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Principles and Practices of Resp Therapy 1 > O2 Delivery Devices > Flashcards

O2 Delivery Devices Flashcards

1
Q

How do we assess patient response to O2 therapy

A

ABG

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2
Q

Nasal Cannula

A

Low Flow System, flow .25-6LPM, FiO2 24-45%, uses humidifier > 4LPM, special rules- decrease in FiO2 increase minute volume, add humidity

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3
Q

Simple mask

A

Low flow, flow range- 5-10 LOL, FiO2- 35-50%, needs humidity, special rules- needs minimum 5LPM to flush CO2 from mask (has no bag, has small bore tubing)

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4
Q

Air-entrainment (venturi-mask)

A

High flow, 10LPM, FiO2- 24-50%, no humidity, speaks in terms of FiO2 (has variable air to O2 ratio. Gives exact FiO2)

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5
Q

Partial rebreather (emergency mask)

A

Low flow, 10LPM, FiO2-40-70%, no humidity, rule- keep reservoir inflated, some CO2 goes back in bag some out of mask

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6
Q

Non-rebreather (emergency mask)

A

Low flow, 10LPM, FiO2- 60-80%, no humidity, one way valve between mask and bag expiratory gas goes outside of mask

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7
Q

Two long pieces of large bore tubing

A

8-10 links for cutting

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8
Q

Drain Bag

A

Catches condensation

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9
Q

Trach collar (TC)

A

Smiley face sits up. Used on trachs

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10
Q

Face tent

A

Used on patients with facial trauma or claustrophobia.

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11
Q

Aerosol Mask

A

Has no tubing. FiO2 28%

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12
Q

Briggs T adapter

A

Green T. Way to provide humidity and O2 to someone intubated (test to see if they can come off ventilator)

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13
Q

Oxygen Analyzer

A

Validates FiO2

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14
Q

Total flow

A

Magic box

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15
Q

hypoxemia

A

low ambient 02, hypoventilation, ventilation-perfusion mismatch, shunt, or diffusion defect

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16
Q

Hypoxemia numbers

A

decreased PaO2 less than 60mmhg or SpO2 bellow 90%

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17
Q

Hypoxemia occur from

A

severe trauma, acute myocardial infarction, short-term therapy or surgical intervention

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18
Q

Pulse Oximetry measures

A

SpO2

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19
Q

Arterial blood gas measures

A

PaO2

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20
Q

CO- oximetry measures

A

SaO2

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21
Q

Uses Spectrophotometry

A

SpO2 (pulse oximeter %), SaO2 (arterial blood draw)

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22
Q

SaO2

A

arterial blood draw= analysis through co-oximeter= distinction between 4 absorption wavelenths

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23
Q

SaO2 4 wavelengths

A
  1. oxy-hemoglobin, 2.Carboxyhemoglobin, 3. Methemoglobin, 4. Reduced Hemoglobin
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24
Q

Limitations to Pulse Oximeter

A

Poor perfusion to sample site, motion artifact, abnormal hbg, intravascular dyes, dark nail polish, light

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25
Q

CO poisoning

A

can run a venous sample through the co-oximeter to get carbon monoxide % value- wrong value

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26
Q

Complications and hazards of O2 therapy

A

Supplemental O2 shouldnt be used as a subsitute for ventilation, Supplement O2 is relatively benign drug, Oxygen toxicity, Nitrogen washout atelectasis, Oxygen-induced hypoventilation, ROP

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27
Q

Goal of RT during O2 therapy

A

use the minimum concentration required to achieve adequate tissue oxygenation

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28
Q

Oxygen toxicity defined as

A

cellular injury of lung parenchyma and airway epithelium

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29
Q

O2 Toxicity occurs when

A

24 to 48 hours at an FiO2 of 1.0. They include hypoxemia caused by right to left shunting from atelectasis, decreased lung compliance, and infiltrates on chest radiograph that reflect the cellular pathology

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30
Q

exposure of FiO2 of 1.0 longer than 72 to 96 hours

A

Inflammatory changes, edema, and fibrosis

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31
Q

Absorption atelectasis/ Nitrogen washout atelectasis

A

Absorption atelectasis can occur with high concentration oxygen breathing, secondary to washout of nitrogen from lungs

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32
Q

Oxygen-induced hypoventilation involves

A

the neurologic control of ventilation

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33
Q

Retinopathy of prematurity (ROP)

A

oxygen radicals attack the incompletely developed retinal tissue, resulting in vasoconstriction

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34
Q

complications and hazards of O2 Therapy to babies

A

Neonates with Congenital heart lesions depend on patency of the ductus arteriosus for either pulmonary or systemic blood flow, Many newbors will have profound hypoxia or circulatory collapse as the ductus closes spontaneously

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35
Q

Fire Hazard

A

is a concern when dealing with normobaric oxygen and a major haxard in hyperbaric applications

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36
Q

Variable-Performance devices (low-flow devices) provide

A

variable and approximate FiO2

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37
Q

Fixed-performance devices (high-flow devices) are designed to provide

A

a fixed and known FiO2

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38
Q

Major difference between high and low flow devices

A

high flow device provides such a high flow of premixed gas that the patient is not required to inhale any room air

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39
Q

Nasal Cannula

A

most widely used device for administering low-flow oxygen.

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40
Q

NC flow should be titrated using

A

vital signs, pulse oximetry, and arterial blood gas measurements

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41
Q

Simple mask

A

used when a higher FiO2 is needed than can be attained with a NC ( has small bore tubing)

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42
Q

Parial Rebreathing mask

A

Simple mask with the addition of 300 to 600 mL reservoir bag

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43
Q

Nonrebreathing Mask

A

uses the same basic system as the partial rebreathing mask but incorporates valves between the bag and mask and on at least one of the exhalation ports

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44
Q

Partial and non rebreathing mask deliver

A

precise delivery of FiO2 is required to supply therapeutic levels of O2 and avoid complications

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45
Q

Nasal Cannulas

A

standard, high flow cannula, reservoir cannula, heated high flow cannula

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46
Q

High flow nasal cannula devices

A

are designed to administer higher O2 flows than the standard NC

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47
Q

Large bore tubing attatches to

A

aerosal

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48
Q

Oxyhood

A

supply flow to flush out CO2, analyze as close as possible to baby. water vapor

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49
Q

Dual flow meters

A

the simplest and most economical method of delivery a specific FiO2 and total flow

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50
Q

Air Oxygen blenders

A

provide a convenient, compact device for dialing in specific FiO2

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51
Q

O2 Enclosures include

A

O2 tents and hoods

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52
Q

Hyperbaric Oxygen Therapy is indicated for treatment of

A

Carbon monoxide poisoning, wounds, air embolism, and decompression sickness

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53
Q

Symptoms of hypoxia are

A

Cognitive impairment, cardiac rhythm and conduction (EKG) dysfunction, and renal dysfunction

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54
Q

Monitoring arterial blood gas analysis is standard for

A

documenting oxygenation, ventilation, and acid-base balance

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55
Q

Most common form of continuoulsy monitioring oxygen saturation

A

pulse oximetry

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56
Q

Oxygen analyzers are used to measure

A

the concentration of oxygen administered to patients

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57
Q

RT are frequently asked to integrate patient info and recommend a medica gas therapy by

A

patient assessment, laboratory data, initial concentration of O2, appropriate O2 therapy device

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58
Q

Helium-Oxygen Therapy

A

Use of heliox for some patients with partial upper airway obstruction or asthma, a mask with a reservoir is used. replaces nitrogen with helium

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59
Q

Accordign to Grahams law, heliox

A

diffuses at a rate 1.8 times greater than oxygen (80%helum/ 20% oxygen)

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60
Q

Carbon Dioxide Therapy

A

Several dangerous side effecs, administration devices for CO2/O2 gas therapy include the disposable nonreabreathing mask with reservoir and the well fitted mask with reservoir

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61
Q

Patients on Carbongen therapy must be carefully monitored by

A

pulse, RR, blood pressure, and mental state

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62
Q

Carbogen is

A

5% carbon dioxide in O2

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63
Q

Nitric Oxide Therapy

A

NO is a selective pulmonary vasodilator. Low toxicity

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64
Q

Selective pulmonary vasodilators

A

reduce pulmonary vascular resistance without affectign systemic vascular resistance and affects vascular resistance only near ventilated alveoli

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65
Q

Only FDA approved indication for inhaled NO is

A

Hypoxic respiratory failure of the newborn

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66
Q

Treat Hypoxemia

A

Supplement O2

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67
Q

O2 therapy is used for periperative conditions, and

A

COPD, ARDS, CPR, MI, Pulmonary edema, CO poisoning, and traumatic brain injury

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68
Q

Complications of O2 therapy include…

A

O2 toxicity, nitrogen washout atelectasis, oxygen induced hypoventilation, retinopathy of prematurity, and failure of ductus closure in infants with Congenital heart disease

69
Q

O2 may be limited use for

A

anemia, low cardiac output, or high shunt

70
Q

Low flow Oygen Devices

A

Nasal catheters, NC, Simple mask, partial rebreather masks, nonrebreather mask

71
Q

FiO2 from a low flow device is determined by

A

flow, reservoir volume and patient inspiratory volume

72
Q

High flow O2 delivery systems meet

A

the inspiratory needs of the patient

73
Q

Oxygen enclosed devices

A

hood incubators, tents

74
Q

Hyperbaric O2 therapy is indicated for treatment of

A

Carbon monoxide poisoning, wounds, air emolism, and decompression sickness

75
Q

Oxygen analyzers are

A

polarography or galvanic cells to measure oxygen concentration

76
Q

Heliox

A

is used clinically because of its low density… at 70/30, 8/20 (Helium/ O2)

77
Q

Therapeutic applications of CO2 therapy are

A

limited or controversal

78
Q

Inhaled NO is

A

Selective pulmonary vasodilator

79
Q

Thorpe tube display true flow

A

Yes

80
Q

How much oxygen is in room air

A

21%

81
Q

For every one liter of O2

A

you increase the FiO2 by 4%

82
Q

Tank Pressure measured in

A

PSI

83
Q

Why is duration of flow important

A

how long tank will last

84
Q

Regulator

A

Reduces pressure and provides flow

85
Q

What types of flow meter would you want to use if you needed to place a cylinder on its side

A

bourdon

86
Q

Standard working pressure of all bulk oxygen gas supply systems

A

50 psi

87
Q

Safety relief valve for E tank

A

fussible flug, frangible disk

88
Q

What type of safety relief valve does an H tank have

A

spring loaded

89
Q

How long would an E cylinder with 800 PSI last at a liter flow of 31pm Nasal Cannula

A

800x.28/ 3 = 74.6 = 1 hour and 15 min

90
Q

E cylinder

A

.28

91
Q

H Cylinder

A

3.14

92
Q

SpO2 arrows

A

Pulse oximeter limited spectrophotometry, 92%-100%

93
Q

PaO2 arrows

A

Blood gas analyzer (electrode pressure of O2), ABG, 80-100mmHg, Reflects O2 available to Hgb

94
Q

SaO2 Arrows

A

ABG, Blood gas analyzer with co-oximeter multiple wavelength spectrophotometry, 92%-100%, Reflects oxygen attatched to Hgb (CO levels - smokers/ poor air quality)

95
Q

Hypoxemia is lack of oxygen in the

A

blood

96
Q

Hypoxia is lack of oxygen in the

A

tissue

97
Q

Mild Hypoxemia

A

PaO2 60-80 mmhg

98
Q

Moderate Hypoxemia

A

PaO2 45-59 mmhg

99
Q

Severe Hypoxemia

A

PaO2 below 45 mmhg

100
Q

Regular PaO2

A

80-100mmhg

101
Q

Start on what with NC

A

21% RA (ambient air)

102
Q

PSi

A

Medical gas

103
Q

mmHg

A

BP

104
Q

FiO2

A

Percent of O2

105
Q

Daltons law

A

760= .21(O2) and .79 (N2)…

106
Q

6LPM NC

A

6x4 = 24 + 21 = 45%

107
Q

E-Cylinder PSI, Wall PSI

A

2500 PSI, 50 PSI

108
Q

Compressed air is color coded

A

yellow

109
Q

Helium

A

Rare gas naturally occuring in the atmosphere, it is colorless, transparent, odorless, tasteless, and nonflammable. Doesnt support combustion or lfie

110
Q

NO

A

Colorless, tasteless gas with slight metallic odor. Nonflammable/ non-life supporting gas. Supports combustion and is toxic

111
Q

Nitrogen

A

major component of the atmosphere 78% by volume. responsible for blue color in sky

112
Q

Cylinders filled between

A

2200-2500

113
Q

O2 Color

A

Green

114
Q

Air color

A

Yellow

115
Q

Heliox Color

A

brown-green

116
Q

Helium

A

brown

117
Q

ASSS

A

Larger Cylinders

118
Q

PISSS

A

Smaller cylinders

119
Q

DISSS

A

any pressure that is passed the reducing falve is a diameter index safety system

120
Q

Grab n GO

A

DISS, cant remove, not true flow, 50 psi source

121
Q

Flow restricter

A

what we used on race… similar to bourdon- not gravity dependent and not true flow. Calibrated liter flow- based on diameter of outlet, 50 PSI with pin

122
Q

Reducing valve

A

On regulator

123
Q

Relief valve

A

is on tank opposite side of hole

124
Q

Quick connect is a

A

DISS, at wall 50 PSI

125
Q

Zone Valves

A

Adjusts for maintanence or a fire

126
Q

Liquid Bulk Oxygen

A

Stores O2 in liquid in large tanks for hospital at 50PSI with back up tank

127
Q

Increase O2 will do what to arterial pressure

A

Increase

128
Q

Normal inspiratory flow demand

A

30LPM

129
Q

How do we asscess a patient response to O2 Therapy

A

ABG, Arterial blood (80-100mmHg), analyze- Electrodes (80-100) and co-oximeter normal SaO2 below 92% and below 95%

130
Q

CO poisoning best treated

A

NRB

131
Q

active pt.. SpO2 86% (normal should be higher)

A

Tape NC to their face

132
Q

PvCo2 values

A

35-45mmHg

133
Q

Norm PaCO2 in COPD, and SpO2

A

45-65 mmHg (high), they depend on a hypoxic drive, SpOx 88-92%

134
Q

COPDers

A

Maintain a low O2, to keep them ventilating; they depend on a hypoxic drive

135
Q

What catches condensation

A

Drainbag, cant be 1/3 full

136
Q

Briggs T adaptor

A

way to provide Humidity and O2 to someone intubated

137
Q

Aerosol humidity can be connected to

A

(limits at 12 flow) Aerosal mask, TC, Face tent, Briggs T, Oxyhood (water not aerosal)

138
Q

Donut heater

A

attatches to aerosal humidity tank

139
Q

Meeting patients inspiratory demand?

A

if you see aerosol coming out of resevore tubing

140
Q

Retinopathy of prematurity

A

Premature infants retinal vasoconstriction in the presence of PaO2 less than 80mmhg ( keep between 50-80 mmHg

141
Q

absorption atelectasis

A

nitrogen washout increase FiO2, nitrogen gets pushed out PaO2 close to 700. alveolar space shrinks. obstruction= atelectasis

142
Q

best mask to least

A

NRB, Partial, Simple, Venturi, NC

143
Q

MAP

A

Sys+ dias x 2/ 3

144
Q

MI

A

heart attack, blockage of coronary arteries.. little bit of O2 to improve heart muscle itself

145
Q

EKG

A

1 time reflection of the electricity in heart, views from different angles (12)

146
Q

Small bore tubing vs large bore tubing

A

NC tubing, Aerosal tubing

147
Q

Oxygen/ air blender why

A

air flow and FiO2 are independent from each other.. flush out CO2

148
Q

O2 and air blender where, when, who

A

Ventilators,oxyhood/ tent, in ER, Patients with trachs, endotracheal tube, heated high flow NC

149
Q

How to use O2 blender

A

Connect O2 and air.. have to have 2 psi sources— O2 and air,L flow and FiO2 must be stated

150
Q

Oxygen analyzer

A

Why.. to validate FiO2, where.. Neonate ICU, Who.. babies; anyone, how.. as close to pt as possible

151
Q

Clinical teaching of O2 analyzer

A

directions on back, needs to be calibrated to 100% and 21% FiO2

152
Q

Clinical teachings of Pulse ox

A

measure SpO2 using infared and red light, look for consistant wave from plethysmograph, has high and low alarms

153
Q

Trouble shoot o2 devices (rebreather)

A

have to re inflate the bag on a rebreather, not a high enough flow

154
Q

name 3 different types of oxygen regulators

A

bourdon gauge, thorpe tube, flow restrictor

155
Q

Bourdon gauge

A

fixed outlet supply, pressure regulator is adjustable= flow adjustment

156
Q

thorpe tube

A

displays actual outlet flow, adjustable flow

157
Q

Flow restrictor

A

fixed flow, not adjustable.

158
Q

What two factors influence total flow

A

FiO2 and liter flow (LPM)

159
Q

List in detail the equipment used in a standard continuous aerosal set up

A

thorpe tube- air entrainment large volume nebulizer- large bore tubing- drain bag - large bore tubing - o2 delivery defice

160
Q

how is liter flow limited with a large colume air entrainment nebulizer

A

driving gas inlet or iface diameter that limits. flow continuous aerosal limits at 12 lpm

161
Q

blip

A

bar moves up and down during pulse heart beat

162
Q

Pleth

A

Graph that moves up and down during pulse heart rate

163
Q

1 Liter=

A

25%

164
Q

6 liters=

A

6x4 = 24+ 21 = 45%

165
Q

duration of flow=

A

PSI x tank factor/ LPM (how long tank will last)

166
Q

Produce O2

A

Photosynthesis, fractional distillation of air, electrolysis of H20, Molecular filtration

167
Q

Liquid O2 creates how much more O2

A

4%

168
Q

boiling point

A

Changes liquid to gas at 760mmHg

169
Q

Temp from C to F

A

number x 1.8 + 32

Principles and Practices of Resp Therapy 1 (4 decks)

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