Oxygen Flashcards
What is oxygen?
Tasteless, colourless and odourless gas
Accounts for about 21% of the atmosphere
Essential for most chemical reactions in the body
In the pre hospital setting it is a POM (prescription only medication). Need to have a reason to give this oxygen, can’t just give it to a patient because they ask for it. Need to check stats first etc or if life threatening.
Actions of oxygen
Essential for cell metabolism
Supplemental oxygen helps to reverse hypoxia
If ventilation (filling lungs with air) is inadequate or absent, assisting or completely taking over the patients ventilation is essential to reverse hypoxia.
Oxygen cylinders
Medical oxygen is supplied in cylinders or all white with oxygen written on it.
Black body with a white cylinder/shoulder
Large cylinders hold 2130 litres of oxygen
Portable cylinders hold 610 litres of oxygen
Regulators reduce the pressure of the cylinders from about 4300 PSI to about 60 PSI
About oxygen cylinders
Oxygen behaves differently to air, compressed air, nitrogen and other inert gases.
Very reactive
Pure oxygen at High pressure, such as from the cylinder, can react violently with common materials such as oil and grease. Nearly all materials including textiles, rubber and even metals will burn vigorously with oxygen.
Medical gases
Uk paramedics carry two medical gases - oxygen and entonox (analgesic mixture of nitrous oxide and and 02)
Medical gases - the law
The health and safety at work act 1974
And…
Medical gas cylinder safety
Keep valves and fittings free from oil and grease
Handle with care
Keep clean and dry and away from extremes of temperature
Open and close valve slowly
Checks before handling
Make sure your hands are clean and alcohol based hand gel has evaporated
Clean and free from damage
Keep away from naked flames, combustible materials, sources of ignition.
Preparing new oxygen cylinder for us
Check it is the correct gas
Check expiry date on the batch
Make sure the contents gauge is in the green zone indicating it hasn’t been used
Remove tamper evident seal when using for first time.
Ensure the flow sector on top of the cylinder is set to zero and hand flow is off.
…
Adiabatic compression
Always ensure the cylinder hand wheel is opened slowly
The flow sector must be set to zero before opening the handwheel
Little bits inside cylinder break off and go into oxygen and into regulator. As it hits regulator it will spark.
Avoiding the risk of fire
Windows open if you can, be careful in confined spaces
Don’t smoke
Don’t refuel vehicle with patient on board and when oxygen is in use
Keep cylinders secure
Don’t let them roll about, store in vehicle correctly.
Don’t leave in sight as can get robbed
Pulse oximetry and administration of oxygen
Pulse oximetry (SP02)
Put the cable on top of the finger not underneath.
Then will give you a number
Measures saturation of oxygen within your bed blood cells as a %
Non COPD patient you want a reading of 94-98%
COPD patients - 88-92%
Can be used for Adults and children
Pulse oximetry false readings
May occur due to
Poor peripheral perfusion e.g. Cold weather
Incorrect sensor application
Movement e.g. shivering
Highly calloused skin
Nail varnish, dirt, oil, grease
False key high readings may occur in cases of carbon monoxide poisoning
Oxygen is a treatment for hyoixaemia not breathlessness
This is why we use the SP02 monitor
