Management of Hypoxic Patient
Cards (5)
- Management of Hypoxic Patient:
- Oxygen therapy +/- humidification - to help moisten and clear secretions (this is always the priority)
- Positioning
- To maximise V/Q
- To relieve breathlessness
- To assist drainage of secretions
- ACBT
- breathing control + + if breathless
- Tailored cycle
- Hypoxic patient with consolidated R lower lobe pneumonia:
- would be breathless - due to hypoxia and pneumonia (inflammation of lungs so cant participate in gas exchange)
- oxygen therapy - provide high (40-60%) fio2 (as pts is not as risk of hypercapnia e.g. copd or cf) via venturi mask - fixed o2 concentration and delivers high flowrate
- pts in left sidelying (right side has disease) to optimise V/Q ratio
- high left sidelying to mix optimising V/Q ratio and reduce breathlessness
- ACBT focus on breathing control (promote relaxation and prevent hyperventilation) and remove secretions
- Hypoxic and breathless patient with L lower lobe atelectasis:
- Oxygen therapy - 40 to 60% via a venturi mask as the pts is breathless, humidify o2 to mobilise secretions
- right sidelying (to optimise V/Q ratio) as left lung as collapsed (atelectasis) - also assists drainage of sputum from left lower lobe (atelectasis could be caused by sputum block)
- ACBT - focus on breathing control as the pts is breathless and modify thoracic expansion exercises (do 2 instead of 5 as the pts is breathless)
- the bird - to mobilise secretions during thoracic expansion exercises
- Hypoxic and productive patient with a chest infection R middle lobe:
- oxygen therapy at 40 to 60% (venturi mask as its high flowrate) with humidification to mobilise secretions
- quarter left sidelying to mobilise secretions and optimise V/Q mismatch
- use the bird to mobilise secretions
- manual techniques to mobilise secretions
- Hypoxic and breathless patient with exacerbation of COPD:
- 24% (low amount as they have copd so at risk of hypercapnia) o2 via venturi mask to keep it fixed
- pts position in high sitting or right side lying
- ACBT to mobilise sputum
- breathing control to relax pts and reduce hyperventilation