OXYGEN THERAPY OB SL

• Oxygen


  Odorless, colorless, tasteless gas that is essential for the body to function properly and to survive
• Oxygen therapy


  The administration of oxygen at a concentration of pressure greater than that found in the atmosphere
• Symptoms of low oxygen

  • Rapid Breathing
  • Shortness of breath
  • Fast heart rate
  • Coughing or wheezing
  • Sweating
  • Confusion
  • Changes in color of the skin
• Classification of Oxygen Delivery System


  • Low flow oxygen therapy system
  • High flow oxygen delivery system
• Low flow oxygen therapy system


  provide oxygen at flow rates that are lower than patients' inspiratory demands; thus, when the total ventilation exceeds the capacity of the oxygen reservoir, room air is entrained
• Nasal cannula


  A medical device to provide supplemental oxygen therapy to people who have lower oxygen levels. The device has two prongs and sits below the nose. The two prongs deliver oxygen directly into your nostrils.
• Nasal cannula


  • Can deliver O2 to "mouth breathers"
  • "Heavy mouth breathers or blocked nasal passages may not be best choice"
  • Most common
  • Used when needs are low
  • Note: not too tight and preventive care for pressure injury
• Parts of a nasal cannula


  • Tubing
  • Prongs
  • Connector
• Advantages of nasal cannula

  • They are well tolerated
  • Allow the patient to eat and expectorate without having to remove the cannulas
  • The oxygen flow fills the nasopharyngeal and oropharyngeal reservoirs at end-expiration and is then inspired into the lungs, even when the mouth is open
• Disadvantages of nasal cannula


  • Limit efficacy and tolerance of oxygen delivery
  • The oxygen is not humidified at low flow
  • The patient usually complaints of dry nose, dry throat, and nasal pain
• Simple mask


  usually used to deliver a low to moderate amount of oxygen. A simple mask contains holes on the sides to let exhaled air through and to prevent suffocation in case of a blockage.
• Parts of a simple mask


  • Mask
  • Tubing
  • Connector
• Advantages of simple face mask

  • Sits lightly on the face, reducing the possibility of skin breakdown under the nose, on the cheeks and on the ears
  • Aids compliance of prescribed oxygen therapy by reducing interruptions
• Disadvantages of simple mask


  • Difficult to eat with a mask on
  • A mask may be confining for some patients, who may feel claustrophobic with the mask on
  • Contraindicated in patients with facial injuries
• Partial re-breather mask


  a face mask that covers both the nose and mouth. It's a step up from a simple face mask and a step down from a non-rebreather mask. A low-flow device, the partial rebreather mask can deliver 60% to 80% oxygen at flow rates of 6 to 11 L/minute.
• Advantages of Partial Re-breather Mask


  • Light weight easy to use
  • Used for O2 high concentration, must keep bag partially inflated all times
  • The mask has reservoir bag attach with no value, which allows patient to breath up to 1/3 of exhaled air together with room air
• Disadvantages of Partial Re-breather Mask


  • Complete deflation of the bag reservoir during inspiration can cause CO2 buildup
  • The FiO2 varies with breathing pattern
  • This device is poorly tolerated by client who have anxiety and claustrophobia
  • Eating and drinking is impaired
  • Use with precaution for client high risk for aspiration and airway obstructions
  • Not use for COPD client
  • Cannot use in high humidification
  • Uncomfortable
  • Malfunction can build up CO2 suffocation
• Non-rebreather mask


  a special medical device that helps provide you with oxygen in emergencies. These masks help people who can still breathe on their own but need a lot of extra oxygen.

  
• Advantages of Non Rebreather Mask

  • Delivers the highest possible in oxygen concentration
  • Suitable for patient breathing spontaneously in patient with severe hypoxemia
  • Economical and easy to apply
  • Indicated in client with nasal irritation and epistaxis
• Disadvantages of Non Rebreather Mask


  • Requires tight seal, uncomfortable
  • Interfere with eating and drinking
  • Not suitable for long term use
• High flow oxygen delivery system


  High flow oxygen therapy delivers oxygen, through nasal prongs, at higher than normal flow rates of traditional oxygen therapy. This therapy is sometimes used for people who are in respiratory distress.

  
• Venturi mask


  air-entrainment mask is a high flow device that delivers a fixed oxygen concentration of 24% to 50%, flow at 4- 15 liters/ min. This device is appropriate for patients who have a hypoxic drive to breathe but also need supplemental oxygen.

  
• Advantages of Venturi Mask


  • Provide total inspiratory flow at a specified FiO2 to patients therapy
  • The use of its fine adjustment capabilities in the long-term management of physiologically stable patients
  • Doesn't dry mucous membrane
  • Delivers most precise oxygen concentration
  • Best suited or client with chronic lung disease
• Disadvantages of Venturi Mask


  • Uncomfortable and noisy
  • Risk for skin irritation
  • Eye irritation
  • Produce respiratory depression in client with COPD with high concentration of oxygen
  • Limited access to mouth for eating, speaking, and expectorations
  • Uneconomical
• Aerosols mask, Tracheostomy Collars, T-tube adapters


  This can be use with high flow supplemental oxygen system, but not all can deliver high oxygen concentration at the needed flow rate. Attach a mist collar (trach mask) with aerosol tubing over the trach with the other end of tubing attached to the nebulizer bottle and air compressor. Sterile water goes into the nebulizer bottle (do not overfill, note line guide). Oxygen can also be delivered via the mist collar if needed.
• Face tent oxygen


  a shield like device that fits under the patient's chin and encircles the face. It is used primarily for humidification and for oxygen only when the patient cannot or will not tolerate a tight-fitting mask. Provides oxygen concentration at 30%- 50% with flow rates of 4-8 Lpm. Use in children and patient who find mask claustrophobics. Useful for patient had facial or nasal surgery. Not optimal for FIO2 requirements.
• BIPAP (Bilevel Positive Airway Pressure)


  It's a form of noninvasive ventilation that providers might use if you can breathe on your own but aren't getting enough oxygen or can't get rid of carbon dioxide. Has 2 pressure settings that allow patient to get more air in and out of their lungs.
• CPAP (Continuous Positive Airway Pressure)


  It's a machine that uses mild air pressure to keep breathing airways open while you sleep. Usually set to a specific setting that will remain throughout the night. Prescribed to treat sleep-related breathing disorders including sleep apnea. CPAP also may treat preterm infants who have underdeveloped lungs.
• Complications of Oxygen Therapy

  • Oxygen toxicity
  • Depression of ventilation
  • Retinopathy in prematurity
  • Absorption atelectasis
  • Fire hazard
• Signs and Symptoms of Oxygen Toxicity

  • Non-productive cough
  • Nausea and vomiting
  • Substernal chest pain
  • Fatigue
  • Nasal stuffiness
  • Headache
  • Sore throat
  • Hypoventilation
  • Nasal congestion
  • Dyspnea
  • Inspirational pain
• Review the protocol at your health authority prior to initiating any high-flow oxygen systems, and consult your respiratory therapist.
• In general, nasal prongs and a simple face mask (low-flow oxygen equipment) may be applied by a health care provider. All other oxygen equipment (high-flow systems) must be set up and applied by a respiratory therapist.
• For patients with asthma, nebulizer treatments should use oxygen at a rate greater than 6 L/min. The patient should be changed back to previous oxygen equipment when treatment is complete.
• Oxygenation is reduced in the supine position. Hypoxic patients should be placed in an upright position unless contraindicated (e.g., if they have spinal injuries or loss of consciousness).
• In general, for most patients with COPD, target saturation is 88% to 92%. It is important to recognize COPD patients are at risk for hypercapnic respiratory failure.
• Check the function of the equipment and complete a respiratory assessment at least once each shift for low-flow oxygen and more often for high-flow oxygen.
• In acutely ill patients, oxygen saturation levels may require additional ABGs to regulate and manage oxygen therapy.
• Oxygen saturation levels and delivery equipment should be documented on the patient's chart.