Mod D Tech 18 Oxygen Therapy Flashcards
What is Oxygen (O2)
- Odourless – can’t smell it.
- Colourless - can’t see it.
- Accounts for 21% of inspired air
- Can be manufactured and stored in cylinders
- Administered to hypoxic patients
- May be used to drive automatic resuscitators
Describe 02 clinder
Oxygen Cylinders
•Ambulance Services typically carry the following cylinders:
–D Size - 340 litres @ 2000 psi.
–CD Size – 610 litres @2000 psi
–F Size - 1360 litres @ 2000 psi.
•They can be identified by their colouring – black body and white collar
OR
•White collar and white body with lettering on the side
Oxygen Equipment - Safety
- Cylinders should be stored under cover, preferably inside, kept dry and clean and not subjected to extremes of heat or cold.
- •Cylinders should not be stored near stocks of combustible materials or near sources of heat.
- •Medical gases containing different gases should be stored on separate shelves. Full cylinders should be used in strict rotation.
- •Medical cylinders should be stored separately from industrial and other non-medical cylinders.
- Cylinders must not be repainted, have any markings or labels removed.
- •F sized cylinders and larger should be stored vertically.
- •No smoking in any area where
oxygen cylinders are in use or
stored.
- Sealing or jointing compounds must never be used to cure a leak.
- •NEVER use excessive force when connecting equipment to cylinders.
- •Cylinder valves and any associated equipment must never be lubricated and must always be kept free from oil or grease.
- Close all valves when the cylinder is not in use, even when it appears to be empty.
- •Secure cylinders as per Service Instructions so that they do not present a hazard during transit.
- •Never place any part of your body over the cylinder outlet valve.
Oxygen Safety - Summary
List
Oxygen Masks
- Simple plastic face mask (medium, vari- or duo- flow)
- •This can deliver up to 60% oxygen concentration depending on the oxygen flow rate.
- •The simple plastic face mask should be used with a flow rate of 6 to 8 litres per minute (or as recommended on packaging) to ensure adequate oxygenation for hypoxic patients.
- •Each mask is sealed in a polythene bag to ensure sterility – don’t open until ready to use.
Oxygen Masks flow rate
Oxygen Masks
Oxygen Masks
• non-rebreathing mask with a reservoir bag.
•
•Oxygen can be provided through a non-rebreathing mask with a reservoir bag.
•
With an oxygen flow rate sufficient to keep the bag inflated (10 – 15 litres/min) a high concentration of oxygen can be delivered
Oxygen Masks
Nasal Cannulae amount
Nasal Cannulae (2-6 litres per minute)
Therapy Face Masks
Nebulisation used for
Nebuliser masks are used to administer medication in the form of a mist inhaled into the lungs.
In-line Nebulisation
The new UK Ambulance Service Clinical Practice Guidelines (2013) identify near fatal asthma to be managed with positive pressure ventilation using a nebulizing T piece.
In-line Nebulisation
VR1 Resuscitator
intended use
Oxygen Equipment – Use
•Position the patient and gain consent for the use of oxygen therapy.
•
•Turn the flow control knob anti-clockwise until the desired flow rate is achieved.
•
•Secure the mask to the patient’s face.
•
- Document the use of oxygen on the PRF / ePRF
- When you are ready to stop giving oxygen shut off the flow control knob until the litre flow is at zero.
•
•Do not leave a mask on a patient if no oxygen is being administered.
•
•Shut off the main cylinder valve by turning it clockwise.
Oxygen Indications
Children
•Significant illness and/or injury
•
Adults
- Critical illness requiring high levels of supplemental oxygen
- Serious illness requiring moderate levels of supplemental oxygen if the patient is hypoxaemic
- COPD and other conditions requiring controlled or low dose oxygen therapy
- Conditions for which the patient should be monitored closely but oxygen therapy is not required unless the patient is hypoxaemic
Hypoxic Drive!?
- Normally respiration is driven by the levels of CO2 in the blood
- In a person with compromised gas exchange (COPD, chronic bronchitis) the body gets used to high levels of CO2 and so no urge to breathe.
- For these individuals it is the lowered Oxygen level that triggers the urge to take a breath
- If these patients are given even moderately high levels of oxygen therapy, respiratory depression may be caused in turn leading to respiratory arrest
- Give 28% oxygen via venturi mask or patients own mask.
Oxygen Alert Card
