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EMR - First on Scene - 9th Edition La Baudour - Bergeron > Oxygen Therapy Chapter 9 > Flashcards

Oxygen Therapy Chapter 9 Flashcards

1
Q

Define supplemental oxygen.

A

A supply of 100% oxygen for use with ill or injured patients.

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2
Q

Define oxygen concentration.

A

The amount of oxygen being delivered to a patient.

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3
Q

Define humidifier.

A

A device used to increase the moisture content of supplemental oxygen.

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4
Q

Name some common reasons a patient may need oxygen.

A 
Respiratory compromise
Cardiac compromise
Cardiac arrest
Shock
Major blood boss
Injury to the lungs or chest
Airway obstruction
Stroke
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5
Q

What are the three (3) most common indications that a patient may be in need of supplemental oxygen?

A

Abnormal signs and symptoms - includes abnormal vital signs, significant pain, or any other complaint that is out of the ordinary.

Significant mechanism of injury - any person who has suffered a significant injury, regardless if there is an open wound or not, may have sustained damage to the circulatory system resulting in a disruption in normal blood flow to all the vital organs.

Increased level of distress - anyone who appears to be in significant distress as indicated by difficulty breathing or significant pain.

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6
Q

What are the three (3) hazards of oxygen.

A
  1. Oxygen used in emergency care is stored under pressure (2,000 psi or greater). If the tank is punctured or if a valve breaks off, the supply tank and the valve can become projectiles, injuring anyone nearby.
  2. Oxygen supports combustion and causes fire to burn more rapidly.
  3. Oxygen and oil do not mix. When they come into contact with one another, there can be a severe reaction, which may cause an explosion.
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7
Q

What does a typical oxygen delivery system include?

A

Oxygen source (oxygen cylinder)
Regulator
Delivery device (cannula, mask)
Humidifier ( occasionally when more than 30 minutes of oxygen are provided)

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8
Q

Oxygen is considered a medication, true or false?

A

True

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9
Q

Describe hypoxic drive.

A

When a patient has become used to the lower levels of oxygen in their lungs and blood. Prolonged use of a high concentration of oxygen can lower their drive to breathe, causing respiratory arrest in some patients.

This is not common in the prehospital setting and is rarely a concern for the EMR. Never withhold supplemental oxygen from someone in respiratory distress.

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10
Q

What is a pressure gauge?

A

The device on a regulator that displays the pressure inside a cylinder.

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11
Q

What is a pressure regulator?

A

The device used to lower the delivery pressure of oxygen from a cylinder.

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12
Q

What are the common cylinder sizes and contents used in EMR?

A

Jumbo D cylinder, which contains about 640 L of oxygen.
D cylinder, which contains about 425 L of oxygen.
E cylinder, which contains about 680 L of oxygen

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13
Q

When should you check an oxygen cylinder?

A

The beginning of your shift
Before each use
While in use
At the end of each use

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14
Q

What should you use to determine the pressure remaining in your oxygen tank?

A

Pressure gauge

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15
Q

Where is the pressure gauge located?

A

Directly on the pressure regulator.

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16
Q

What does a pressure gauge show you?

A

Actual pressure inside the tank.

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17
Q

What is the PSI of a full oxygen tank?

A

2,000

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18
Q

What is the PSI of a half-full oxygen tank?

A

1,000

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19
Q

What is the PSI of a quarter-full oxygen tank?

A

500

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20
Q

You should never allow the pressure of an oxygen cylinder to fall below what PSI?

A

200

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21
Q

What can happen if an oxygen cylinder is completely empty?

A

Moisture can accumulate inside the tank and cause oxidation or rust to develop.

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22
Q

What does a five point star stamped on the crown of a cylinder indicate?

A

It is allowed to go up to 10 years between test dates.

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23
Q

What are the twelve (12) general guidelines to keep in mind when working with high-pressure cylinders?

A
  1. never allow smoking around oxygen equipment
  2. never use oxygen equipment around open flames or Sparks
  3. never use grease or oil on devices that will be attached to an oxygen cylinder. Do not handle those devices when your hands are greasy.
  4. never put tape on the cylinder outlet or used tape to mark or label any oxygen cylinder or oxygen delivery equipment. The oxygen can react with the adhesive left behind and produce a fire.
  5. never store a cylinder near high heat or in a closed vehicle that is parked in the sun.
  6. always keep portable oxygen cylinders lying flat. If you must stand a tank up right, keep your hand on the tank to prevent it from falling over.
  7. always use the pressure gauges and regulators that are intended for use with oxygen and the equipment you are using.
  8. always ensure that the O-ring is in good condition and free of cracks or divits. This will help prevent dangerous leaks.
  9. tighten all valve connections hand tight only.
  10. open and close all valves slowly
  11. always store reserve oxygen cylinders in a cool, ventilated room as approved by your EMS system.
  12. always have oxygen cylinders hydrostatically tested. This should be done every five years for steel tanks (three for aluminum cylinders). The date for retesting should be stamped on the top of the cylinder near the valve.
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24
Q

What grade of oxygen is used in EMS?

A

Medical grade oxygen

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25
Q

How often must medical grade oxygen cylinders be tested?

A

Every 5 years

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26
Q

Define hydrostatic test.

A

The process of testing high-pressure cylinders.

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27
Q

What are the three (3) functions of an oxygen or pressure regulator?

A
  1. Reduce tank pressure
  2. Display tank pressure
  3. Control the delivery of oxygen
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28
Q

And oxygen regulator can reduce the pressure in the tank to what PSI?

A

Between 30 and 70 psi

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29
Q

Define liter flow.

A

The measure of the flow of oxygen being delivered through a mask or cannula.

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30
Q

Define LPM.

A

liters per minute

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31
Q

Describe the liter flow valve and its function.

A

Sometimes called the flow meter, it is an adjustable dial on the regulator that allows you to select a specific flow of oxygen to the patient in liters per minutes (LPM).

An oxygen delivery device, such as a mask, can be connected to the liter flow valve. Then, when it is placed on the patient, it can deliver supplemental oxygen.

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32
Q

On portable oxygen what is the name of the assembly used to secure the pressure regulator to the cylinder valve assembly?

A

Yoke assembly

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33
Q

Define pin index system

A

The safety system used to ensure that the proper regulator is used for specific gas, such as oxygen.

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34
Q

Which pin on the pin index system goes to the oxygen port?

A

The largest pin

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35
Q

Define O ring.

A

The gasket used to seal a regulator to the oxygen cylinder.
It sits over the oxygen port and serves as a gasket and ensures an airtight seal between the regulator in the tank valve.

36
Q

What important step must you do before connecting the pressure regulator to an oxygen supply cylinder?

A

Open the cylinder valve slightly for just a second to clear dirt and dust out of the delivery port. This is called “cracking” the cylinder valve.

37
Q

What is the unbreakable container of sterile water that can be placed in line between the flow valve and oxygen delivery device?

A

Humidifier

38
Q

What is the purpose of using an in-line humidifier?

A

Non-humidified oxygen delivered to a patient over a long period of time (usually more than 20 minutes) will dry out the mucous membranes in the airway and lungs. With an in-line humidifier the oxygen from the cylinder passes through the water, it picks up moisture from the water, and in turn, the oxygen because more comfortable for the patient to breathe.

39
Q

Define nasal cannula.

A

A device used to deliver low concentrations of supplemental oxygen to a breathing patient.

40
Q

What is the effective flow rate of a nasal cannula?

A

Between 1 and 6 LPM

41
Q

A patient with a nasal cannula receiving a flow rate of 1 to 6 LPM will receive what level of oxygen concentration?

A

25% - 45%

42
Q

What type of patient would receive a nasal cannula?

A

Most medical patients in mild to moderate distress.

43
Q

1 LPM would provide what percent of concentrated oxygen?

A

25%

44
Q

2 LPM would provide what percent of concentrated oxygen?

A

29%

45
Q

3 LPM would provide what percent of concentrated oxygen?

A

33%

46
Q

4 LPM would provide what percent of concentrated oxygen?

A

37%

47
Q

5 LPM would provide what percent of concentrated oxygen?

A

41%

48
Q

6 LPM would provide what percent of concentrated oxygen?

A

45%

49
Q

Define non-rebreather mask.

A

A device used to deliver high concentrations of supplemental oxygen.

50
Q

Define reservoir bag.

A

A device attached to an oxygen delivery device to temporarily store oxygen.

51
Q

When would you use a nonrebreather mask?

A

When the patient requires a higher concentration of oxygen than the nasal cannula can deliver.

52
Q

What is the minimum flow rate when using the nonrebreather mask?

A

8 LPM but a higher flow (12 to 15 LPM) may be required.

53
Q

8 LPM would provide what percent of concentrated oxygen?

A

53%

54
Q

10 LPM would provide what percent of concentrated oxygen?

A

61%

55
Q

12 LPM would provide what percent of concentrated oxygen?

A

69%

56
Q

15 LPM would provide what percent of concentrated oxygen?

A

81%

57
Q

What does the nonrebreather mask consist of?

A

Face mask
One-way valve
Reservoir bag

58
Q

What must you do with a non-rebreather mask to ensure the patient will receive a supply of 100% oxygen directly from the reservoir with each breath

A

Inflate the reservoir bag before placing the mask on the patient’s face

59
Q

What is the maximum the reservoir bag should deflate when a patient takes his deepest breath?

A

No more than one third of the reservoir bag.

60
Q

What can you do to maintain the volume in the reservoir bag?

A

Adjust the oxygen flow to ensure no more than one third of the bag is deflated when the patient takes his deepest breath.

61
Q

What happens to the patients exhaled air when using a non-rebreather mask?

A

The patient’s exhaled air does not return to the reservoir; instead, it is vented through the one-way flaps or portholes on the mask.

62
Q

What is a venturi mask and where is it most commonly seen?

A

The Venturi mask has adjustable jets that allow the user to more accurately determine the specific oxygen concentration delivered to the patient. Venturi masks are most commonly seen and used in the hospital setting.

63
Q

What is blow-by oxygen and how would you use it?

A

Another technique for the delivery of supplemental oxygen to a breathing patient. It can be used for any patient who will not tolerate having a traditional mask or cannula placed on his face. With the blow by technique, you can use a non-rebreather mask set to 15 L and simply have the patient hold the mask as close to the faces comfortable. This technique is especially good for small children who are typically frightened by a mask or cannula. Be sure that the mask is held as close to the face as possible to ensure that a good supply of oxygen reaches the patient.

64
Q

What are the three (3) devices commonly used in the EMS setting to provide high concentration oxygen while providing rescue breaths for a non-breathing patient?

A
  1. Pocket mask with oxygen inlet
  2. Bag mask device (BVM)
  3. Demand valve device
65
Q

What LPM should be used with a pocket mask with oxygen inlet?

A

10 LPM

66
Q

What LPM should be used with a bag mask device (BVM)?

A

At least 15 LPM

67
Q

When using a BVM with supplemental oxygen and without a reservoir bag what is the approximate level of oxygen the patient receives?

A

51%

68
Q

When using a BVM with supplemental oxygen with a reservoir bag what is the approximate level of oxygen the patient receives?

A

100%

69
Q

Describe how the demand valve device works.

A

A demand valve device delivers oxygen through a specialized regulator. That regulator can deliver 100% oxygen on demand when the patient inhales. The EMR can also activate the regulator by pressing a trigger.

70
Q

What are the standard features of the demand valve device?

A
  • Peak flow rate of 40 LPM
  • Inspiratory pressure relief valve that opens at approximately 60 call me of water pressure
  • Trigger that enables the rescue were to use both hands to maintain a mask seal while activating the device
71
Q

Delivering oxygen with a demand valve device, when do you release the trigger?

A

When the patient’s chest rises to allow for passive exhalation.

72
Q

If there is no chest rise seen when delivering oxygen with a demand valve device what steps should you take?

A 
Reposition the head to ensure an open airway
Check for obstructions
Reposition the mask
Check for a seal
Try again
73
Q

Supplemental oxygen can be helpful to ill or injured patients by:
A. reducing the concentration of available oxygen
B. increasing the concentration of available oxygen
C. helping eliminate carbon dioxide
D. increasing the concentration of carbon dioxide

A

B. increasing the concentration of available oxygen

74
Q

Which one of the following best describes the oxygen consumption of a normally functioning human being:
A. the body requires a constant supply of oxygen at 79%
B. the human body needs a minimum of 10% oxygen to survive
C. the body exhales an average of 21% carbon dioxide with each breath
D. the average exhalation contains an oxygen concentration of between 10% and 16%

A

D. the average exhalation contains an oxygen concentration of between 10% and 16%

75
Q

All of the following are reasons a patient might need supplemental oxygen except a/n:
A. significant mechanism of injury
B. upset over the break up of a boyfriend
C. suspected heart attack
D. difficulty breathing

A

B. upset over the break up of a boyfriend

76
Q

Which one of the following best defines the term oxygen concentration:
A. available amount of air to the patient
B. amount of oxygen remaining in one exhalation
C. ratio between oxygen and carbon dioxide
D. concentration of oxygen available to the patient

A

D. concentration of oxygen available to the patient

77
Q 
The pressure gauge of a full oxygen cylinder will display approximately what psi?
A. 500
B. 1000
C. 1500
D. 2000
A

D. 2000

78
Q 
A typical oxygen regulator will not:
A. display tank pressure
B. display ambient air pressure
C. control liter flow
D. regulate tank pressure
A

B. display ambient air pressure

79
Q 
You are caring for a patient complaining of mild shortness of breath and have her on a nasal cannula at 6 LPM. What oxygen concentration are you delivering to the patient?
A. 25%
B. 29%
C. 33%
D. 45%
A

D. 45%

80
Q

You were caring for a victim of a motor vehicle crash and have placed her on a non-rebreather mask. Which one of the following best describes how you know the liter flow has been adjusted properly?
A. the patient is able to speak in complete sentences
B. the reservoir bag completely deflates with each breath
C. you see no movement of the reservoir bag with each breath
D. the reservoir bag refills completely between breaths

A

D. the reservoir bag refills completely between breaths

81
Q 
You are caring for a patient who was ejected from a vehicle that rolled over. She is alert and responsive. Her respirations are 20 times per minute with good tidal volume and unlabored. Which device is most appropriate to deliver oxygen to this patient?
A. nasal cannula
B. demand valve
C. bag mask device
D. non-rebreather mask
A

D. non-rebreather mask

82
Q 
In reference to the patient in the previous question, the primary reason you decided to provide supplemental oxygen is due to:
A. the patient's level of distress
B. abnormal vital signs
C. the mechanism of injury
D. the respiratory rate
A

C. the mechanism of injury

83
Q

You are a single rescuer caring for the victim of a cardiac arrest. Your equipment bag, along with a supply of oxygen, is within reach. Which one of the following is the most appropriate choice for beginning rescue breaths on this patient?
A. pocket mask with supplemental oxygen
B. bag mask without supplemental oxygen
C. mouth-to-mouth
D. waiting for another rescuer before beginning rescue breaths

A

A. pocket mask with supplemental oxygen

84
Q 
The proper placement of a/n \_\_\_\_\_\_\_\_ will help you ensure an airtight fit between the regulator and tank valve.
A. cannula
B. venturi
C. O ring
D. demand valve
A

C. O ring

85
Q 
You were caring for a 12-year-old patient who is having severe difficulty breathing. His respirations are 28 times per minute and shallow. The best choice for oxygen therapy for this patient is a:
A. demand valve
B. nasal cannula
C. bag mask
D. non-rebreather mask
A

C. bag mask

86
Q 
Which one of the devices listed below is recommended for adult patients only and can be used to provide rescue breaths for a non-breathing patient?
A. bag mask
B. demand valve
C. venturi mask
D. pocket mask
A

B. demand valve

87
Q 
One of the most common consequences of over inflating a patient during rescue breaths is:
A. a ruptured lung
B. inadequate chest rise
C. gastric distention
D. a weak mask seal
A

C. gastric distention

EMR - First on Scene - 9th Edition La Baudour - Bergeron (26 decks)

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