Oxygen therapy Flashcards
What are the factors that will cause a Left shift in Oxyhemoglobin dissociation curve?
DecreasedTemp(hypothermia)
Decreased 2-3 DPG
Decreased (H+)
CO
What are the factors that will cause a Right shift in Oxyhemoglobin dissociation curve?
IncreasedTemp
Increased 2-3 DPG
Increased (H+)
What are the causes of Hypoxia?
Hypoxemia(resp system cant oxygenate)
Impaired Blood Flow(dec Heart)
Dysoxia(tissues cant utilize O2)
What are the causes of Hypoxemia?
Low ambient PO2 Hypoventilation Hb Deficiencies Impaired Alveolar-Cap diffusion V/Q Mismatch Shunts
What are the causes of Dysoxia?
Cellular use of O2 is abnormally decreased
Cyanide poisoning
What are the causes of Normal O2 content but impaired delivery to tissues?
Circulatory failure(shock) Local Reduction in perfusion -clot -stenosis Ischemia MI, Stroke
What are the causes of Physiologic Shunt?
Anatomic(BF doesn’t participate in gas exchange)
-R=>L Shunt
DOESNT RESPOND TO O2 THERAPY
Alveolar Shunts(Areas of poorventilation) -Pneumonia, COPD, atelectaisis
What are the causesof Physiologic Dead Space?
Anatomical: Conducting airways
Alveolar: Inc ventilation/poorly perfused alveoli
What are the physiologic Effects of Hypoxia?
Pulm vasoconstriction Inc CV workload Harmful effects on Myocardial Funct Impaired renal function Cerebral vasodilation, Inc cerebral BF Anaerobic Mets, LA accumulation, metabolic Acidosis
What are the CLinical Objectives in Oxygen therapy?
Correct Hypoxemia
(Adults/kids SaO2
What is the pathological response to Oxygen therapy?
Damage Capillary Endothelium
Thickening of alveolar-cap membrane
Alveolar Exudate and Consolidation causing physiological shunting
Pulm fibrosis and HTN at end stage
What Disease staes are caused by Oxygen tharapy?
O2 induced hypoventilation
Retinopathy of Prematurity
Absorptive Atelectais(N2 replaced with O2)
What are the different forms of Oxygen monitoring?
Pulse Oximetry
Arterial Blood Gas
Capillary Sampling
What are indications of Oxygen therapy?
Air Embolism
CO poisoning
Wound therapy
What are the complictions of Hyperbaric O2 therapy?
Barotrauma caused by high pressure
CNS, Pulm complications caused by O2 toxicity
What are the different Forms of delivery of O2 therapy?
Low flow systems -nasal cannula -simple mask -partial/non rebreather with reservoir High Flow Systems -Venturi mask -aerosol mask Enclosures -Tents and hoods -Isolettes
Waht are the Pros/Cons of Nasal Cannula?
Comfotable
Low cost
Mobility
Mouth breathing ok
Cant do High O2
Requires adequate vent pattern
What are the Pros/Cons of the Simple O2 mask?
Overflow valves if flow rate too high
Higher inspired O2
WOnt dry Mucous membranes
Interferes with eating/talking
Irritating to face
Var FiO2
What are the Pros/Cons of the Partial Rebreather Mask?
Higher FiO2
Better gas reserve
Requires tight fit
Not practical for long term therapy
Remove for eating/talking
!!! Keep reservoir filled!!!
Monitor ABG
Keep good seal
What are the Pros/Cons of the Non-rebreather mask?
Good for short term
Similar to partial rebreather
Higher potential for O2 Tox
What are the Pros/Cons of the Venturi mask?
Delivers exact FiO2
FiO2 independant of vent rate
Interferes with eating/talking
Condensation
Needs to fit well!
What are the Pros/Cons of the Aerosol mask?
Humidification and heat
Port Can control FiO2 28%-100%
Water can build up in tubing
Heater malfunction
