Oxygen therapy and equipment

Question 1

What is hyperoxia and why is it harmful?

Answer 1

Hyperoxia is providing excessive oxygen resulting in high O2 above physiologic normal levels, which may cause harm to patients with myocardial infarction, sepsis, and intracerebral catastrophes

Question 2

What should be done if hypoxia is suspected in a patient?

Answer 2

Use pulse oximetry to assess oyxgen saturations and treat accordingly. If unable to check oxygen saturations quickly, provide oxygen and titrate the flow rate once the patient improves.

Question 3

Why is continuous oxygen administration important?

Answer 3

The body can’t store oxygen, so it must be administered continuously if required

Question 4

What precautions should be taken with patients having decreased levels of consciousness when administering oxygen?

Answer 4

Never leave them alone with an oxygen mask secured to their face, as they might aspirate if they vomit

Question 5

What should be done for a patient showing marked respiratory distress

Answer 5

Provide supplemental oxygen at a flow of 10 Lpm until oxygen saturations are normal and consider switching to a nasal cannula if the supply is limited or the patient becomes less distressed.

Question 6

What are the signs of impending carbon dioxide narcosis in COPD patients?

Answer 6

Slowing of the respiratory rate, sleepiness, confusion, and decreasing level of consciousness.

Question 7

List the indications for the use of oxygen

Answer 7

• Respiratory/cardiac arrest
• Hypoxic patient
• Shortness of breath
• Shock
• Cardiovascular
  /respiratory illness
• Inadequate respiration
• Decreased consciousness
• Pregnant trauma patients
• Medical air evac patients
• Decompression illness
• Potential carbon monoxide/toxic smoke inhalation

Question 8

What are the key safe handling practices for oxygen therapy equipment?

Answer 8

1. Avoid oil/grease
   2, Prohibit smoking/open flames near oxygen
2. Secure cylinders
3. Store in a cool/ventilated area
4. Use proper regulators/gauges
5. Handle cylinder valves carefully

Question 9

What materials are oxygen cylinders typically made from and how are they connected?

Answer 9

They’re made of seamless steel or lightweight aluminum/carbon-fiber. Connected via medical-post type or threaded type with a hand valve.

Question 10

How is cylinder duration calculated?

Answer 10

Duration (T) = k x (P-R) / F where k is the tank constant (0.16 for D, 0.28 for E, 3.14 for K), P is the tank pressure in PSI, R is safe residual pressure (200 PSI) and F is flow rate in Lpm

Question 11

Describe the function of a regulator in oxygen therapy

Answer 11

Reduces cylinder pressure to a safe working pressure. Can be one-stage or two-stage and connects to cylinders via yoke assembly or hand valve assembly

Question 12

What sizes of oxygen cylinder are you most likely to use as an OFA attendant?

Answer 12

D (14.5 cu. ft)
E (26 cu. ft)
K (249 cu. ft)

Question 13

What do the pressure gauge and flowmeter indicate?

Answer 13

The pressure gauge shows the amount of compressed oxygen in the cylinder in PSI, while the flow meter shows the rate of oxygen flow in Lpm

Question 14

What is the nasal cannula and how is it used?

Answer 14

A nasal cannula is an oxygen-delivery method consisting of a flexible clear plastic tube that connects to two smaller tubes at one end. These smaller tubes form a loop, with two 1cm long hallow prongs placed into the nostrils. The loop is placed over the patient’s head, with each side above the ears. The other end connects to a regulator and oxygen cylinder. Oxygen passes through the tube into the nostrils as the patient breaths, providing oxygen at flow rates of 1-5 Lpm, with concentrations varying between 24-44$. Higher flow rates may cause discomfort and dryness.

Question 15

What are the advantages and limitations of using a nasal cannula?

Answer 15

Advantages: Greatest freedom for movement and talking
Limitations: Flow rates above 5 Lpm may cause discomfort, drying of nasal passages, and nosebleeds

Question 16

What is a simple face mask and how is it used?

Answer 16

A simple face mask is a formed clear plastic unit with soft sides that cover the mouth and nose, connecting to a flexible plastic tube that links to a regulator and oxygen cylinder. An elastic strap holds the mask on the patient’s face. Perforations in the mask allow excess oxygen and exhaled CO2 to escape. Flow rates greater than 6 Lpm ensure CO2 washout. Oxygen concentrations vary between 30% at 6 Lpm and 60% at 10 Lpm.

Question 17

What are the advantages and limitations of using a simple face mask?

Answer 17

Advantages: Inexpesnive, disposable, eliminates need for cleaning. Suitable for moderate oxygen requirements and patients with nasal irritation, epistaxis, or who are mouth breathers.
Limitations: can be obtrusive, uncomfortable, muffle communication, and impede coughing. Cannot provide 100% oxygen due to perforations.

Question 18

What is a partial rebreathing mask and how is it used?

Answer 18

A partial rebreathing mask is similar to a simple face mask but includes a reservoir bag. It allows part of the patient’s exhaled air to enter the reservoir bag, enriching it with oxygen. Each inhalation draws from this enriched mixture plus pure oxygen from the cylinder. This mask can deliver oxygen concentrations of 40-60% with flow rates between 6 and 10 Lpm. The mask must fit well and the reservoir bag should not deflate completely during inhalation.

Question 19

What are the advantages and limitations of using a partial rebreathing mask?

Answer 19

Advantages: Higher oxygen concentrations than a simple face mask. Limitations: Mask must fit well and be adjusted correctly to prevent the reservoir bag from collapsing during inspiration.

Question 20

What are the advantages and limitations of using a non-rebreathing mask?

Answer 20

Very effective for delivering high concentrations of O2.
Limitations: must be properly fitted with no leaks to achieve high concentrations

Question 20

What is a non-rebreathing (NRB) mask and how is it used?

Answer 20

A non-rebreathing mask features a one-way valve between the mask and the reservoir bag, preventing exhaled air from entering the reservoir bag. It provides high oxygen concentrations by delivering oxygen from the reservoir bag and cylinder, approaching 90% if properly fitted with no leaks. The reservoir must not collapse during inspiration, requiring adjustment of the flow rate if it does.

Question 21

What are the steps for setting up oxygen equipment?

Answer 21

1. Inspect cylinder and regulator for dirt, dust, oil, grease, and damage.
2. Secure the cylinder upright.
3. Install the regulator:
   - Yoke-type: remove tape, crack valve, check gasket, fit yoke, hand tighten.
   - Nut-gland: remove cover, crack valve, fit regulator, tighten with wrench.
   - Hand-tight: remove cover, crack valve, thread and tighten.
4. Connect delivery equipment to regulator outlet.
5. Open cylinder valve slowly, stabilize pressure, and check for leaks.
6. Adjust flow rate on the regulator.
7. Close cylinder valve, open regulator to relieve pressure, then close regulator valve.
   Remove regulator if necessary.

Question 22

How do you apply oxygen to a patient?

Answer 22

Attach tubing from the mask to the oxygen regulator, open flow valve, and initiate flow. Allow oxygen to flow through tubing to clear out any dust before placing the mask on the patient’s face. Reassure the patient about the use of oxygen, and let them hold the mask if necessary before securing it with the elastic strap

Question 23

What is pulse oximetry and how is it used?

Answer 23

Pulse oximetry uses a Health Canada-approved finger pulse oximeter, a small battery-operated device that detects pulse signals and calculates oxygenated hemoglobin (SpO2) and pulse rate. Proper placement and cleanliness of the probe are crucial for accurate readings.

Question 24

What factors can interfere with pulse oximeter readings?

Answer 24

Factors include bright light, shivering, low pulse volume, vasoconstriction, and carbon monoxide poisoning. These can cause false readings or difficulty in detecting a pulse signal.

Question 25

How do you use a pulse oximeter?

Answer 25

Turn on the device, select the site (finger, toe, or ear), ensure cleanliness, and position the probe correctly. Allow time for detection and calculation, and verify pulse signal. Check for correct function and troubleshoot if no signal is obtained.

Question 26

How should oxygen equipment be cleaned, cared for, and stored?

Answer 26

Shut off the cylinder, bleed gauges to zero, check for damage, and ensure adequate oxygen supply. Store face masks as single-use disposables or disinfect per guidelines. Store cylinders upright or horizontal, secured, away from corrosives, and in a ventilated area.

Question 27

How much residual pressure should oxygen cylinders have when being sent out for refilling?

Answer 27

200 PSI

Question 28

Where can you find a copy of the duration times for the D, E, and K cylinders at various pressure levels?

Answer 28

In your oxygen therapy kit (see p. 80 of textbook)