Oxygen Therapy Flashcards
How long can a person last without O2?
4-6 minutes before irreversible brain damage
Without O2 what happens to cellular metabolism?
Cellular metabolism ceases and eventually death will occur
What is the function of the respiratory system?
The exchange of oxygen and carbon dioxide between the external environment and circulatory system of the body
What are the major features of the lungs?
Bronchi, bronchioles and alveoli
What are the alveoli?
Microscopic blood vessel-lined sacs in which oxygen and carbon dioxide are exchanged
What is the pleural cavity composed of?
The layers of the membrane lining the lung and chest cavity
What is the radiographers role in O2 therapy?
Radiographer must be ready to respond to potentially dangerous changed in the patient’s respiratory condition
What should the radiographer reposition O2 equipment?
When the tubes could potentially cause artifacts on the image or become superimposed over anatomy
How should a radiographer ensure O2 therapy doesn’t become a source of infection?
Making sure the equipment is single use only and discarded after use
Under what conditions should O2 equipment be completely removed from patients?
Under NO circumstance should it be completely removed by radiographers
What are the pulmonary functions?
The lungs ability to exchange O2 and carbon dioxide efficiently
How is oxygen transported to the body tissues?
Through arterial blood
What are Arterial Blood Gases (ABG’s)?
Lab values that measure the arterial blood concentration of oxygen, Co2, pH and other gases
What condition is demonstrated by inadequate levels of arterial blood gases?
Hypoxemia
What is hypoxemia?
A condition of insufficiency of oxygenation of the blood
What is hypoxia?
Deficiency in the amount of oxygen reaching the tissues
What are signs of Hypoxia?
- Rapid pulse
- Rapid and shallow respirations
- Dyspnea
- Cyanosis
What tissues are the most sensitive to hypoxia?
Brain, Heart, Lungs and Liver
What is the average rate of respiration for adults?
12-20 breaths/min
What is the average rate of respiration for children?
20-30 breaths/min
What is the average rate of respiration for infants?
30-60 breaths/min
What are decreased respirations classified by?
Less than 10 breaths/minute
What can decreased respirations cause?
Cyanosis, confusion, apprehension, restlessness and loss of consciousness
What is the goal of O2 therapy?
To maintain adequate tissue oxygenation while minimizing cardiopulmonary work
What are the 4 indications for O2 therapy?
- Correct hypoxemia
- Reduce respiratory distress
- Minimize cardiopulmonary workload
- Compensate for hypoxia
How can oxygen be supplied to a patient?
Via O2 tanks or wall delivery systems
Who’s consent should you receive to temporarily remove oxygen equipment?
Consent and supervision should come from a MD or attending nurse
Why is oxygen considered a drug (medication)?
Because it must be prescribed by a MD
How is oxygen prescribed?
Prescribed as either a percentage or a fraction
- 26% or .26
What will happen if oxygen is given at 100%
It will cause damage to the lungs
What is the saturation of oxygen hemoglobin called?
SAO2
How is the flow rate of oxygen measured?
In LPM (liters per minute)
What is the standard oxygen flow rate?
3-5 LPM
What happens to O2 when oxygen flow rates are high?
They’re humidified to prevent excess drying of the mucosa
When positioning a patient how should tubes be taken care of?
Avoid bending or pinching the tubes to reduce oxygen flow
What two things should never be done around oxygen therapy?
- No smoking
- Be careful not to produce sparks with x-ray equipment
Is oxygen flammable or combustible?
Combustible
What percentage of atmospheric gas does oxygen make up?
21%
How can oxygen be described physically?
Colorless, tasteless and odorless gas
What are the two regulator valves that are part of portable O2 tanks?
- Valve that indicates how much O2 is left in the tank
- Valve that displays the rate of flow
How do physicians order O2?
- Specified liter flow per minute
- Concentrations of oxygen (%)
- Method of delivery (facemask)
What is a pulse oximeter?
A noninvasive photoelectric device that measures oxygen saturation of the hemoglobin in arterial blood
Where are pulse oximeter attached?
The finger or earlobe
What are the normal levels of oxygen saturation (SAO2)?
Between 95-100%
What SAO2 value is considered life threatening?
Levels less than 70%
What can the pulse oximeter detect before symptoms arise?
Hypoxia
What is oxygen transported by in the blood?
Hemoglobin
What is hemoglobin a major component of?
Red blood cells
How is oxygen delivery method determined for patients?
Depended on the patient’s needs
What are the two types of O2 devices?
Low flow and high flow devices
What are low flow devices also called?
Variable performance devices
What are high flow devices also called?
Fixed performance devices
Why are high flow delivery devices also called fixed performance devices?
Because the amount of concentration of O2 breathed in by the patient will not change according to their breathing patterns
What do high flow delivery devices provide to the patient?
Entire inspiratory volume
Why are low flow delivery devices called variable performance devices?
Because the percentage of O2 the patient receives will change with their breathing pattern, respiratory rate and depth of respiration
What do low flow delivery devices provide to the patient?
Only part of the inspiratory concentration as it’s dilated by room air
Which type of O2 delivery device should be used for patients with chronic COPD?
Low flow delivery device
What is an O2 nasal cannula?
A low flow device that is inserted into the nose to deliver O2 to the patient
How long can cannulas be used for oxygen therapy?
Short term or Long term use as they don’t obstruct the mouth
What is a usual flow rate for nasal cannula?
1-4 LPM at approximately 24-36%
Why are flow rates higher than 6 not used with nasal cannula?
Because it causes severe drying of the nasal mucosa and sinus pain
What are the 5 other types of oxygen masks?
- Simple oxygen mask
- Partial rebreather mask
- Non-rebreather mask
- Aerosol mask
- Air-entrainment mask
What is a simple oxygen mask?
A mask shaped to fit snugly over the patients mouth and nose that is secured in place by a strap
What is a simple oxygen mask?
A mask shaped to fit snugly over the patients mouth and nose that is secured in place by a strap
How long should simple oxygen masks be used?
For short term use only, as they become hot, uncomfortable and prevent the patient from eating/drinking while its on
What are the standard flow rates for simple oxygen masks?
Flow rates over 5 LPM that can be delivered at 35-60% oxygen
What is a non-rebreather mask?
An O2 mask with a reservoir bag attached to a one-way valve that prevents exhaled air from being re-breathed
What are features of non-rebreather masks?
Provide the highest concentration of oxygen and are the most precise mean of oxygen administration
What is a partial rebreather mask?
Similar to a non-rebreather mask in that it has a reservoir, but it does not contain a one-way valve
What is an aerosol mask?
O2 mask that is used when high concentration of O2 and humidity are needed
How does an aerosol mask work?
It’s attached to a bottle of distilled water to provide the high concentrations of humidity
What are the standard flow rates of aerosol masks?
Flow rates less than 6 LPM and O2 concentrations between 21-100%
What is an air-entrainment mask?
An O2 mask that provides an accurate source of maintaining O2 concentrations
What are the O2 concentration values of an air-entrainment mask?
24%, 28%, 35%, 40% or 50%
What is an oxygen tent?
O2 delivery device that is used when there is need fir humidity and higher concentrations of O2 than the room air
Who primarily uses oxygen tents?
Pediatric patients so that it covers their beds
What is an oxygen hood?
An O2 delivery device only used for infants by covering their head
What O2 concentrations can be delivered by an oxygen hood?
Concentrations between 21-100%
What is a ventilator?
An artificial airway inserted into the trachea and connected to a mechanical device to deliver a preset volume of oxygen therapy at a constant rate
What are mechanical ventilators commonly called?
Respirators
What does mechanical ventilators control?
- Respiratory rate
- Volume
What should be done if ventilator alarms go off during imaging?
Should never be reset or turned off by an RT
What is intubation?
A tube placed in the trachea to establish or maintain an airway
What is an Endotracheal Tube (ET)?
Tube inserted through the nose or the mouth into the trachea to maintain an open airway
Where are ET tubes placed within the trachea?
ET tube terminate 1-2 inches superior to the bifurcation of the trachea
How is correct placement of an ET tube confirmed?
With a CXR
What is a tracheostomy?
A surgical incision in the trachea, right below the larynx
Where does the tracheostomy extend and what is it used for?
Extends to the trachea and is used for long-term airway support
What is a thoracotomy tube?
Chest tube inserted into the pleural space to reduce negative pressure and drain fluid blood
What is a thoracotomy tube also known as?
Intra-pleural or chest tube
What happens if the lung pressure falls too low?
The lung will collapse
What does a chest tube setup entail?
Consists of a rubberized tube, which is sutured in place and connected to a drainage system
What conditions are chest tubes used to treat?
- Pneumothorax
- Hemothorax
- Pleural Effusion
- Empyema
What is a pneumothorax?
A collection of air in the pleural space
What is a hemothorax?
A collection of blood in the pleural space
What is pleural effusion?
An abnormal collection of fluid in the chest
What is pleural effusion?
An abnormal collection of fluid in the chest
What is empyema?
A lung abscess or pus in the pleural space
What is thoracentesis?
A surgical puncture of the chest for the removal of air or fluids
What is parenteral?
Introduction into the body by route other than the digestive system
What is atelectasis?
A collapsed lung or incomplete expansion of the lung/part of lung
What is asthma?
Difficulty breathing by bronchospasm or constriction of the bronchi
What is anemia?
Too few red blood cells or RBCs that contain too little/abnormal hemoglobin and interferes with O2 delivery
What is the procedure for inserting a chest tube?
- Area where the tube is inserted is numbed or patient is sedated
- Tube is inserted between the ribs into the chest and connected to a bottle containing sterile water
- Suction is attached to the system to encourage drainage
- A stitch, or tape is used to keep the tube in place
How long is a chest tube placed in a patient?
Remains in place until the x-ray shows that all the blood, fluid or air has been drained from the chest and lung is fully expanded
What do chest tube insertion sites depend on?
The variety of the substance and location within the lung
How is a chest tube inserted to remove fluids?
Chest tube is inserted at the 5th and 6th intercostal space and laterally to the mid-axillary
Where is a chest tube inserted to remove air?
Higher in the lung apical region, since air rises. Typically at the 2nd or 3rd intercostal space at the mid-clavicular
What must chest tubes be connected to?
A sealed drainage systems that allows one-way drainage and doesn’t allow air from the outside
What is collected in a chest tube drainage container?
Blood and fluids
Where should chest tube drainage containers be placed?
Always below the level of the patient’s chest to prevent back flow
What should be done if a chest tube is accidentally disconnected?
Drainage tube should be clamped close to the insertion site, the wound should be covered with a sterile dressing and you should call for help
What is COPD?
Cardiopulmonary obstructive pulmonary disorder
What is COPD characterized by?
A group of diseases characterized by limited airflow with variable degrees of air sack enlargement and lung tissue destruction
What are the two main COPD disorders?
Emphysema and chronic bronchitis
What is emphysema?
A chronic pulmonary disease characterized by over inflation of the alveolar walls
What are CVP lines?
Central venous catheters or venous access lines inserted into major veins
If a CVP lines is inserted into a peripheral vein what is it referred to as?
PICC line (peripherally inserted central catheter)
What is the ideal location for a CVP line?
In SVC just above the right atrium
What are the clinical applications for CVP lines?
- Drug administration
- Fluid volume management
- Portal for blood analysis and transfusions
- Monitory cardiac pressure
What are the 3 types of CVP lines?
Single, double or multi-lumen
What are common insertion sites of CVP lines?
- subclavian vein
- internal jugular vein
- femoral vein
What is the procedure for suctioning a patient?
Before suctioning patient should be aerated with 5-10 breaths of O2
- Catheter is inserted into the stoma until resistance is met, then removed slightly about 1cm
- While moving the catheter up/down suction should be applied
- Assess the airway by using a stheteschope to listen to breath sounds
- Repeat procedure until the airway is clear
What is the max time suction should be applied to a patient?
No longer than 15 seconds with rest periods in between for the patient
