MANAGEMENT Flashcards
also known as supplemental oxygen,
is the use of oxygen as medical treatment. Acute
indications for therapy include hypoxemia and carbon
monoxide toxicity.
Oxygen therapy,
administration of oxygen at concentrations
greater than in ambient air with the intent of treating or preventing the
symptoms and manifestations of hypoxia.
oxygen therapy
Goal of O2 Therapy
Goal: The overall goal of O2 therapy is to maintain adequate tissue oxygenation while minimizing
cardiopulmonary work.
Objectives of O2 therapy
Correct documented or suspected acute hypoxemia.
Decrease symptoms associated with chronic hypoxemia.
Minimizing cardiopulmonary workload.
*Easiest objective to attain and measure
*By raising alveolar and blood levels of oxygen
correcting hypoxemia
Decreasing symptoms of hypoxemia
*Supplemental oxygen can help relieve symptoms of associated with certain lung disorders.
*It lessens dyspnea and work of breathing
*Improve mental function
Cardiopulmonary System will compensate for Hypoxemia by:
- Increasing ventilation and cardiac output.
- Increasing work of breathing.
- Increase cardiac output.
- Increase workload on the right side of the heart.
Basic ways to assess the need of Oxygen Therapy
- Laboratory Measures
- Clinical Problem or Condition
Indications of O2 Therapy
- PaO2 < 60 mmHg or SaO2 < 90% in subjects breathing room air
- PaO2 or SaO2 is below desirable range for a specific clinical situation
- Acute care situation (hypoxemia is suspected)
- Severe trauma
- Acute Myocardial Infarction
- Short term therapy / surgical intervention
Oxygen toxicity can occur with :
Fio2 —— longer than 36 hrs
Fio2——-longer than 24 hrs
Fio2——-longer than 12hrs
> 60%,>80%,>100%
Possible complications in O2 Therapy
- Atelectasis
- O2 toxicity
- Retinopathy or Prematurity (in infants)
- Respiratory depression
- Reduce mucociliary activity
- Bacterial contamination
Methods of dispensing oxygen
Piped in
Cylinder
Oxygen concentrator
Calculating how long cylinder content will last:
Minutes remaining in cylinder= Cylinder pressure x cylinder factor over Flow Rate
To convert min to hour, divide the final answer to
60
CYLINDER SIZE VOLUME/ CYLINDER FACTOR
D
E
G
H
K
D 0.16 L/psig
E 0.28 L/psig
G 2.41 L/psig
H 3.14 L/psig
K 3.14 L/psig
What are the oxygen delivery devices?
Low-flow Delivery Systems
Reservoir Delivery Systems
High-flow Delivery Systems
Enclosure Delivery Systems
provides oxygen at flow of 8lpm or less
Low-flow Delivery Systems
Examples of low flow delivery systems
- NASAL CANNULA
- NASAL CATHETER
- TRANSTRACHEAL CATHETER
Flow that equal or exceed the patient’s peak inspiratory flow
High flow delivery systems
examples of high flow delivery system
- Air- Entrainment Mask
- Air- Entrainment Neblizer
- High- Flow Nasal Cannula
DELIVERS MODERATE TO HIGH FiO2
Reservoir delivery system
examples of reservoir delivery system
Simple mask, Reservoir Cannula, Partial re- breathing mask, Non- re- breathing mask
Completely Enclosing the patient
from the outside environment
enclosure delivery system
Enclosure delivery syste examples
Oxygen Tent, Oxygen Hood
A PLASTIC DISPOSABLE DEVICE CONSISTING
OF TWO TIPS OR PRONGS 1 CM LONG
CONNECTED TO OXYGEN TUBING
nasal cannula
FiO2 of nasal cannula
24—40% LPM
Flow of nasal cannula
1⁄4 - 8Lpm ( adult)
2 LPM ( CHILD)
is a soft plastic tube with several small holes at the tip
that is inserted by gently advancing it along the floor of
either nasal passage and visualizing it just behind and
above the uvula.
rarely used device
Nasal catheter.
used for limited, short-term O2 administration during
specialized procedures such as a bronchoscopy.
It should be replaced with a new one (placed in the
opposite naris) at least every 8 hours.
nasal catheter
is a thin polytetrafluoroethylene (Teflon) catheter
inserted into the trachea between the second and
third tracheal rings, secured by a chain necklace.
Compared with a nasal cannula, a transtracheal
catheter needs approximately half of the O2 flow to
achieve a given PaO2
however, transtracheal O2 therapy can pose serious
problems and risks and these devices are not currently
in widespread use.
transtracheal catheter
Low to medium concentration of O2
PATIENT exhales through ports on sides of
mask
Should not be used for controlled O2 levels
simple oxygen mask
O2 flow rate- 6 to 8L
Can cause skin breakdown; must remove to eat.
simple oxygen mask
Consists of mask with exhalation
ports and reservoir bag
Reservoir bag must remain inflated
O2 flow rate - 6 to 10L (FIO2=60%-
80%)
partial rebreathing mask
has 3 undirectional valves, to deliver 100% O2 bag should be remained inflation
6 to 15 L PM
(FIO2=80%-
100%)
non rebeathing mask
characteristics of AED
- AMOUNT OF AIR ENTRAINED VARIES
DIRECTLY WITH SIZE OF THE PORTS AND
VELOCITY OF O2 AT JET. - THEY DILUTE OXYGEN SOURCE WITH AIR
- THE MORE AIR THEY ENTRAIN, THE HIGHER
IS THE TOTAL OUTPUT FLOW BUT THE LOWER
IS DELIVERED FiO2
2 most common air- entrainment system are:
1.Air- Entrainment Mask ( Venturi Mask)
2. Air- Entrainment Nebulizer
Venturi or Air-Entrainment Mask
*50% –
*40% –
*35% –
*31%;
*28% –
*24%
- green;
- red;
- yellow;
is orange; - – white;
- is blue.
FiO2 Range: ———
24%-50%
Flow meter setting
typically from 10-15
LPM; should provide an
output flow of at least 60
LPM.
Delivered FIO2 ranges
from 0.28 to 1.0.
Air Entrainment nebulizer
Types of
Air-Entrainment
Nebulizer
Interfaces
covers only
the head of the infant
* O2 is delivered to hood
through either a heated
entrainment nebulizer or a
blending system
oxygen hood
- Fixed performance device
Fio2 - 21-100% - Minimum Flow > 7/ min to
prevent CO2 accumulation
oxygen hood
evaluation
Breathing pattern regular and at normal rate
pink color in nail beds, lips, conjunctiva of eyes.
No confusion, disorientation, difficulty with cognition.
Arterial oxygen concentration or hemoglobin
Oxygen saturation within normal limits.
documentation
Date and time oxygen started
Method of delivery.
Oxygen concentration and flow rate.
Patient observation.
Add oronasal care to the IF ITS DONE
