Chapter 41 Flashcards
hyperbaric oxygen and the physiological effects
HBO
Therapeutic oxygen use at pressure greater than 1 atm.
Effects: embolism, hyper oxygenation of blood and tissue vasoconstriction, enhanced host immune function, neurovascularation, national formation of new blood vessels
indications for hyperbaric oxygen therapy
Two types: Acute (actively happening) and Chronic (always happening)
Acute:
-Decompression sickness
-air gas embolism
-Carbon monoxide poisoning / cyanide poisoning
-Acute traumatic Ischemia (compartment/crush injury)
- Acute peripheral arterial insufficiency
-Inter-cranial assesses
Clostridial gangrene
Chronic:
-Diabetic wounds of lower extremities/ wounds non-healing
-refractory Osteomyelitis
-actinomycosis (chronic systemic abscesses)
- Radiation necrosis
complications of hyperbaric oxygen therapy
3 Types: barotrauma, oxygen toxicity, other
Barotrauma:
-ear/tissue since trauma
-claustro
-Gas embolism
-tympanic membrane rupture (eardrum)
-Alveolar overdistination
Oxygen toxicity:
-CNS toxic reaction
-Pulmonary toxic reaction
Other:
-fire
-sudden decompression
-claustrophobia
-decrease cardio output
carbogen
mixture of carbon dioxide and oxygen
5%:95% (5% carbon to 95%. oxygen)
7%:93% (7% carbon to 93% oxygen)
what is carbogen used for
not common but can be used for
-hiccups
-carbon monoxide poisoning
-preventing washout of CO2
-
what is a laboratory gas and which gas/gasses are in this category
equipment and calibration / diagnostic testing.
-nitrogen and CO2 ( blood gas diagnostic/ analysis)
-collaboration testing allows you to trust results
what is therapeutic gas and which gasses are in this category
relieve symptoms and improve oxygenation (hypoxemia)
-oxygen- maintain adequate O2
what is anesthetic gas and which gasses are in this category
combined with O2 to provide anesthesia during surgery
-Oxygen- anesthetic use for surgery
-nitrous oxide- anesthetic properties
tell me about oxygen
O2
-colorless
-oderless
-transparent
-tasteless
-combustable
how is oxygen produced
Large quantities
-fractional distillation
small quantities
-physical separation of O2 from air
Other ways
-chemical electrolysis of water
-chemical decomposition of sodium chlorate (NaClO2)
which oxygen is used in hospital settings
fractional distillation- filtering atmospheric air
tell me about air
-colorless
-oderless
-naturally occurring
-21% O2, 78% nitrogen, 1% trace gases
-50 psig to flow is 100 L/m
tell me about carbon dioxide
CO2
-colorless
-oderless
- doesn’t’t support combustion
Common uses
- calibration of blood gas
-diagnostic purposes
what composition makes up air
21% O2, 78% nitrogen, 1% trace gases
-50 psig to flow is 100 L/m
tell me about helium
He
-colorless
-oderless
-tasteless
-non-flamible (inactive)
- less dense than air
-ALWAYS mixed with at LEAST 20% O2
how much oxygen must be mixed with helium
-ALWAYS mixed with at LEAST 20% O2
tell me about heliox uses
HeO2
-therapeutic
-mixture of O2 and He
-manages airway obstruction
-decreases work of breathing
-lower density
-makes gas flow more laminar
tell me about nitric oxide and its uses
already did
tell me bout nitrous oxide
N2O
-For anesthetic uses
-colorless
-slightly sweet oder/taste
-anesthetic agent
-always mixed with O2
-produced by thermal decompression of ammonium nitrate
cylinder colors of gases
O2-green
CO2-gray
N2O-blue
He-brown
C2H4-red
CO2O2-gray/green
HeO2-brown/green
N2-black
N2O2-black/green
Air- yellow
Cyclopropane-orange
gas cylinder safety test
-conducted every 5-10 years
-pressurized to 5 thirds of service pressure
CHECK FOR
-clinical leakage
-expansion
-wall stress
-results stamped on tank
what is the purposes of release valves
-gas release if too much heat
-prevent tank pressure from becoming too high
3 basic designs:
-frangible metal disk rupture
-fusible plug melts
-spring loaded valve opening
how do you know how much oxygen is in tanks:
compressed gas
Liquified gas
Compressed:
normally filled to service pressure at 70F
-can be filled to 10% over (+)
-measured by pressure
Liquid:
-included CO2 and N2O
-cylinders filled according to specific density
-measured by weight
what are the 3 types of bulk oxygen
(all are more cost effective)
used to meet large O2 needs, holds at least 20,000 cubic feet (149,610.32 liquid weight)
1)Alternating supply system
-H or K tank
- Primary reserve bank
2)Cylinder system w/ reserve supply
-pressure reducing valves
-automatic switch and alarm system
3)Bulk gas system w/ reserve
-reserve for 1 day
- 1 cubic ft of liquid = 860 cu/ft of gaseous O2
what is central piping system used for
-delivers compressed gas to all areas of hospital
-gas pressure reduced to standard working pressure of 50 PSI
-alarm for pressure drop
-closed for maintenance or fire
American standard safety system (ASSS)
- for large cylinders and their attachments
-prevents accidental misconnections
Diameter-Index Safety System (DISS)
-for low pressure gas connectors
-found at outlets for pressure reducing valves, outlets of central piping system and inlets of blenders, flowmeters, and vents
Pin-Index Safety System (PISS)
-for small cylinders including & up to size E
-exact position and pinholes vary
2-5 for O2
1-5 for Air
tell me about nitric oxide (NO)
-non-toxic gasses supported by O2 and supports conduction
-colorless
-oderless
-improves blood flow to lungs
- infants with persistent pulmonary hypertension (newborn)
-pulmonary hypertension after cardiac arrest
- cardiac transplantation
-acute pulmonary embolism
-dependable dose
-limited production
-maintain adequate ventilation
-testing pulmonary vascular response
-ARDS
-COPD
-congenital diagrammatic hernia
what is flow of a full E tank
2200
what is cylinder factor for E tank
0.28
what is cylinder factor for H
3.14
