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CPPT II > COMPS:UNIT 2: O2 DELIVERY SYSTEMS + EQUIPMENT > Flashcards

COMPS:UNIT 2: O2 DELIVERY SYSTEMS + EQUIPMENT Flashcards

1
Q

What should you ALWAYS REMEMBER w/ mobilizing a pt w/ vent?

A

ALWAYS MOBILIZE TO SIDE OF VENT!!!

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2
Q

FiO2 ===

A

fraction of inspired O2

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3
Q

FiO2

Inspired O2 conc. depends on 3 things:

A
  1. Flow of 02 in the unit
  2. VT of the pt
  3. Pts breathing pattern
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4
Q

Normal FIO2 in Room Air===

A

20.98% or ~21%

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5
Q

PulseOX Normal lvl should read====

A

95-100

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6
Q

PulseOX

Purpose

A
  • measures of Arterial O2 saturation and Pulse Rate
  • O2 saturation (SaO2)== % of hgb saturated w/ O2
  • Spectophotometry det’s amt of Hgb
    • ​sensor measures absorption of selected wavelengths beamed thru tissue
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7
Q

PulseOX

Indications

A
  • Used to detect hypoxemia in pts w/ unstable O2 status
  • Medicare/Medicaid
    • ​Sat. of =88% qualifies some for O2 tx
  • NORMA==95-100%
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8
Q

PulseOX

Documentation MUST include: 3

A
  • BEFORE: Ambulation/stairs/exercise on room air
  • DURING: Exertion on room air and on satisfactory O2 lvl
  • AFTER: Exertion
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9
Q

PulseOX

Applying…

A
  • Body probes:
    • Digit
    • Earlobe
    • Bridge of nose
    • Forehead
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10
Q

PulseOX

Limitations:

REASONS FOR FALSE READINGS

A
  1. Error in initial calibrations
  2. Motion artifacts
  3. **Diminished pulse
  4. **Peripheral vasoconstriction from drugs or hypOthermia
  5. Dysfunctional Hgb
  6. Injected dyes
  7. **Dark nail polish
  8. Optical shunting (light wont reach vascular bed)
  9. Outside light sources
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11
Q

O2 Delivery systems often involve 2 pieces:

A
  1. Flowmeter

2. Humidification system

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12
Q

O2 Delivery Systems

1. Nasal Cannula

PURPOSE

A
  • Delivers FiO2 of 24-44% w/ flow rates up to 6L of O2/minute
    • _​_6L is MAX for regular Nasal Cannula*****
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13
Q

O2 delivery

  1. Nasal Cannula

DEVICE DESIGN (MOST IMPORTANT STUFF)

A
  • Prongs attach tubing that is connected to O2 tank, portable O2 generator, or wall connection via Flowmeter
  • **For every 1L/min INC in O2 delivered—> APPROXIMATE 4% INC in FiO2
  • ADD HUMIDIFICATION if >3L O2
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14
Q

O2 Delivery

1. Nasal Cannula

INDICATIONS :

A
  • LOW lvls O2 w/in any pt setting
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15
Q

O2 Delivery

1. Nasal Cannula

BENEFITS

A
  • Convenient in delivering O2 conc’s ranging 24-44%
  • EZ pt mobility
  • Permits pt to eat, drink, talk, oral/facial ADLs, take oral meds and/or nebulizer while receiving O2
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16
Q

O2 Delivery

1. Nasal Cannula

LIMITATIONS:

A
  • UNABLE to deliver O2 conc’s >6L OR 44%****
  • MUST nasally breath==> encourage “Pursed-Lip breathings”
  • May NOT be used if pt unable to tolerate, or no cognition or cooperation to consistently wear
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17
Q

O2 Delivery

2. High Flow Nasal Cannula

*THICKER TUBING

*LOUDER SOUND

PURPOSE:

A
  • Allows flow of 6-15L/min of O2
  • FiO2 is 54-75%
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18
Q

O2 Delivery

2. High Flow Nasal Cannula

DEVICE DESIGN:

A

LARGE prongs/tubing for HIGHER O2 flows

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19
Q

High Flow Nasal Cannulas mostly seen where?

A

Hospitals

20
Q

High Flow Nasal Cannulas

BENEFITS

A
  • ALL SAME AS Reg. Nasal Cannula
  • allows for 6-15L/min O2
  • FiO2 delivery is 54-75% (better for higher O2 demand)
21
Q

High Flow Nasal Cannula

LIMITATIONS:

A
  • SAME as reg. nasal cannula
  • Min. research on bennies long term
  • MUST be humidified for long durations
22
Q

O2 Delivery

3. Aquinox/Optiflow/High Flow Humidification System

PURPOSE

A
  • humidification system delivers warm, humid O2 @ HIGH FLOWS
    • ​up to 45L/min, 100% FiO2—Lg. nasal cannula
23
Q

O2 Delivery

3. Aquinox/Optiflow/High Flow Humidification System

DEVICE DESIGN:

A
  • Humidifier chamber
  • O2 tubing
  • Delivery tube
  • High flow nasal cannula
24
Q

O2 Delivery

3. Aquinox/Optiflow/High Flow Humidification System

INDICATIONS:

A
  • ONLY in hospital or LTACH
    • *cannot go home w/ this
25
Q

O2 Delivery

3. Aquinox/Optiflow/High Flow Humidification System

BENEFITS

A
  • SAME as nasal cannula’s
  • Pot. provide some Positive Pressure (not measurable)
26
Q

O2 Delivery

3. Aquinox/Optiflow/High Flow Humidification System

LIMITATIONS:

A
  • CANNOT UNPLUG
    • cannot mobilize in hallway
  • Need continuous nasal breathing to receive FiO2 (100% FiO2 received)
27
Q

O2 Delivery

4. NON-Rebreather Mask

*Bag ALWAYS inflated

PURPOSE:

A
  • High lvl of O2 to pts in varying lvls of resp. distress
  • High amts of O2 to pts during emergency situations @ 100% FiO2 @ 15L/min
    • ​hypoxia
    • seizures
    • conscious w/ VTACH
28
Q

O2 Delivery

4. NON-Rebreather Mask

*Bag ALWAYS inflated

DEVICE DESIGN

A
  • 3 one-way valves and bag reservoir to supply highest O2 conc. possible
  • Flap valves–> prevent EXHALED air from entering bag and ensure EXHALED air exit side of mask—> INSP air therefore 100% from reservoir bag
29
Q

O2 Delivery

4. NON-Rebreather Mask

*Bag ALWAYS inflated

INDICATIONS

A
  • SHORT TERM for emergency situation when pts have adequate, spontaneous respirations
    • hypoxia
    • seizures
    • VTACH w/ conscious pts
30
Q

O2 Delivery

4. NON-Rebreather Mask

*Bag ALWAYS inflated

SETUP:

A

Reservoir bag must be COMPLETELY INFLATED BEFORE applying to pt

31
Q

O2 Delivery

4. NON-Rebreather Mask

*Bag ALWAYS inflated

BENEFITS:

A
  • Delivers O2 conc 100%
  • easy setup in an emergency situation
32
Q

O2 Delivery

4. NON-Rebreather Mask

*Bag ALWAYS inflated

LIMITATIONS:

A
  • NO POSITIVE PRESSURE
  • Cannot complete ADL while donned–> switch to alternative nutrition source/medication route
    • ​MORE SHORT TERM ANYWAY!
  • Only provide ONE setting reliably: 15L/min @ 100% FiO2
    • ​Can be placed on 6-14L/min w/ LESS FiO2
      • prevents O2 induced barotrauma to parenchyma
33
Q

Partial Rebreather Mask

What’s the deal w/ this?

A
  • SIMILAR to NRM BUT:
    • _​_Resp. bag W/OUT flaps–> this makes both valves, 2-way valves allowing for passage of gases during INHALE AND EXHALE.
    • about 1/3 of EXHALED VT re-enters bag to be re-inhaled
    • specific design allows for pt to inhale MIXTURE of atm. air, O2, and EXHALED air
      • ​Use of CO2==Resp. stimulant***
34
Q

O2 Delivery

6. Face Tent

*OPEN-CIRCUIT

PURPOSE:

A
  • Delivers HIGH FLOW to pt thru soft plastic “bucket”
35
Q

O2 Delivery

6. Face Tent

*OPEN-CIRCUIT

DESIGN:

A
  • FLOW RATE:
    • 8-10L/min w/ estimated FiO2 30-100%
      • ​bc OPEN CIRCUIT
36
Q

O2 Delivery

6. Face Tent

*OPEN-CIRCUIT

BENEFITS:

A
  • Post-op pts, claustrophobic, facial trauma, burn pts
  • comfortable
37
Q

O2 Delivery

6. Face Tent

*OPEN-CIRCUIT

LIMITATIONS

A
  • Amt. of O2 pt actually receives varies
    • bc OPEN CIRCUIT
  • remove to eat/ADL
  • NO POSITIVE PRESSURE
38
Q

O2 Delivery

7. Ambu Bag/Resuscitator Bag

The CPR one*

PURPOSE:

A
  • Used when POSITIVE PRESSURE is indicated
  • provides POSITIVE pressure vent–> directs O2 (or CO2) inside via 1-way valve
39
Q

O2 Delivery

Ambu Bag/Resuscitator Bag

DESIGN:

A
  • Reservoir bag connected by tubing and a non-rebreathing valve to a face mask and/or ET tube
  • self-inflating w/ room air OR from O2 source
40
Q

Ambu Bag/Resuscitator Bag

SET UP

A
  • Squeeze bag once every 6s for adequate RR
    • ​10 respirations/min for Adult
41
Q

Ambu Bag/Resuscitator Bag

INDICATIONS

A
  • IMMEDIATE ventilation/POSITIVE PRESSURE short term
  • 1-1.5L capacity in bag
  • CAN provide FiO2 100% if flowmeter available OR provides 21% FiO2 if set to Room Air
42
Q

Ambu Bag/Resuscitator Bag

BENEFITS:

A
  • Used in emergency when pt loses consciousness but vent. is not present OR ET not placed
  • used if vent malfunctions or stops working
  • used for pt who req’s POSITIVE PRESSURE during mobilization
43
Q

Ambu Bag/Resuscitator Bag

LIMITATIONS:

A
  • Need person to squeeze bag
  • 1x every 5s appears slow and untrained indiv’s can struggle to maintain this rate
44
Q

O2 Delivery

Tracheostomy weaning: Trach Mask vs. T-piece

TRACH MASK

A
  • BLUE TUBING BC HUMIDIFICATION
  • OPEN CIRCUIT
  • Similar to face tent—-humidified HIGH FLOW O2 via soft plastic mask
  • used after weaning from vent for weeks prior to physician decannulation
  • unreliable FiO2 due to lost O2 around collar
  • Flow rate changed via air entrainment port on wall
45
Q

Tracheostomy weaning: Trach Mask Vs. T-Piece

T-Piece

*CLOSED CIRCUIT

A
  • CLOSED CIRCUIT means you can directly measure amt O2 delivered
  • adaptor attached to trachostomy and tubing to provide closed circuit O2 delivery
  • Flow rate changed via air entrainment port on wall
  • BENEFIT: aware of specific FiO2
46
Q

Tracheostomy weaning: Trach Mask vs. T-Piece

*BOTH PORTABLE!!

A
  • Either can be attached to a O2 tank via air entrainment port and tubing
  • trach collar or t-piece portable entrainment port O2 tubing
47
Q

Monitoring SpO2 sats

Maintain >/= 90%

FLOWCHART

A

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CPPT II (6 decks)

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