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Oxygen Therapy

9. Oxygen Therapy. Objectives. Define the following terms: blow-by method humidifier hydrostatic test liter flow nasal cannula nonrebreather mask O ring. (continued). Objectives. Define the following terms: oxygen concentration oxygen supply tubing pin index system pressure gauge

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Oxygen Therapy

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  1. 9 Oxygen Therapy

  2. Objectives • Define the following terms: • blow-by method • humidifier • hydrostatic test • liter flow • nasal cannula • nonrebreather mask • O ring (continued)

  3. Objectives • Define the following terms: • oxygen concentration • oxygen supply tubing • pin index system • pressure gauge • pressure regulator • reservoir bag • supplemental oxygen (continued)

  4. Objectives • Explain the benefits of supplemental oxygen. • Explain the indications of supplemental oxygen. • Explain the potential hazards of working with high-pressure cylinders. • Explain the safe practices when working with high-pressure cylinders. • Differentiate between the common sizes of oxygen cylinders used in EMS. (continued)

  5. Objectives • Describe the purpose and functions of an oxygen regulator. • Explain the indications for the use of a nasal cannula. • Explain the indications for the use of a nonrebreather mask. • Demonstrate the proper use of a nonrebreather mask. • Demonstrate the proper use of a nasal cannula. (continued)

  6. Objectives • Demonstrate the ability to add supplemental oxygen to a pocket mask and/or bag-mask device. • Demonstrate the proper technique for attaching a regulator to a cylinder. • Demonstrate the ability to identify and troubleshoot a leaky oxygen cylinder/regulator. • Recognize the value that supplemental oxygen might offer for most ill and injured patients.

  7. Topics • Importance of Oxygen • Hazards of Oxygen • Oxygen Therapy Equipment • Administering Oxygen

  8. IMPORTANCE OF OXYGEN

  9. Importance of Oxygen Oxygen is a drug. The air we breathe contains 21 percent oxygen(O2). Supplemental oxygen is 100 percent O2. Oxygen concentration: amount of oxygen being delivered to patient.

  10. Importance of Oxygen • Patient may need oxygen for: • Respiratory or cardiac compromise • Cardiac arrest • Shock • Major blood loss • Injury to lungs or chest • Airway obstruction • Stroke

  11. Importance of Oxygen • Common Indicators • Abnormal signs and symptoms • Significant mechanism of injury • Increased level of distress

  12. Think About It What physiological needs are met by adequate breathing? What are some causes of inadequate breathing? What are the signs of inadequate breathing?

  13. HAZARDS OF OXYGEN

  14. Hazards of Oxygen • Oxygen tank has approximately 2,000 pounds per square inch(psi) of pressure (full tank). • If tank is punctured or valve breaks off, supply tank and valve can become deadly projectiles.

  15. Hazards of Oxygen Oxygen itself is nonflammable, but it greatly increases (supports) rate and intensity of combustion. Oxygen and oil do not mix, causes an explosion.

  16. Think About It Do not underestimate the dangers of oxygen! What safety precautions should the EMR take when working with oxygen cylinders? Which placards are used by the U.S. Dept. of Transportation for pressurized oxygen?

  17. OXYGEN THERAPY EQUIPMENT

  18. Oxygen Therapy Equipment • Oxygen-delivery System: • Oxygen source • Regulator • Delivery device • Oxygen Cylinders • Aluminum cylinders filled with pressurized oxygen. • Are green or have a green band (continued)

  19. An oxygen-delivery system.

  20. Oxygen Therapy Equipment • Oxygen Cylinders • Various sizes, identified by letters. • D cylinder (425 liters oxygen) • Jumbo D cylinder (640 liters oxygen) • E cylinder (680 liters oxygen) (continued)

  21. Various-size portable oxygen cylinders.

  22. Oxygen Therapy Equipment • Oxygen Cylinders • Pressure gauge determines pressure remaining in tank. • Never allow to go completely empty. • Never allow pressure in oxygen cylinder to fall below 200 psi.

  23. Oxygen Therapy Equipment • Oxygen System Safety • Never allow smoking. • Never use around open flames or sparks. • Never use grease or oil. • Never put tape on cylinder. (continued)

  24. Oxygen Therapy Equipment • Oxygen System Safety • Never store near high heat or in a closed vehicle parked in the sun. • Keep portable cylinders lying flat. • Use pressure gauges and regulators. • Ensure O ring is in good condition. (continued)

  25. Oxygen Therapy Equipment • Oxygen System Safety • Valves/connections hand-tight only. • Open and close all valves slowly. • Store in cool, ventilated room. • Have hydrostatically tested.

  26. Oxygen Therapy Equipment • Oxygen Regulators • Pressure in full oxygen cylinder: 2,000 psi. • Regulators have three functions: • Reduce tank pressure • Display tank pressure (pressure gauge) • Control delivery of oxygen (flow meter) (continued)

  27. Pressure regulators, one on and one off the tank.

  28. Oxygen Therapy Equipment • Oxygen Regulators • Connecting the Regulator • Pin index system: safety system used to ensure proper regulator is used for specific gas. • Largest pin is oxygen port. • O ring ensures airtight seal between regulator and tank valve. (continued)

  29. The PIN safety system.

  30. Oxygen Therapy Equipment • Oxygen Regulators • Humidifiers- moistens the air • Unbreakable container of sterile water. • Oxygen becomes more comfortable for patient to breathe. • Many EMS systems no longer use humidifiers due to infection risk.

  31. Oxygen Therapy Equipment • Oxygen-Delivery Devices • Nasal cannula Used to deliver low concentrations of supplemental oxygen to breathing patient. • Delivers 25-45% O2 at 2-6 LPM • Non-rebreather mask. • Used to deliverhigh concentrations of supplemental oxygen. • Delivers 90-100% O2 at 12- 15 LPM. (continued)

  32. Oxygen-Delivery Devices

  33. Example of a nasal cannula.

  34. A nasal cannula properly placed on the face of the patient.

  35. Oxygen Therapy Equipment • Oxygen-Delivery Devices • Non-rebreather mask • Face mask, one-way valve, reservoir bag. • Inflate bag before placing on patient's face. • Always ensure adequate oxygen flow (12–15 lpm). (continued)

  36. Example of a nonrebreather mask.

  37. A nonrebreather properly placed on the face of a patient.

  38. Oxygen Therapy Equipment • Oxygen-Delivery Devices • Venturi mask • Adjustable “jets”that allow user to more accurately determine specific oxygen concentration. (continued)

  39. Oxygen Therapy Equipment • Oxygen-Delivery Devices • Blow-by Delivery • Used for patient who will not tolerate traditional mask or cannula placed on face. • Especially good for small children.

  40. Think About It What is the length of time an oxygen cylinder can be used? How often should the oxygen regulator be checked for adequate pressure?

  41. ADMINISTERING OXYGEN

  42. Administering Oxygen • Step-by-step process of preparing oxygen-delivery system and administering oxygen. • Three devices: • Pocket mask with oxygen inlet • Bag-valve mask device • Demand-valve device

  43. Remove the plastic wrapper or cap protecting the cylinder outlet.

  44. Keep the plastic washer that is used in some setups.

  45. “Crack” the main valve for one second.

  46. Place cylinder valve gasket on regulator oxygen port.

  47. Tighten T-screw hand-tight. Do not over-tighten because this can crush or crack the O-ring, thus causing a leak.

  48. Attach tubing and delivery device.

  49. Explain the need for oxygen therapy.

  50. Open the main valve.

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