Oxygen Therapy Flashcards
What is the percentage of all patients in hospital on any given day that uses oxygen?
40%
Is oxygen regarded as a drug?
Yes it should be prescribed.
If it is given at inappropriate concentrations or flow rate it can have fatal consequences.
It is always prescribed incorrectly.
Name of the council
British thoracic society (BTS)
- Respiratory
When is oxygen indicated?
Patients who have hypoxemia
- severe asthma
- PE
- pneumonia
- fibrosis alveolitis
Establish reason for hypoxia and treat the underlying cause
For example; anaemia, LVF,
Cancer - airflow obstruction, infections, pleural effusions.
What are the dangers of giving too much oxygen?
Hypercapnia (high pCO2) high carbon dioxide
T2 respiratory failure - COPD, severe chronic asthma, bronchiectasis, CF. Chest wall disease e.g. Kyphosis, neuromuscular disease, obesity hypoventilation.
Can cause people to become acidotic.
Should we give oxygen in MI/ischemia
No - only if they are hypoxic.
It can cause free radicals which causes further myocardial damage
What are target oxygen ranges?
94-98% - normal
88-92% - pt high risk of respiratory failure e.g. COPD
SaO2
SpO2
Arterial blood sample
Via pulse oximeter (over finger)
When might your oxygen sats drop?
During sleep
Elderly
What is a base excess?
mmol of base needed to correct 1 L blood to normal pH if patient is acidotic
What is the ideal pH of extracellular fluid?
7.35-7.45
This is maintained both by renal and respiratory systems.Respiratory mechanisms kick in a lot quicker than the renal.
pH <7.35 and high PaCO2 this means….
respiratory acidosis
pH >7.45 and a low PaCO2 this means….
respiratory alkalosis (hyperventilating and closing off a lot of CO2)
Normal pH, high PaCO2 and high HCO3 (bicarbonate) this means….
fully compensated respiratory acidosis or metabolic alkalosis (something wrong with the renal or respiratory system) Patient s retain carbon dioxide and the kidneys have kicked in to retain bicarbonate to neutralise the pH. for example by taking an overdose (retained high levels of bicarb and resp rate will drop to reduce to rate of carbon dioxide and neutralise the effects of the bicarb)
