1. OXYGEN THERAPY Oyewole Deboye O.

2. Introduction Conditions for oxygen therapy Administration Monitoring Side effects Conclusion

3. Oxygen therapy is the administration of oxygen as a medical intervention, which can be for a variety of purposes in both chronic and acute patient care Oxygen is essential for cell metabolism Room air contains 21% oxygen Delivery of oxygen to tissues depends on : Inspired oxygen conc. Alveolar ventilation Ventilation-perfusion distribution within the lungs

4. 4. Hb conc. Conc. of CO Cardiac output Distribution of capillary blood flow within the tissues Oxygen levels in the blood can be helpful or damaging

5. Conditions for oxygen therapy ACUTE CONDITIONS : in emergency medicine Resuscitation Documented hypoxia Severe respiratory distress (acute asthma or pneumonia) Shock Cor pulmonale Acute myocardial infarction Severe trauma

6. Pulmonary HTN Major hemorrhage Convulsion Hypothermia As home therapy to abort cluster headache attacks,due to its vasoconstrictive effect Used as a drug delivery route as nebulizer mask for delivery of Salbutamol or Epinephrine

7. CHRONIC CONDITIONS : COPD Lung fibrosis Sleep apnoea Kyphoscoliosis Myopaties/muscular dystrophy Brain stem lession Right-to-left shunts

8. ADMINISTRATION Source Pressure regulator flow meter(preset or selective)L/min Supplemental oxygen: Nasal cannulae :3-6LPM, delivering 02 conc of 24-40% Simple face mask :5-15LPM, delivering 02 conc of 28-50% Venturi mask :1-2LPM, delivering 02 conc of 24-28%

9. HIGH CONC (40-60%) 02 via high flow mask are particularly useful in acute type I respiratory failure because respiratory drive is high, such as acute asthma,pneumonia,pul. edema,pulmonary embolus,ARDS.when used for prolonged periods,it should be humified by passing over warm water LOW CONC (Venturi masks 24-28%) are particularly useful in delivering controlled 02 therapy in type II respiratory failure.02 delivery through a nasal cannulae vary depending on minute ventilation,nasal blockage,and tendency to mouth-breath.humidification is not necessary as a high proportion of atmospheric air is mixed with 02

10. In COPD, and type II respiratory failure,patient develop an abnormal tolerance to raised CO2 and may become dependent on hypoxic drive to breathe.In these patients, lower 02 conc is needed to avoid precipitating worsening respiratory depression. Positive pressure delivery system is used in patient who are unable to breathe on their own.use of AMBU bag,Resuscitator used in surgery with anaesthetic machines.

11. MONITORING In patient with acute respiratory failure, close monitoring is essential and aterial bld gases taken on presentation should be repeated within 20min to establish that tx has achieved acceptable Pa02 levels ? 7kPa(55mmHg) or 02 saturation ? 88%

12. SIDE EFFECTS Vasoconstrictive effect on the circulatory system May increase the effect of stroke Seizures In infants,may cause blindness(promoting overgrowth of bld vessels in the eye obstructing sight.this is retinopathy of prematurity. Also in infant, it may contribute to construction of a ductus ateriosus

13. In adult,pulmonary 02 toxicity manifested by pulmonary oedema and free radical damage leading to fibrosis. Administration of high levels of 02 in patient with type II respiratory failure which reduces respiratory drive precipitating respiratory failure and can lead to death RISK OF FIRE!!!

14. CONCLUSION Oxygen is essential for cell metabolism, and in turn, tissue oxygenation is essential for all normal physiologic functions. Prompt recognition of life threatening situations and immediate administration of oxygen appriopriately will benefit the patient in reducing morbidity and mortality.

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