Oxygen and Entonox theory

Question 1

Ventilation

Answer 1

-act of inhaling and exhaling

Question 2

Oxygenation

Answer 2

addition of oxygenation to the blood stream

Question 3

Different types of mask

Answer 3

-Nasal cannula- give 1-4LPM
-Medium flow mask ( simple face mask)- 5-8LPM
-Nebuliser mask- additional chamber to give medication 6-8LPM
-High flow mask (non rebreather mask)- 15LPM to keep bag inflated
-Tracheostomy mask- within ambulance mask set to 15LPM

Question 4

Hypoxia signs and symptoms

Answer 4

Signs
-low SPO2
-cyanosis- blue/ grey skin
-confusion/ agitation
-reduced LOC
Symptoms
-shortness of breath
-anxiety

Question 5

Emphysema

Answer 5

-lung disease that results from damage to the walls of the alveoli in your lungs
-causes chronic reduction in SPO2 readings

Question 6

Limitations of pulse oximeter

Answer 6

Patients- nail polish, poor circulation
Environment- extremes of temperature, bright light
Equipment- battery powered, calibrated

Question 7

SPO2 levels when asleep

Answer 7

-normal to be lower when asleep eg. 91%

Question 8

JRCALC guidelines for critical illness

Answer 8

-administer high flow O2 until vital signs normal
-then titrate to 94-98%

Question 9

JRCALC guidelines for serious illness

Answer 9

-administer initial O2 until reliable SPO2
-then titrate to 94-98%

Question 10

JRCALC guidelines for COPD and other conditions

Answer 10

-administer initial O2 dose until reliable SPO2
-then titrate to 88-92%

Question 11

JRCALC guidelines for conditions not requiring O2 unless hypoxic

Answer 11

-administer initial O2 does until reliable SPO2
-titrate to 94-98%

Question 12

JRCALC guidelines for children

Answer 12

-all children with significant illness or injury should receive high levels of supplementary O2

Question 13

Paraquat poisoning

Answer 13

-extremely rare
-aim SPO2 with 85-88% if hypoxic
-paraquat is an oxygen reacting species, so giving oxygen could worsen situ
-similar for bleomycin poisoning

Question 14

Entonox- what actually is it

Answer 14

-gas and air
-analgesic gas
-50% nitrous oxide
-50% oxygen

Question 15

What we use Entonox for

Answer 15

-moderate to severe pain
-self administered with demand valve
-analgesic wears off rapidly

Question 16

When not to give Entonox

Answer 16

-chest injury and suspected pneumothorax (air in body cavity)
-sever head injuries with impaired consciousness
-decompression sickness (diving)
-disturbed psychiatric patients
-intraocular injection of gas within las 8 weeks
-abdominal pain where intestinal obstruction suspected