Chapter 42 Egan's Flashcards
What can always provide an exact FiO2?
Nonrebreathing reservoir
What system allows precise control over FiO2 and total output flow?
Blending system
Protocol-based O2 therapy ensures…
1) Undergoes initial assessment
2) Evaluated for protocol criteria
3) Receives a treatment plan that is modified to needs
4) Stops receiving therapy as soon as is no longer needed
O2 therapy is used for
correcting hypoxia, decreasing symptoms of chronic hypoxemia, decreasing cardiopulmonary workload
When is high FiO2 acceptable?
If concentration can be decreased to .70 within 2 days and .50 in 5 days
Fire triangle
O2, heat, fuel
What does the iNO machine do?
Improves blood flow to ventilated alveoli, reduces intrapulmonary shunting, improves arterial oxygenation, decreases pulmonary vascular resistance and pulmonary arterial pressure
What does back pressure decrease?
The volume of entrained air and the total output of air-entertainment devices
3 Ps
purpose, patient, performance of device
Air-entrainment nebulizers are also known as what?
jet nebulizers or large volume nebulizer
Venturi mask
AEM
Simple mask
5-10L/min
What is the body humidity
37 degrees Celsius, 47mm Hg partial pressure, 100% saturation
What is the purpose of a baffle in a large volume nebulizer?
Stabilize particle size
What controls the particle size generated by an ultrasonic nebulizer?
Frequency
What happens to FiO2 when back pressure is applied distally?
Increases
Low Flow
Nasal cannula (variable)
1/4-6L/min 22%-40% FiO2
Nasal catheter (variable)
1/4-5L/min 22%-45% FiO2
Transtracheal catheter (Variable)
1/4-4L/min 22%-35% FiO2
Reservoir Systems
Reservoir cannula (Variable)
1/4-4L/min 22%-35% FiO2
Simple Mask ( Variable)
5-10L/min 35%-50% FiO2
Partial Rebreathing (variable)
min 10L/min 40%-70% FiO2
Nonrebreather Mask (Variable)
Min 10L/min 60%-80% FiO2
High Flow
AEM (Fixed)
>60L/min 24%-50% FiO2
Air-Entrainment Nebulizer
(Fixed) 28%-100% FiO2
10-15L-input >60L output
Blending System (Fixed)
>60L/min 21%-100%
High-Flow Nasal Cannula
(Generally Fixed, depends)
Up to 50L/min or more
35%-100% FiO2
Enclosure
Oxyhood =/>7L
21%-28% FiO2 (Fixed)
Isolette (Variable)
8-15L/min 40%-50% FiO2
Tent (Variable)
12-15L/min 40%-50% FiO2
What are the numbers for hypoxemia?
PaO2 <55-60mm Hg
SaO2 <87%-90%
What typically occurs first when monitoring the earliest physiologic response to breathing 100% O2?
Substernal chest pain
A patient breathing 100% O2 for 24hrs or longer would most likely exhibit what?
Decreased vital compacity
What is consistent with the radiographic appearance after prolonged exposure to O2?
Patchy infiltrates
Signs of hypoxia
Respiratory, Cardiovascular, Neurologic
Respiratory signs of hypoxia
Tachypnea, dyspnea, paleness, cyanosis
Cardiovascular signs of hypoxia
Tachycardia, arrhythmia, hypertension
Exposure time to 100% O2 complications
0-12 hours
-normal pulmonary function
-tracheobronchitis
-substernal chest pain
12-24 hours
-decreasing vital compacity
25-30 hours
-decreasing lung compliance
-increasing P(A-a)O2 and
(A-a)gradient
-decreasing exercise PO2
30-72 hours
-decreasing diffusing compacity
When is high FiO2 acceptable?
If concentration can be decreased to 70% within 2 days and 50% within 5 days
Air Embolism Treatment
Immediate pressurization in air to 6ATA for 15-30min, then decompression to 2.8ATA with prolonged O2 therapy
Carbon Monoxide Treatment
Breathing 100% O2 reduces to 80 minutes
HBO at 3 ATA is 23 minutes
Helium Canisters
20:80 = 1.8
30:70 = 1.6
What is the density of air?
1.293g/L
