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Hazards of Oxygen Therapy First year Respiratory Therapy MJC

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Hazards of Oxygen Therapy First year Respiratory Therapy MJC 220 Oxygen Therapy The RCP is the primary member of the healthcare team responsible for oxygen ... – PowerPoint PPT presentation

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Title: Hazards of Oxygen Therapy First year Respiratory Therapy MJC


1
Hazards of Oxygen Therapy
  • First year Respiratory Therapy
  • MJC 220

2
Oxygen Therapy
  • The RCP is the primary member of the healthcare
    team responsible for oxygen administration.
  • RCP must be well-versed in its goals and
    objectives

3
Oxygen is a DRUG
  • Must be considered as a drug
  • TOO MUCH of a drug can cause overdosing problems
  • TOO LITTLE isnt enough to treat the symptoms

4
Goals of Oxygen Therapy
  • Correct hypoxemia
  • Decrease symptoms associated with hypoxemia
  • Decrease workload on cardiopulmonary system

5
Indications for Oxygen
  • Documented hypoxemia
  • PaO2 less than 60 torr or SaO2 less than 90 in
    adults and infants older than 28 days while
    breathing room air
  • Acute care situation where hypoxemia is suspected
  • Severe trauma
  • Acute myocardial infarction
  • Short term therapy i.e. Post-op anesthesia

6
Monitoring the Patient
  • Clinical assessment including but not limited to
    cardiac, pulmonary, and neurological status
  • Assessment of physiologic parameters measurement
    of oxygen tensions or saturation in any patient
    treated with oxygen

7
Clinical Signs of Hypoxia
  • Respiratory
  • Increased respiratory rate (Tachypnea), dyspnea,
    cyanosis, acc muscle use
  • Cardiac
  • Increased heart rate (Tachycardia), hypertension
  • Neurological
  • Confusion or panic
  • Cyanosis
  • Diaphoresis
  • Somnolence, confusion, blurred vision, loss of
    coordination, impaired judgment

8
Long Term Sign
  • Clubbing

9
Precautions of Supplemental Oxygen
  • 1. Oxygen toxicity
  • 2. Depression of ventilation
  • 3. Retinopathy of Prematurity
  • 4. Absorption atelectasis
  • 5. Bacterial infection with humidifiers

10
Oxygen Toxicity
  • Patients exposed to high oxygen levels for a
    prolonged period of time have lung damage.
  • First damage is capillary epithelium, leading to
    edema, thickened membranes and finally to
    pulmonary fibrosis and hypertension.

11
A Vicious Cycle
12
Depression of Ventilation
  • COPD patients with CO2 retention have blunted
    stimuli to breathing
  • Hypoxic drive theory
  • They have a different stimulus to breathe then
    normal
  • GOLDEN RULE You should never stop giving oxygen
    to a patient in need.

13
Retinopathy of Prematurity
  • Is an abnormal eye condition in some premature
    infants who receive high FIO2s
  • Retinal arteries hemorrhage and scaring cause
    retinal detachment and blindness.

14
Absorption Atelectasis
  • The alveoli in the lungs collapse and cause
    shunting in the capillary lung fields.
  • Loss of nitrogen in the blood causes less total
    venous pressure. This leads to the collapse of of
    the alveolus.

15
Pressure gradients that cause absorption
atelectasis
16
Infection Control
  • Therapist must use an aseptic technique when
    handling supplemental oxygen and humidity
    equipment
  • Never drain water from the tubing back into the
    heated humidifier
  • Always date the opened container
  • Only use sterile liquids in reservoirs

17
Oxygen a fire hazard
  • NEVER smoke while using supplemental oxygen
  • Severe facial burns can and do happen

18
Clinical Guidelines
  • Consider Oxygen as a drug
  • Use the lowest FIO2 .
  • Use it for the shortest possible time
  • Keep oxygen below 50 if
  • If you have to - accept lower saturations than
    normal in some situations
  • Check equipment regularly for contaminants

19
Thats all folks!
  • Any questions?

20
Typical Question
  • Administration of high oxygen concentrations to a
    neonate for prolonged periods of time may result
    in which of the following
  • Atelectasis
  • CO2 retention
  • Retinopathy of Prematurity
  • Pneumothorax

21
Another?
  • Typically, which are the precautions of
    administering oxygen to patients in the hospital
    EXCEPT
  • Retinopathy of Prematurity
  • Oxygen narcosis
  • Absorption atelectasis
  • Depression of ventilation
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