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Administration of Oxygen

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Flow of gas from the equipment. Equipment reservoir. Does NOT fully meet patient's inspiratory demand. Needs additional mixing with ... Stridor. Tracheal tumors ... – PowerPoint PPT presentation

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Title: Administration of Oxygen


1
Administration of Oxygen
  • Need for Oxygen
  • Hazards
  • Delivery Devices
  • Hyperbaric Oxygen
  • Other Medical Gases

2
5 Indications for Oxygen Therapy
  • Suspected or Documented hypoxia
  • Severe trauma
  • MI
  • Post op

3
Hazards of Oxygen Therapy
  • Ventilatory depression
  • Absorption atelectasis
  • ROP
  • Oxygen toxicity
  • Fire hazard
  • Contamination

4
Delivery DevicesLow and High Flow
  • Getting the gas to the patient

5
Low Flow Device Definition
  • FiO2 can vary with
  • Patients respiratory rate and pattern
  • Flow of gas from the equipment
  • Equipment reservoir
  • Does NOT fully meet patients inspiratory demand
  • Needs additional mixing with room air

6
Low Flow Oxygen
  • Low Flow
  • Nasal cannula
  • Simple oxygen mask
  • Non-rebreathe mask
  • Face tent

7
Nasal Cannula
8
Nasal Cannula
  • Delivers about 24 to 44 FiO2
  • Flow is set at 1 to 6 liters for adults
  • 0.1 to 0.9 with newborns (special flowmeter)
  • FiO2 varies with patient respiratory rate and
    volumes
  • Add moisture over 4 L/min or with pt comfort

9
Simple Mask
10
Simple Mask
  • Delivers 40 to 50 oxygen
  • Need at least 5 L/min to flush out CO2

11
Non RebreatheMask
12
A reservoir system
  • Delivers better oxygenation then simple mask.
  • The most oxygen without intubation
  • 50 to 70 oxygen (some say 80-90-100)

13
Something New (VIASYS)
14
The Hi-Ox 80
15
Helps patients more ways than one
  • Provides an FiO2 of gt80 at a flow of 8 L/min
  • Studies show that high FiO2
  • Reduces nausea post operatively
  • Reduces s/p infections by 50

16
Trach Mask
17
Trached?
  • Usually blue tubing connected to heated aerosol.
  • Can use transport tee

18
T-piece
19
Tee Piece
  • Must be intubated
  • With aerosol mist setup or transport tee

20
Face Tent
21
Face Tent
  • Ideal for post anesthesia
  • Not enclosed and claustrophobic
  • Only for low oxygen concentrations

22
Delivery DevicesHigh Flow
  • Venturi (Entrainment) Mask
  • Aerosol mist setup

23
Definition of High Flow
  • Meets or exceeds patient inspiratory demand
    (usually textbook of 30 LPM)
  • Provides precise concentrations despite patients
    breathing pattern

24
Why 30 Liters per minute?
  • Based on minute volume
  • Respiratory rate times tidal volume
  • The number of breaths multiplied by the size of
    the breaths
  • People inspire one-third of the time.

25
Air Entrainment Mask
26
Venturi Masks
27
Entrainment Ratios
28
Venturi High flow device
  • Ideal for use with CO2 retainers
  • Matches patient demand
  • Usually 24 to 50 (some have up to 100 running
    at flush)

29
Aerosols and Nebulizers
  • Jet nebulizers
  • Small volume nebs
  • Aerosol setups
  • Aerosol output calculations
  • Aerosol density calculations

30
Keep the flow up!
31
Monitoring Oxygen Therapy
  • Pulse Oximetry
  • Arterial Blood gases
  • Work of Breathing
  • Tidal Volume and Respiratory Rate
  • Pulse and Blood Pressure

32
Less common used O2 delivery
  • Head hoods
  • Pendant or reservoir nasal cannula
  • Bi-flow
  • Tracheal catheters
  • Croup tents
  • Incubators
  • Hyperbaric chamber

33
Head Hood
34
Head Hood
  • Newborns only
  • Watch for cooling

35
Pendant Reservoir
36
Reservoir Cannula
37
(No Transcript)
38
Nasal Biflow
39
Tracheal Catheter
40
Nasal Catheter
41
Oxygen (Croup) Tent
42
Croup Tent
  • Can supply 30 to 50 oxygen

43
Incubator
44
Oxygen Blender
45
Functional Diagram of Blender
46
Blenders
  • Found on all ventilators
  • Easiest and most accurate way to deliver oxygen
    at precise percentages

47
Even Less Commonly Used
48
Hyperbaric Oxygen (High Pressure Oxygen)
  • Monoplace Chamber
  • Multiplace Chamber

49
Hyperbaric Oxygen
  • Used to increase the amount of oxygen carried in
    the blood.
  • HENRYS LAW the amount of gas dissolved in a
    liquid is directly related to the partial
    pressure of the gas(es) above the liquid.

50
Hyperbaric Oxygen
  • Reduce the size of the air bubbles in the body
  • Air Embolism
  • Decompression sickness
  • Boyles Law Pressure and Volume are inversely
    related.

51
Indications for HBO
  • Decompression sickness
  • Diver with the bends
  • Gas Embolism
  • Reduces the size of the bubbles
  • Carbon monoxide and Cyanide poisoning
  • Decreases half life of CO bond
  • Severe anemia (blood loss)
  • Wound healing
  • Ischemic skin grafts, flaps, burns

52
Monoplace HBO Chamber
53
Hyperbaric Chambers
54
Other Gases
  • Carbogen
  • Heliox
  • Nitric Oxide

55
Carbogen
  • Usually 95 oxygen and 5 carbon dioxide
  • Treats singulitus (hiccups)
  • Provides a challenge to stimulate breathing in
    some patients

56
Heliox
  • Useful with ventilators and in ER
  • Upper airway narrowing
  • Croup
  • Asthma
  • Stridor
  • Tracheal tumors
  • The less dense gas is ideal for the tight passage
    through a narrow passage

57
Nitric Oxide
  • Treatment of neonates with hypoxic respiratory
    failure associated with pulmonary hypertension
  • A significant improvement has been noted with
    premature infants

58
Nitrous Oxide
  • Used with anesthesia
  • Dont get confused between NO and N2O

59
Thats all folks
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