Oxygen therapy Flashcards
causes of airway obstruction
CNS depression foreign body (blood, vomit, secretions, food) trauma blocked tracheostomy swelling (infection, oedema) laryngospasm, bronchospasm
causes of breathing porblem
CNS depression causing decreased repsiratory drive
poor/diminished respiratory effort from muscle weakness/pain/restrictive abnormalities
disorders of lung function - pneumonia, pneumothorax, haemothorax, asthma, PE, ARDS, oedema
cause of circulatory problem
primary cardiac –> ischaemia, arrhytjmia, cardiac failure, tamponade, rupture, myocarditis, HOCM
secondary cardiac –> asphyxia, tension pneumothorax, blood loss, hypoxia, hypothermia, septic shock, hyperthermia, rhabdomyolysis
assessing breathing
Look for signs of respiratory distress • Count respiratory rate • Assess depth/quality of breathing • Note chest deformity, raised JVP, abdominal distension • Record FiO2 and SpO2 • Listen near the face then palpate, percuss & auscultate the chest • Trachea position? • Decide upon specific treatments
oxygen flow l/min and FiO2: 1
24%
oxygen flow l/min and FiO2: 2
28%
oxygen flow l/min and FiO2: 3
32%
oxygen flow l/min and FiO2: 4
36%
oxygen flow l/min and FiO2: 5
40%
oxygen flow l/min and FiO2: 6
44%
oxygen flow l/min and FiO2: 7
48%
oxygen flow l/min and FiO2: 8
52%
oxygen flow l/min and FiO2: 9
56%
oxygen flow l/min and FiO2: 10
60%
nasal cannulae flow rate
1-6l/min
hudson mask flow rate
5-10l/min
NRM
12-15l/min
BVM
15l/min + positive pressure
CPAP
1-15L + positive pressure
ventilator
1-15L + invasive positive pressure
blue venturi flow rate and oxgyen delivered
2L/min 24%
white venturi flow rate and oxgyen delivered
4l/min 28%
yellow venturi flow rate and oxgyen delivered
8l/min 35%
red venturi flow rate and oxgyen delivered
10l/min 40%
green venturi flow rate and oxgyen delivered
15l/min 60%
NRBM
15l/min 85%
What criteria do you look at if spontaneous pneumothorax
age>50 and significant smoking history
evidence of underlying lung disease on exam / CXR
what to do if bilateral/ahemodynamically unstable pneumothorax
proceed to chest chain
primary pneumothorax mx if >2cm / breathless
aspiration with 15-18G cannula
primary pneumothorax mx if not <2cm / breathless q
consider discharge review in OPD 2-4 weeks time
secondary pneumothorax >2cm/breathless
chest drain size 8-14
secondary pneumothorax size 1-2cm mx
aspirate with a 16-18G cannula
secondary pneumothorax <1cm
admit with high flow oxygen and observe for 24 hours
what happens if you aspirate a pneumothorax size 1-2cm and it is unsuccessful
insert a chest drain
triangle of safety
lateral border of pec major
mid axillary line
level of nipple
ECG findings PE
sinus tachy S1Q3T3 non specific ST changes RAD s wave (I and aVL) >1.5mm Q wave in III and avf p pulmonale RBBB
