Oxygen And Medical Gas Therapy - PDF

OXYGEN AND MEDICAL GAS THERAPY  Medical Gas and Cylinder Characteristics Cylinders are constructed of molybdenum steel. Gas cylinders are stored at high pressures; a full O2 cylinder contains 2200 psig pressure (H) and 1900 (E). The most common sizes for O2 storage are the...

OXYGEN AND MEDICAL GAS THERAPY  Medical Gas and Cylinder Characteristics Cylinders are constructed of molybdenum steel. Gas cylinders are stored at high pressures; a full O2 cylinder contains 2200 psig pressure (H) and 1900 (E). The most common sizes for O2 storage are the “H” cylinder and the “E” cylinder. Cylinder factor as follows: H = 3.14L/psig and E =.28L/psig CONVERSION How to calculate Minutes Remaining in Cylinder: = Cylinder pressure x cylinder factor flow rate How to convert LPM to FiO2: = LPM x 4 + 20 = % How to convert FiO2 to LPM: 𝑓𝑖𝑂2 = + 20 = 𝑙𝑝𝑚 4 DIFFERENCE BETWEEN PRIMARY SYSTEM AND SECONDARY SYSTEM PRIMARY SYSTEM – oxygen tanks, reservoir found on the hospitals (emergency rooms, ICU, etc.) SECONDARY SYSTEM – oxygen deliver devices (low flow system and high flow system) OXYGEN DELIVERY DEVICES LOW FLOW SYSTEM – are O2 delivery devices that does not meet the patients inspiratory flow demands; therefore room air must make the remainder of the patients VT. HIGH FLOW SYSTEM – O2 delivery device provides all of the inspiratory flow required by the patient at relatively accurate and consistent O2 percentage. LOW FLOW SYSTEM Nasal Cannula – 24% to 40% at 1-5 LPM. A nasal cannula is generally used wherever small amounts of supplemental oxygen are required, without rigid control of respiration, such as in oxygen therapy.  Simple Mask – 35% to 50% at 5-10 LPM. This mask is only meant for patients who are able to breathe on their own, but who may require a higher oxygen concentration than the 21% concentration found in ambient air. And also patient who are experiencing conditions such as chest pain (possible heart attack), dizziness, and hemorrhage.  Partial Rebreathing Mask – 40% to 70% at 8-15 Lpm. The partial re- breather mask looks very similar to the non-rebreather mask except that it has a two-way valve that permits the patient to rebreathe about one-third of his or her exhaled air. And is used if patient has respiratory disease, cardiac disease, shock, trauma, and severe blood loss.  Non-Rebreathing Mask – 60% to 80% at 10-15 Lpm. The non- rebreather mask is utilized for patients with physical trauma, chronic airway limitation, cluster headache, smoke inhalation, and carbon monoxide poisoning, or any other patients who require high- concentration oxygen, but do not require breathing assistance. HIGH FLOW SYSTEM Venturi Mask (Air Entrainment Mask) – 24% to 60% also known as an air-entrainment mask, is a medical device to deliver a known oxygen concentration to patients on controlled oxygen therapy.  Aerosol Mask – 21% to 100% at flow rates of 8 to 15Lpm is a mask used for the therapeutic administration of a nebulized solution, humidity, or high airflow with oxygen enrichment. It has a large-bore inlet and an exhalation port.  Face Tent – 21% to 40% at flow rates of 8 to 15 L/min. Face tents are used to provide a controlled concentration of oxygen and increase moisture for patients who have facial burn or a broken nose, or who are claustrophobic.  Tracheostomy Mask (Collar) – 35% to 60% at 10 to 15 L/min. Tracheal Masks. Tracheostomy is an opening in the neck, into the trachea to deliver oxygen or remove secretion build up in the airway. Tracheostomy can be necessary after a disease, trauma or surgery. The tracheostomy tube is placed on the stoma and is secured with a harness.  Oxygen Tent – 21% to 50% of O2 at flow rates 10 to 15 L/min, used primarily on children with croup or pneumonia. OXYGEN THERAPY INDICATIONS: Hypoxemia – low levels of oxygen in the body Labored breathing or Dyspnea – Difficulty in breathing Increased Myocardial Work – overworked heart muscles SIGNS AND SYMPTOMS OF HYPOXEMIA TACHYCARDIA DYSPNEA CYANOSIS IMPAIRMENT OF SPECIAL SENSES HEADACHE MENTAL DISTURBANCE SLIGHT HYPERVENTILATION COMPLICATIONS OF O2 THERAPY RESPIRATORY DEPRESSION – common among patient “hypoxic drive” mechanism. Maintain oxygen between 50 to 65 mmHg oxygen. Atelectasis – too much oxygen in take can wash out nitrogen Oxygen Toxicity Reduced Mucociliary activity. FOUR TYPES OF HYPOXEMIA HYPOXEMIC HYPOXIA – caused by lacked of oxygen in the blood. ANEMIC HYPOXIA – blood’s capacity to carry O2 is reduced STAGNANT HYPOXIA – O2 capacity and carrying is normal but perfusion is diminished. HYSTOTOXIC HYPOXIA – oxidative enzyme of the cell is impaired.