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Questions and Answers
What is the normal range for PaO2 in mmHg?
What is the normal range for PaO2 in mmHg?
Oxygen therapy is warranted when PaO2 is greater than 60 mmHg.
Oxygen therapy is warranted when PaO2 is greater than 60 mmHg.
False
List two indications for oxygen therapy.
List two indications for oxygen therapy.
Severe trauma, acute myocardial infarction
The clinical assessment finding of _____ indicates severe CNS distress.
The clinical assessment finding of _____ indicates severe CNS distress.
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Match the clinical assessment findings with their severity:
Match the clinical assessment findings with their severity:
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Which of the following is NOT a method to monitor hypoxemia?
Which of the following is NOT a method to monitor hypoxemia?
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Normal SpO2 levels are considered to be between 80% and 90%.
Normal SpO2 levels are considered to be between 80% and 90%.
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What does ABG stand for and why is it used?
What does ABG stand for and why is it used?
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What characterizes a high-flow oxygen delivery system?
What characterizes a high-flow oxygen delivery system?
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A nasal catheter is commonly used for oxygen delivery due to its comfort and low irritation.
A nasal catheter is commonly used for oxygen delivery due to its comfort and low irritation.
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What is the typical FiO2 range for a simple mask?
What is the typical FiO2 range for a simple mask?
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During inhalation, fresh O2 enters the bag in a ______ mask.
During inhalation, fresh O2 enters the bag in a ______ mask.
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Match the oxygen delivery device with its characteristics:
Match the oxygen delivery device with its characteristics:
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What are some merits of using reservoir systems?
What are some merits of using reservoir systems?
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What is the typical FiO2 range for a non-rebreathing mask?
What is the typical FiO2 range for a non-rebreathing mask?
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The FiO2 will increase by 4% for every litre of flow added to a nasal cannula.
The FiO2 will increase by 4% for every litre of flow added to a nasal cannula.
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A tracheostomy mask is used primarily for delivering high concentrations of oxygen.
A tracheostomy mask is used primarily for delivering high concentrations of oxygen.
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What is a significant drawback of using a simple mask?
What is a significant drawback of using a simple mask?
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What principle does the high flow device operate on?
What principle does the high flow device operate on?
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The FiO2 range for an oxygen hood is _____ to 100%.
The FiO2 range for an oxygen hood is _____ to 100%.
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Match the following devices with their characteristics:
Match the following devices with their characteristics:
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What is one of the indications for Hyperbaric Oxygen Therapy?
What is one of the indications for Hyperbaric Oxygen Therapy?
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Incubators have a fixed performance in terms of FiO2 delivery.
Incubators have a fixed performance in terms of FiO2 delivery.
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What pressure condition is required for Hyperbaric Oxygen Therapy?
What pressure condition is required for Hyperbaric Oxygen Therapy?
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Study Notes
Oxygen Therapy
- Normal O2 levels are 80 to 100mmHg
- PaO2 less than 60mmHg requires oxygen therapy
- SaO2 less than 90% normally at room temperature requires oxygen therapy
- If saturation is below 90% or PaO2 decreases, oxygen therapy may be needed
- Indications for oxygen therapy include severe trauma, acute myocardial infarction, and short-term post-anesthesia therapy
Assessment of Hypoxia
- Monitoring ABG shows PaO2, SpO2
- Assess clinical findings
- Mild to moderate CNS: restlessness, disorientation, headache
- Mild cardiac: tachycardia, mild hypertension, vasoconstriction of peripheries
- Respiratory: dyspnea, tachypnea, shallow/laboured breathing
- Skin: pallor, cold skin
- Severe CNS: desire to sleep, loss of coordination, impaired judgment
- Severe cardiac: bradycardia, hypotension, arrhythmia
- Severe respiratory: increasingly dyspnea, tachypnea, possible bradypnea
- Skin: cyanosis
Monitoring Hypoxia
- Physical examination for clinical findings
- Pulse oximetry
- ABG analysis
- pH
- PaO2
- Minted venous blood oxygenation
Oxygen Delivery Systems
- Low-flow systems (variable performance device): oxygen does not fully meet the patient's breathing demands, especially peak inspiratory flow or their minute ventilation; examples- nasal cannula, face mask
- Reservoir systems (variable performance device): store O2 that provides oxygen equal to or more than the patient's tidal volume. Examples Reservoir Masks.
- High-flow systems (fixed performance device): meet the patient’s needs regardless of breathing pattern. Examples: venturi mask.
- Enclosures: used for infants
Low-flow Devices
- Nasal Cannula: FiO2 24-40%, Flow 8L/min (Adult), 21/min (Child). Consits of two prongs. These are inserted into the nostrils
- Nasal Catheter: used to fill up dead space with O2, very irritating and uncomfortable
- Transtracheal catheter: FiO2 22-35%, flow 4 L/min. Inserted below the second and third tracheal rings.
Nasal/Pendant Systems
- Merits: Lower cost, increased mobility, can be easily transported, and less discomfort because of lower flow.
- Demerits: Unattractive, difficult to use, poor compliance, must be replaced regularly, and affects breathing pattern.
Masks
- Reservoir Masks: simple, face masks that store 100-200mL of oxygen; variable performance that varies input flow with oxygen.
- How's the oxygen flow related to patten of breathing? Minimum flow should be 5-10 L/min to prevent rebreathing CO2. FiO2 of 40% to 60% .
Partial Rebreathing Mask
- FiO2 60-80%, Flow must be 8 to 10L/min to ensure the bag remains inflated.
- No valves are open during inhalation; fresh O2 is going inside, but during exhalation, some CO2 enters into the bag, which is rebreathed.
- Non-rebreathing mask: FiO2 80-100%, store fresh O2 in one-valve that helps during inhalation and exhalation.
- Factors affecting FiO2: air leakage, breathing pattern.
Tracheostomy Mask
- Humidification flows the oxygen that is directed to the variable performance device
- Bernoulli's principle: tube's narrowed; as the tube's velocity increases, which increases the pressure that creates lateral pressure
Venturi Mask
- Venturi Masks consists of fixed orifice that have fined flows. Many varieties available. FiO2 low to moderate. FiO2 0.24-0.68).
- Air entrainment works based on Bernoulli's principle. It provides humidification and oxygen, used to deliver medications with FiO2 28 – 100%, man/gas flow 14 – 16 L/min
Oxygen Enclosures
- Oxygen tents (variable device); covers the entire body; difficult to use
- Rebreathing covers the whole body
- Oxygen hood covers only the head of the infant. It is a fixed performance device, which allows precise blending of Oxygen and air at a perfect range. FiO2 21-100%. Allows for a baby/infant in a incubator to be kept warm.
Hyperbaric Oxygen Therapy (HBO)
- Hyperbaric oxygen therapy: 100% of oxygen at greater than 1 atm which is equal to 760 mmHg at sea level.
- Indications: Decompression sickness, bubble reduction, hyperoxia of blood
- Enhanced host immunity, neo-vascularization, and better circulation. This takes time
Adverse Effects of HBO
- Barotrauma: ear trauma, tympanic membrane rupture, pneumothorax
- Oxygen toxicity: central nervous system tonicity (seizures, convulsions), pulmonary oxygen toxicity (acute inflammation, ARDS-like state).
- Increased cellular damage due to fibrous deposition, causing vessel leakage within the lungs, and the formation of a shunt that can result in hypoxia.
- Retinopathy: occurs in infants, vessels have necrosis and retina lost.
- Denitrogenation atelectasis; increasing O2 causes N2 to be washed out, which causes atelectasis
- Fire hazard since O2 helps in combustion.
Vasoconstriction and Vasodilation
- Vasoconstriction: hyperbaric oxygen therapy
- Hyperoxia: causing vasoconstriction will help in reducing inflammation
- When attached to HBO, the oxygen dissolves with the plasma. This is in accordance with Henry's law
Methods of giving Hyperbaric Oxygen Therapy
- Multichamber can treat many patients.
- Monochamber can only treat one patient at a time.
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Description
Test your knowledge on oxygen therapy, normal PaO2 ranges, and arterial blood gas (ABG) significance. This quiz covers clinical assessment findings and monitoring methods for hypoxemia. Understanding these concepts is crucial for effective patient care in respiratory therapy.
