L14: Oxygen Therapy

Question 1

Def of Oxygen Therapy

Answer 1

• Administration of oxygen at a concentration greater than room air (>21%), to treat or prevent hypoxemia
  —-> Increase availability of oxygen to body tissues.

Question 2

Assessment & Monitoring of Oxygen Therapy

Answer 2

Question 3

Normal Value of ABGs

Answer 3

Question 4

Classification of Hypoxemia

Answer 4

Question 5

Types of Oxygen Therapy

Answer 5

Acute Therapy & Chronic Therapy

Question 6

Indications of Acute Oxygen Therapy

Answer 6

Question 7

Indications of Continous chronic Oxygen Therapy

Answer 7

Question 8

Indications of Non-Continous chronic Oxygen Therapy

Answer 8

Question 9

Sources of Oxygen Therapy

Answer 9

Question 10

when is Humidification needed in Oxygen Therapy?

Answer 10

• Supplemental inspired medical gases should be humidified when administered at flow rates >4 L/min.

Question 11

Why is Humidification needed in Oxygen Therapy?

Answer 11

• For maintenance of normal function of mucociliary system.

Question 12

Complications of Oxygen Therapy

Answer 12

• Pulmonary oxygen toxicity.
• Hypoventilation & carbon dioxide narcosis.
• Absorption atelectasis.
• Retrolental fibroplasias.
• Bronchopulmonary dysplasia in neonates.

Question 13

Causes of Pulmonary Oxygen Toxicity

Answer 13

• Exposure of pulmonary tissues to a high O2 tension can lead to various degree of Injury

Question 14

Degree of injury in Pulmonary Oxygen Toxicity is related to ….

Answer 14

• Duration of exposure.
• O, concentration of delivered oxygen i.e. dose

Generally, O2 concentration >50% is considered toxic.

Question 15

Manifestations of Pulmonary Oxygen Toxicity

Answer 15

Question 16

Mechanism of Acute respiratory distress syndrome (ARDS) by Pulmonary Oxygen Toxicity

Answer 16

Prolonged exposure to high O2 concentration → Disruption of endothelial lining of pulmonary capillaries —-> Leakage of proteinaceous fluid into alveoli —–> Damage —-> Cell death.

Question 16

Orygen delivery systems

Answer 16

Question 17

Prevention of Pulmonary Oxygen Toxicity

Answer 17

Question 18

Where does Hypoventelation & CO2 Narcosis by oxygen toxicity occur?

Answer 18

Chronic hypercapnia (PaCO, >45mmHg) why?
- CNS response to elevated CO, level becomes blunted.
- & Hypoxia becomes the main ventilatory stimulus.

Question 19

Mechanism of Hypoventelation & CO2 Narcosis by oxygen toxicity

Answer 19

Question 20

Causes of Absorbtion Atelectasis by O2 Toxicity

Answer 20

Decreases Nitrogen in the alveoli: Normally nitrogen not absorbed from the alveoli so keeps alveoli opened.

Question 20

Mechanism of Absorbtion Atelectasis by O2 Toxicity

Answer 20

Patients at particular risk

• More likely to occur in areas distal to partial obstruction of airways, because oxygen is absorbed into blood at a faster rate than it is replaced.

Question 20

Retrolental Fibroplasis in O2 Toxicity

Answer 20

Excessive oxygen to premature infants may result in…

• Constriction of retinal vessels.
• Retinal detachment.
• Endothelial cell damage.
• Possible blindness.

Question 21

Delivery of FiO2 in Nasal canula

Answer 21

24%- 44%

Question 22

O2 Flow Rate in **Nasal canula**

Answer 22

1-6 L/min (The best → 4 L/min)

Question 22

Advantages of **Nasal canula**

Answer 22

- Inexpensive - Well tolerated & Comfortable - Patients can eat & drink - Ideal for patients on long-term oxygen therapy

Question 23

Disadvantages of **Nasal canula**

Answer 23

Question 24

Delivery of FiO2 in **Simple face mask**

Answer 24

35% - 60%

Question 25

O2 Flow Rate in **Simple face mask**

Answer 25

5-10 L/min

Question 26

Advantages of **Simple face mask**

Answer 26

- Inexpensive. - Simple light weight easy to apply disposable. - Its FiO2. - Can be used in infants, children & adults.

Question 27

Disadvantages of **Simple face mask**

Answer 27

Question 28

Delivery of FiO2 in **Partial rebreathing mask**

Answer 28

> 60%

Question 29

O2 Flow Rate in **Partial rebreathing mask**

Answer 29

15L/min

Question 30

Advantages of **Partial rebreathing mask**

Answer 30

- Patient can inhale room air through openings in mask if 02 supply is briefly interrupted. - Its FiO2

Question 31

Disadvantages of **Partial rebreathing mask**

Answer 31

Question 32

delivery of FiO2 in **Non-rebreathing mask**

Answer 32

80% - 100%

Question 33

O2 Flow Rate in **Non-rebreathing mask**

Answer 33

15L/Min

Question 34

Advantages of **Non-rebreathing mask**

Answer 34

- Can give high O, concentrations very quickly - Always use when initially assessing an unwell patient

Question 35

O2 Flow Rate in Venturi mask

Answer 35

Question 36

Disadvantages of **Non-rebreathing mask**

Answer 36

Question 37

Advantages of **Venturi mask**

Answer 37

Question 38

Disadvantages of **Venturi mask**

Answer 38

Interfere with eating, drinking & expectoration.

Question 39

Picture of **Venturi mask**

Answer 39

Question 40

Synonyms of **Manual resuscitation bag**

Answer 40

- Bag-Valve Mask (BVM). - Ambu Resuscitator.

Question 41

Delivery of FiO2 in **Manual resuscitation bag**

Answer 41

Up to 100%

Question 42

O2 Flow Rate in **Manual resuscitation bag**

Answer 42

15L/min

Question 43

What does **Manual resuscitation bag** Consist of?

Answer 43

Question 44

Indications of **Manual resuscitation bag**

Answer 44

- Oxygenation & ventilation during resuscitation of patient with Cardiopulmonary arrest & critically ill patients. - Preparation of patient to general anesthesia.

Question 45

Uses of **Manual resuscitation bag**

Answer 45

Provide: - Oxygen - Positive-pressure ventilation To a sealed airway such as a mask, endotracheal tube or tracheostomy tube.