oxygen therapy sajoo RT

8/14/2019 oxygen therapy sajoo RT

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njoy my presentation that Iuarantee it will be full of. . &xygen interesting,hings to know SO

E READY ^_^..AJO


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Info.

774 . Priestlyproduced O2 Dephlogisticated Air

776 . .L Lavoisier termed this vital airOXYGEN ate 1800 Bonnairegave O2to preterm lueaby .with success

.907 A Laneinvented NASAL CATHETER .919 L Hilldeveloped O2 .TENT -920 O2therapy became routine for ICK NEWORN


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..Impotency of o2

Living cells must be fuelled withoxygen in order to survive!

The respiratory system functions tosupply oxygen to the cells andremove carbon dioxide from thetissues.

Illness and injury increase tissueoxygen demand


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Definitionefinition

Oxygen therapy is the administrationof oxygen at concentrations greaterthan that in ambient air (21%) withthe intent of treating or preventingthe symptoms and manifestations

of hypoxia


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Indications for oxygentherapy ( )Hypoxemia Actual or suspected Adult children and infants 28 days on room air /PaO2 and or SaO2 below desirable range for specific

( . ..clinical situation e g - ).patients with intra cardiac shunting < , < %,Neonates PaO2 50 mm Hg SaO2 88 or capillary

60 mm Hg may depress ventilation in somepatients with chronic

Hypercapnia.

FiO2 > 50% O2 toxicity

Absorption atelectasis

Decreased ciliary function, leukocyte function

Fire hazard

Retinopathy of prematurity (PaO2 > 80 mm Hg)

Bacterial contamination

Humidification system


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Classification of o2 deliverydevices

- ;;Low flow system Nasal Cannula

Simple oxygen

mask Partial rebreathing

oxygen mask

Non-rebreathing

oxygen mask


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Cont. of the classification;

- -High flow oxygen-High flow oxygen .elivery devices.elivery devices Venturi Mask

Aerosol Mask Trach collar

Face tent

Briggs Adapter

(T-piece)


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other oxygen deliverydevices;Oxygen-ConservingDevices:

Reservoir Cannula

Demand Oxygen

DeliverySystems orPulse Dose

Oxygen Devices

Transtracheal

OxygenCatheters


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LFS VS HFS

LFS- uses onlypartialpatients need

HFOS the flowrate andreservoircapacity

adequate toprovide thetotal inspiredflow needed.

HFOS must becapable ofmeeting the

patients PIF toensureconsistentFIO2.

Device deliversat least 3xMV

Advantage1.consistentFIO2


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Criteria for use of LFS

When thepatient isbreathing

VT 300-700

RR 25Ventilatory

patternregular

and

In LFOS thelarger the TVor the faster

the RR thelower the FIO2

The smaller theVT or the

slower the RRthe higher theFIO2

MV FIO2


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Nasal Cannula

Most used oxygentherapy device.

If used with flowlarger than 4 lpmbubble humidifierindicated..

Oxygenconcentrationsdelivered by thenasal cannula

according to flow.

The use of NC forlong term use led todiscovery oflimitation

During expirationthere is waist offlow to the room .


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NC. Cont..

Flow Up to 6 L/min.

Humidifier should be

used when flowexceeds 4 L/min

< 2 L/min (infants)

FiO2 range 22 - 45%

FiO2 stability Variable

Advantages Use in adults, children,

infants, Easy to apply,Disposable,

Low cost, Well tolerated

Disadvantage Unstable, Easily dislodged,High flows uncomfortable,Can

cause dryness/bleeding,Deviated septum may

block flow, mouth breathing may reduce

FiO2

Bestuse

Stable patients needing lowFiO2, Home care patients


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uide lines for estimating FIO2ith NCF IO 21 .242 .283 .32

4 .365 .406 .44??one liter O2 there is increase by 4


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Simple maskFlow rate must be at least5l/min

Exact concentration of

oxygen depends onpatients respiratory pattern

Useful post-operatively


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Flow

5 - 12 L/minute

FiO2 range 35 - 50%

FiO2 stability

Variable

Advantages

Use on adults, childrenand infants, Quick,easy to apply,

Dis osable,

Disadvantages

Uncomfortable, Must

be removed foreating, Blocksvomits inunconsciouspatients

Best use

Emergencies, Short-term therapyrequiring moderateFiO2


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REBREATHER MASK Reservoir bags WITH one

way valve = nonrebreather.. Withoutvalve= partial-

rebreather.. Flow rate must be set to

15l/min

Fill reservoir 2 thirdsbefore applying

Useful in acute situation

Should not be worn


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Partial rebreather

Flow

6 - 10 L/minute

(Prevent bagcollapsing on Insp.)

FiO2 range

35 - 60%

FiO2 stability

Variable

Ad tAdvantag

es


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AdvantagesAdvantages

Use on adults, children and infants, Quick,easy to apply,

Disposable, Inexpensive, Moderate to highFiO2

Disadvantages

Uncomfortable, Must be removed foreating, Blocks vomits in unconsciouspatients,

potential suffocation hazard

Best use Emergencies, Short-term therapy requiring

moderate to high FiO2


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Non rebreather..

Flow

6 - 10 L/minute

(Prevent bagcollapsing on Insp.)

FiO2 range

55 - 70%

FiO2 stability

Variable

Advantages

Same as partial-

Rebreathing Mask,High FiO2

Disadvantages

Same as partial-

Rebreathing Mask,potential suffocationhazard

Best use

Emergencies, Short-


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Air Entrainment >or= 3years

Total amount of airdepends on:

1. The size ofentrainment port.

2. The velocity ofoxygen at jet.

The smaller the orifice the greater is thevelocity of oxygen and the more air is

entrained.The largest jet provides the lowest oxygenvelocity and thus the least air entrainment andthe higher FiO2


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Flow

Varies, should provide

output flow > 60L/min

FiO2 range

24 - 50%

FiO2 stability

Fixed


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Tents

Uses a frame and a large , soft plastic materialto enclose the patient.

Used in pediatrics especially with croup.

Tents receive O2 from a high flow aerosolsystem .

FIO2 is difficult to be controlled because of

large volume.


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& ..2 DELIVERY IN pedia infant& ..2 DELIVERY IN pedia infant


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KEY POINTS with neonates.

Use the lowest FIO2 to Keep PaO2 50 80 mm. Hg. ,

SpO2 88 - 95 %

n O2 is a DRUG only should be used Documented hypoxia Resp. Distress

Cynosis

n When prescribing O2 specify - Dose

Device Duration Monitoring

n Take care when the devices is used to prevent NOS.INFECTION


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Thanq

oxygen therapy sajoo RT

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