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Oxygen Gas Administration

Oxygen Gas Administration. م.م زيد وحيد عاجل. Oxygen Therapy General Goals/objectives. Correcting Hypoxemia By raising Alveolar & Blood levels of Oxygen Easiest objective to attain & measure Decreasing symptoms of Hypoxemia Supplemental O2 can help relieve symptoms of hypoxia

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Oxygen Gas Administration

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  1. Oxygen Gas Administration م.م زيد وحيد عاجل

  2. Oxygen TherapyGeneral Goals/objectives • Correcting Hypoxemia • By raising Alveolar & Blood levels of Oxygen • Easiest objective to attain & measure • Decreasing symptoms of Hypoxemia • Supplemental O2 can help relieve symptoms of hypoxia • Less dyspnea/WOB • Improve mental funx

  3. Oxygen TherapyDesign & Performance • Flow does not meet inspiratory demand • O2 is diluted with air on inspiration • Nasal Cannula • Nasal Catheter • Xtracheal Catheter • Resevoir Cannulas

  4. Nasal Cannula

  5. Oxygen TherapyLow Flow Devices • Nasal Cannula • Adult • requires Humidity • Can cause irritax, dryness, bleeding, etc. • Rule of thumb Nasal • Neo • 0-2 l/m

  6. Oxygen TherapyLow Flow Devices • Nasal Catheter • Adult • Visualize placement or blind to depth = to length of nose to tragus • Replace Q8hrs • Affects secretion, irritax, etc. • Good for short procedures • bronchoscopy

  7. Oxygen TherapyLow Flow Devices • Xtracheal catheter • Surgically inserted in trachea • Uses trachea/upper airway as reservoir • Requires very low flows to meet needs

  8. Oxygen TherapyLow Flow Devices • Reservoir Cannula • Frequent replacement • No humidificax • Requires nasal exhalax • Nasal • Stores ~20ml • Aesthetically displeasing • Pendant • Better aesthetically • Extra weight can irritate ears/face

  9. Low Flow DevicesReservoir Masks • Simple Mask • Gas gathers in mask • Exhalax ports • Air entrained thru ports & around mask

  10. Partial rebreather Non-rebreather

  11. AEM

  12. Oxygen TherapyMore Reservoirs • Enclosures • Tents • Hoods • Incubators • Others • BVM • Pulse Dose Cannula • Concentrators

  13. Oxygen TherapyMore Reservoirs – Enclosures • Oxygen Tents • Rare • Air conditioned to provide constant desired Temp • Frequent opening & constant leakage • Make FiO2 variable • Analyze FiO2 @pt head level (layering) • Primarily for pediatric aerosol therapy for Croup or CF

  14. Oxygen TherapyMore Reservoirs – Enclosures • Hoods • Best method to deliver controlled O2 to infants • Covers only head • Ideal to allow nursing access • 7 L/m minimum flow • To flush adequately • Flows above 10-15 L/M are contraindicated • Generate damaging noises, cold, & dry • Cold stress can increase O2 consumpx & apnea • Analyze FiO2 @pt head level (layering) • Must heat & humidify incoming gas • Do not direct at pt face • Maintain Neutral Thermal Environment • Age & weight appropriate

  15. Oxygen TherapyMore Reservoirs – Enclosures • Incubator (isolette) • Plexiglas enclosure • Servo controlled convex heating with supplemental O2 • Freq opening & dilution makes it hared to deliver high O2 • Hoods are used in Incubators to provide supplemental O2

  16. Oxygen Blender

  17. Oxygen TherapySelecting Delivery Approach • Purpose (Objective) • Increase FiO2 to correct hypoxemia • minimize symptoms of hypoxemia • Patient • Cause & severity of hypoxemia • Age • Neuro status/orientax • Airway in place/protected • Regular rate & rhythm

  18. Oxygen TherapyPrecautions & Hazards • O2 Toxicity • Primarily affects Lungs & CNS • 2 determining factors of O2 tox • PO2 • Time of exposure • i.e., higher the PO2 & exposure time the greater the toxicity. • CNS effects occur with Hyperbaric Pressures • Pulmonary effects can occur @ clinical PO2 levels • Patchy infiltrates on x-ray, prominent in lower lung fields • Major alveolar injury

  19. Oxygen TherapyPrecautions & Hazards • Retinopathy of Prematurity (ROP) retrolental fibroplasia • Up to 1month of age • excesive Blood oxygen level causes retinal vasoconstrix

  20. Oxygen TherapyPrecautions & Hazards • Fire Newspaper! • Fire Triangle • O2, Heat, & Fuel • increase risk of fire • High Concentrax of O2 • High Pressures of O2 • Reduce O2 buildup in enclosed environments • Under drapes • Operating rooms, etc. • Be cautious when using electronic equipment • Scalpels, Cardioverx, Cardio Shock

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