Clinical skills week 2

Question 1

healthy individual normal oxygen range is

Answer 1

94-100%, normal target is 94-98%

Question 2

Normal oxygen saturation level in patients with COPD/Type II respiratory failure

Answer 2

88-92%

Question 3

What do you use a pulse oximeter to measure?

Answer 3

The oxygen saturation levels within ARTERIAL blood supply

Question 4

What can hinder an oxygen saturation level reading?

Answer 4

Nail polish on the nails (this must be removed before measurement is taken). Other situations include: Strong ambient light, severe anaemia and CO poisoning.

Question 5

Areas where the SpO2 can be measured other than the finger? (In both adults and in infants)

Answer 5

The finger, toe and pinna (Adults)

The hand, feet, big toe, thumb (Infants)

Question 6

When a patient is on oxygen - what all needs to be considered?

Answer 6

Oxygen a prescribed drug (although in an emergency can be given and retrospectively.
Record the patient name, DOB and CHID.

AS WELL AS:
The drug chart - in the case of oxygen delivery such as: 1. Name, 2. Target Saturation level, 3. flow rate and the 4. delivery method.

Question 7

How does the pulse oximeter work to measure the Oxygen saturation levels?

Answer 7

When the red light is shone through, oxygenated Hb responds differently to that than deoxygenated Hb.

Oxygen Sat level: it calculates the proportion of Hb molecules passing through with 4 oxygen molecules attached compared to the number of Hb molecules with less than 4 molecules attached to the Hb.

Question 8

What is different between oxygenated and deoxygenated Hb in terms of absorption and light passage?

Answer 8

Deoxygenated Hb absorbs more red light and allows more infrared light to pass through.

Oxygenated Hb allows more red light to pass through and absorb more red light.

Question 9

What does Fi O2 Stand for?

Answer 9

Fraction of Inspired Oxygen. For e.g. ambient air is 21%

Question 10

Name the different types of Oxygen devices.

Answer 10

1. Nasal cannula
2. Simple face mask
3. Venturi Mask (controlled)
4. Reservoir Mask

Question 11

Describe the conditions in which is a nasal cannula is used.

Answer 11

Low Oxygen requirements 
Patient can speak and eat  
Flow rate of 2-6L/min 
24-50% FiO2 
no-rebreathing 
Disadvantages - easily dislodged.

Question 12

What term describes if someone has oxygen saturation levels of below 94%? (Note: not COPD or Type II resp failure)

Answer 12

Hypoxic

Question 13

True or false: A nasal cannula can be used in both Type I and Type II Respiratory Failure.

Answer 13

True

Question 14

What is the flow rate range of a nasal cannula?

Answer 14

2-6 L/min

Question 15

Describe the conditions in which a simple face mask is used (AKA Hudson mask)

Answer 15

Short-term low oxygen needs
5-10L/min flow rate
Downside is that the delivery is variable (FiO2)

Question 16

Describe the conditions in which a Venturi mask is used

Answer 16

Type II respiratory conditions such as COPD

Flow rate dependent on device - this FiO2 is exactly achieved (range is between 24-60%).

Question 17

Describe the conditions in which a reservoir bag is used.

Answer 17

Critical illness
Fi O2 60-80%
15 L/min

Question 18

Target saturation where Type II respiratory failure is a risk

Answer 18

88-92% (high CO2 and low O2)

Question 19

The unit of delivery for oxygen is

Answer 19

L/min (Litres per min)

Question 20

Pro’s and con’s of simple face mask

Answer 20

Pro’s: Cheap, allows mixing of air within the mask and CO2 to escape.

Con’s: Uncomfortable and variable FiO2.

Question 21

Pro’s and con’s of a Venturi mask.

Answer 21

Can choose a specific oxygen level to ventilate: 24,28, 35 and 60%.