Oxygen Therapy Indications and Delivery Methods

Questions and Answers

What is the main purpose of endotracheal intubation during cardiopulmonary resuscitation?

To prevent airway obstruction

To reduce the risk of cardiac arrest

To enhance blood circulation

To ensure adequate ventilation (correct)

What is the recommended oxygen saturation level to maintain in patients requiring oxygen therapy?

Above 85%

Above 100%

Above 90%

Above 95% (correct)

Which condition is NOT typically associated with cardiogenic shock?

Hypotension

Compensatory peripheral vasoconstriction

Congestive cardiac failure

Sepsis (correct)

What management is essential in the treatment of cardiogenic shock?

Treatment of the underlying cause Signup and view all the answers

What is the goal central venous pressure (CVP) for most patients with cardiogenic shock?

5 to 10 cm water Signup and view all the answers

What is one of the first steps in maintaining adequate airway and breathing in cardiogenic shock patients?

Using high flow oxygen via face mask Signup and view all the answers

How should the administration of inotropic agents be viewed in the context of treating cardiogenic shock?

As a temporary measure Signup and view all the answers

What strategy should be used if a central venous line is not available for measuring CVP?

Examine neck veins Signup and view all the answers

What is the primary therapeutic option for patients with sinoatrial block and sick sinus syndrome, if persistent?

Pacemaker therapy Signup and view all the answers

Which medication is NOT typically used in the management of acute pulmonary oedema?

Antibiotics Signup and view all the answers

What is a critical characteristic of epiglottitis that differentiates it from other conditions?

Acute airway obstruction risk Signup and view all the answers

In the case of acute pulmonary oedema, which patient condition may necessitate endotracheal intubation?

Failure to respond to nebulized adrenaline Signup and view all the answers

When should oxygen therapy be considered essential?

If there are signs of potential oxygen deprivation Signup and view all the answers

What age group is primarily affected by epiglottitis?

Children between 3 and 8 years Signup and view all the answers

In managing acute pulmonary oedema, which of the following should NOT be withheld?

Oxygen Signup and view all the answers

Which of the following treatments is NOT appropriate for a patient with epiglottitis?

Attempting to visualize the throat Signup and view all the answers

Which condition is NOT an indication for oxygen therapy?

Chronic Heart Block Signup and view all the answers

What is the recommended oxygen saturation target for most patients receiving oxygen therapy?

92% Signup and view all the answers

Which method of oxygen delivery is appropriate for patients with mild hypoxia?

Intranasal catheters Signup and view all the answers

What flow rate should intranasal catheters be used at for children?

1 to 2 liters per minute Signup and view all the answers

Which oxygen delivery method can provide nearly 100% oxygen concentration?

Tight fitting face masks Signup and view all the answers

What complication may arise from administering oxygen to patients with COPD?

Hypoventilation Signup and view all the answers

What is the acceptable flow rate for a plastic face mask?

4 to 15 liters per minute Signup and view all the answers

Why is humidification of oxygen not necessary?

It does not provide any clinical benefit. Signup and view all the answers

Study Notes

Indications for Oxygen Therapy

Cardiac or respiratory arrest necessitates immediate oxygen therapy.
Hypoxia from any cause requires intervention.
Essential for managing cardiac failure and myocardial infarction.
Effective in cases of shock, irrespective of cause.
Critical for treating carbon monoxide poisoning.
Monitor oxygen therapy with pulse oximetry and arterial blood gases (ABGs) when available.
Target oxygen saturation of at least 92%, except in carbon dioxide retainers.
Humidification of oxygen is generally unnecessary.

Methods of Oxygen Delivery

Intranasal Catheters:
- Deliver oxygen concentrations between 25% and 40% at flow rates of 1 to 4 liters per minute.
- Suitable for mild hypoxia or cardiac ischaemia; insufficient for significant hypoxia or cardiac arrest.
Plastic Face Masks:
- Provide 35% to 70% oxygen concentration, with flow rates of 4 to 15 liters per minute.
- Effective for moderate hypoxia or shock.
Tight Fitting Face Masks (e.g., Laerdal, CPAP):
- Can deliver up to nearly 100% oxygen.
- Indicated for severe hypoxia or cardiac arrest situations.

Adverse Effects of Oxygen

In patients with COPD and elevated carbon dioxide, oxygen therapy may cause hypoventilation and increased CO2 levels.
Such instances may present risks but are often less severe than hypoxia itself.

Cardiogenic Shock

Defined as inadequate cardiac output to maintain tissue perfusion, characterized by hypotension and peripheral vasoconstriction.
Important to distinguish from hypovolaemic and distributive shock.
Commonly caused by acute myocardial infarction; treatment should address the underlying cause.
Administration of inotropic agents is a temporary measure; close monitoring in intensive care is crucial.
Prognosis is generally poor, with many patients failing to recover.

Airway and Breathing Management

Maintain airway and ventilation through typical maneuvers, including endotracheal intubation if necessary.
Provide high flow oxygen via face mask to maintain arterial oxygen saturation above 95%.

Optimizing Intravascular Volume

Insertion of a central venous line permits accurate central venous pressure (CVP) measurement and safer inotropic administration.
If unavailable, neck vein examination can be utilized to assess CVP.
Correct anaemia through blood administration; use normal saline boluses for optimal CVP between 5 to 10 cm water.
Patients with right ventricular infarction require higher CVP (around 20 cm water).

Acute Pulmonary Oedema

A medical emergency requiring swift treatment with oxygen, morphine, vasodilators, and diuretics.
Monitor blood pressure; hypotensive patients need immediate intervention.

Epiglottitis

A critical medical emergency often caused by Haemophilus influenzae infection.
Primarily affects children aged 3 to 8 years but can occur in adults.
Symptoms include severe sore throat, fever, dysphagia, drooling, and respiratory distress.
High risk of acute airway obstruction; avoid throat examination to prevent complications.
Immediate referral to anaesthesia and intensive care is required.
Administer ceftriaxone or chloramphenicol for treatment.

Importance of Oxygen

Oxygen is vital for metabolism; absence can lead to fatality within 5 to 6 minutes.
Generally low adverse effects when used acutely; should not be withheld if necessary.

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Description

This quiz covers the indications for oxygen therapy and various methods of oxygen delivery. It includes topics like hypoxia, cardiac failure, and monitoring oxygen saturation levels. Test your knowledge on when to administer oxygen and how to do it correctly.