wire wheel (4-4), and two ends of the central output wire rope (4-5) are respectively connected with a left wire wheel assembly (5) and a right wire wheel assembly (6);
the left wire guiding wheel assembly (5) and the right wire guiding wheel assembly (6) have the same structure,
the left wire guide wheel assembly (5) comprises a wire guide wheel chute (5-1), a wire guide wheel carriage (5-2), a pressure spring (5-3), a wire guide wheel (5-4) and a wire guide rope (5-5),
a strip-shaped horizontal sliding hole (5-1-1) is formed in a wire dividing wheel sliding groove (5-1), a wire dividing wheel sliding frame (5-2) is installed in the wire dividing wheel sliding groove (5-1), a sliding shaft on the outer side of the wire dividing wheel sliding frame (5-2) is installed in the strip-shaped horizontal sliding hole (5-1-1), the upper end of a pressure dividing spring (5-3) is connected with the lower end of the wire dividing wheel sliding frame (5-2), the lower end of the pressure dividing spring (5-3) penetrates through the wire dividing wheel sliding groove (5-1) and then is connected with one output end of a central output steel wire rope (4-5), the wire dividing wheel (5-4) is rotatably installed on the wire dividing wheel sliding frame (5-2), the two ends of the wire dividing output steel wire rope (5-5) are wound on the wire dividing wheel (5-4), and the two ends of the wire dividing output steel wire rope (5-5) are connected with the two ends of one tensioning rope (3) respectively.
2. The mask fastening system according to claim 1, wherein: the driving system (1) comprises a motor (1-1), a motor mounting frame (1-2), a driving wheel (1-3) and a driving rope (1-4), wherein the motor (1-1) is mounted on the motor mounting frame (1-2), the driving wheel (1-3) is mounted on an output shaft of the motor (1-1), one end of the driving rope (1-4) is fixedly mounted on the driving wheel (1-3), and the other end of the driving rope (1-4) is connected with the transmission system.
3. The mask fastening system according to claim 2, wherein: the left wire guide wheel assembly (5) further comprises a steering sleeve (5-6), the steering sleeve (5-6) is rotatably arranged in the shell (C) of the anesthesia airway auxiliary management instrument, and the steering sleeve (5-6) is positioned on the left upper side of the central wire guide wheel (4-4).
4. A mask fastening system according to claim 3, wherein: the left wire guide wheel assembly (5) further comprises two copper wire guide pipes (5-7), the two copper wire guide pipes (5-7) are arranged parallel to the central wire guide wheel sliding groove (4-1), and two ends of the split output wire rope (5-5) are respectively arranged in one copper wire guide pipe (5-7) in a penetrating mode.
5. The mask fastening system according to claim 4, wherein: both ends of the branch output steel wire rope (5-5) are provided with a circular ring (5-5-1).
6. The mask fastening system according to any one of claims 2 to 5, wherein: the motor (1-1) adopts torque control.
7. An anesthesia airway auxiliary management apparatus, which is characterized in that: comprising a mask fastening system according to any one of claims 1 to 6.
CN202110863357.2A 2021-07-29 2021-07-29 Mask fastening system and anesthesia airway auxiliary management instrument with same Active CN113577489B (en)

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CN202110863357.2A CN113577489B (en) 2021-07-29 2021-07-29 Mask fastening system and anesthesia airway auxiliary management instrument with same

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Application Number Priority Date Filing Date Title
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CN113577489B true CN113577489B (en) 2023-12-26

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104474622A (en) * 2014-12-15 2015-04-01 简阳市人民医院 Synchronous fixing rack for mandible mask
CN109646774A (en) * 2018-12-27 2019-04-19 哈尔滨医科大学 Assist the airway management manipulator of mask positive airway pressure
CN109939318A (en) * 2019-03-28 2019-06-28 寇建敏 A kind of Inhalational anesthesia device
CN112972855A (en) * 2021-03-17 2021-06-18 屈蕾蕾 Apparatus for sensing respiration and providing ventilation therapy

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104474622A (en) * 2014-12-15 2015-04-01 简阳市人民医院 Synchronous fixing rack for mandible mask
CN109646774A (en) * 2018-12-27 2019-04-19 哈尔滨医科大学 Assist the airway management manipulator of mask positive airway pressure
CN109939318A (en) * 2019-03-28 2019-06-28 寇建敏 A kind of Inhalational anesthesia device
CN112972855A (en) * 2021-03-17 2021-06-18 屈蕾蕾 Apparatus for sensing respiration and providing ventilation therapy

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