Oxygen Therapy

Question 1

Oxygen Therapy

Answer 1

Patients exhibiting signs and symptoms of hypoxia require supplemental oxygen
Use pulse oximetry as well as clinical observation to gauge the patients need for oxygen

Question 2

Indications

Answer 2

• Symptomatic cardiac problems w/ dyspnea
• Respiratory problems
• ALOC
• Seizures
• Severe trauma
• Signs of shock or hypoperfusion
• Signs of hypoxia - pallor, cyanosis, aloc
• Carbon monoxide (CO) and other toxic exposures

Question 3

Delivery Devices

Answer 3

Nasal Cannulae (NC) @ 2-4lpm [O2 24-44%]

Standard Mask @6-15lpm [O2 40-60%]

Non-rebreather mask (NRB) @8-15lpm [O2 80-95%]

Bag Valve Mask (BVM) @15lpm [O2 100%]

Question 4

Pulse Oximetry

Answer 4

Use the pulse oximeter on any patient whom you would consider administering oxygen

Question 5

Pulse Ox - standards

Answer 5

• Ensure the pulse ox is clean, in working order and the finger probe is attached
• check the batteries or main lead (oximeters are self calibrating)

Question 6

Pulse Ox - Inspect the pt’s hands // as they can adversely affect the reading

Answer 6

• Nail polish, especially blue, green or black - all nail polish should be removed prior to measuring pulse oximetry
• Synthetic nails - these should be removed
• Dye on fingers - i.e nicotine stains may also affect the readings
• Cold hands, raynauds disease, poor peripheral circulation
• Excessive motion - i.e patients w/ marked tremor

Question 7

Pulse Ox - use

Answer 7

• Determine the patients baseline SpO2 reading on room air

- Admin supp O2 if indicated - target O2 sats is 95%

Question 8

Pulse Ox - monitor

Answer 8

Any significant change in pulse rate on the oximeter should be verified w/ a manual pulse check

• Record the oximetry findings, along w/ flow-rate and method of O2 delivery

Question 9

Pulse Ox - troubleshooting

Answer 9

• Check to see if there is pulsatile blood flow registered by the probe (most oximeters have a way of indicating this).
• Reattach the probe, or change its location.
• Avoid bright light on the sensor. “Shade” the probe with a blanket or sheet if necessary to get a reading.
• A cold, vasoconstricted finger may give unreliable readings. Place the probe on another site if necessary.
• Check for excessive movement (tremor, seizure activity). Stabilize the site to get a reading
• Ask if the patient has a known cardiac arrhythmi

Question 10

Pulse Ox - notes

Answer 10

Assess the patient.
Do the primary survey. Obtain vital signs.
Assess the rate and quality of respirations.
DO NOT RELY on the oximeter signal to accurately determine the pulse rate.
Palpate the patients pulse for rate and quality.