O2 Devices

Nasal Cannula

1 - 6 LPM 24-44% Wall Device Room atmosphere 02 is already 21% 1 Liter of 02 = 24% (3% more)

Why is 02 given?

It is given to decrease the work of breathing & decrease the work of the heart Body compensates, HR greater than 100, tachypnea (RR over 20) Body kicks into high gear; cyanosis, syncope, confusion

Non-rebreather Mask

about 10 - 15 LPM 80-95% Not rebreathing your CO2 Non-rebreather has FLAP in bag NO CO2, only 02 Has plastic little flap in middle creating a 1-way valve You are NOT rebreathing your carbon dioxide Flap doesn't let carbon dioxide in bag

Aerosol Mask, Trach- collar, Face tent: Advantages

-Administers large volumes of mist -Indicated for patients with thick secretions or for those with a bypassed upper airway (intubation, trach, laryngectomy)

Aerosol Mask, Trach- collar, Face tent: Disadvantages

-Condensate may collect in the tracheostomy collar or T-tue (may drain into the trach or weight of the T tube can put stress on the trach. tube)

Venti-mask: advantages

-Delivers highly accurate oxygen concentrations despite patients respiratory pattern because the same amount of air is always being entrained. -Dilute jets can be changed or dial turned to change oxygen concentration -Will not dry mucous membranes

Simple Mask: Advantages

-Delivers oxygen concentrations up to 60%

Nasal Cannula: Advantages

-Effective for low oxygen concentrations -Safe and simple to apply -Comfortable/easily tolerated -Allows movement; eating & talking

Venti-mask: disadvantages

-Requires a tight seal: -confining -may irritate skin -interferes with talking/eating -Oxygen concentration may be altered if: -mask fits loosely -tubing kinks -oxygen intake ports become blocked -flow is insufficient, or the patient is hyperpneic

Hypoxia

Less than 95% at tissue level pulse ox

Symptoms for indications for O2 therapy

tachycardia tachypnea syncope confusion/disorientation cyanosis decreased Sa02 Decreased Pa02 (ABG)

Risk of 02 Therapy

02 toxicity = dry cough, chest pain, numbness in extremities, lethargy, nausea 02 induced hypoventilation in patients with COPD -> high 02 depresses their respirations, they depend on low PA02 and high PaCO2 to breathe Collapse of alveoli

Partial Rebreather Mask

6 - 11 LPM 60-75% Has bag Partially rebreathing. Some of carbon dioxide being exhaled Your rebreathing a portion of your carbon dioxide & 02 in bag Partial -> flaps on outside more flaps, Increase 02 from wall more 02 = add flaps More flaps it has, the higher the FI02

Hypoxemia

Blood Saturation Pa02 = <80% Detected on a ABG

Indications for 02 Therapy

Pt. is unable to maintain oxygenation -Sao2 < 90% RA Less than 95% - why? Able to cough & DB to bring it up? 88% or less is what it has to be sometimes for insurance to pay

Non-rebreather mask: advantage

Delivers the highest possible oxygen concentration without intubation/mechanical ventilation -Effective for short-term therapy -Will not dry mucous membranes

Aerosol Mask

at least 10L/MIN 24-100% Breathing treatment Medicated solution being delivered

Trach Collar

at least 10L/MIN 24-100% Humidified/solution over trach site

Face Tent

at least 10L/MIN 24-100% Seen a lot in oral surgeries -> helps supplement them

Simple Mask: Disadvantages

-Tight seal is required for higher oxygen concentrations: -interferes with eating/talking -hot and confining -may cause skin irritation -impractical for long-term therapy because of imprecision

Nasal Cannula: Disadvantages

-Will not deliver oxygen concentrations higher than 40% -Cannot be used in complete nasal obstruction -May cause headaches or dry mucous membranes -Dislodges easily

Non-rebreather mask: disadvantage

-Requires a tight seal! -may cause discomfort -may irritate skin -interferes with talking/eating -Impractical for long-term therapy

Venturi Mask

4 - 10 LPM (at recommended per markings) 24-55% Dial = a good guide a dial will tell you exactly what the FI02 will be & what the dial on the wall should be More open the hole, the less F102 being delivered Moe open = Less 02 More Closed = more 02

Simple Mask

5 - 8 LPM 40-60% Mask with Holes Lowest dialed #5 @5L = 40% @ 8L = 60%