Low Flow Oxygen Devices PDF

Device Administering Medical Gases Oxygen Therapy Low Flow Devices   Compare low-flow and high-flow oxygen delivery systems.  Name several commonly used low-flow oxygen delivery system. Objectives  Discuss the advantage...

Device Administering Medical Gases Oxygen Therapy Low Flow Devices   Compare low-flow and high-flow oxygen delivery systems.  Name several commonly used low-flow oxygen delivery system. Objectives  Discuss the advantages and disadvantages of oxygen- conserving devices.  Device for Administering Medical gases Oxygen Therapy Low Flow Versus High Flow Low Flow Devices Oxygen Conserving Simple Oxygen Partial Rebreathing Nonrebreathing Nasal Cannulas Nasal Catheter Devices Masks Masks Masks Transtracheal Catheters Reservoir Cannulas Pulse demand Oxygen Delivery Outlines System  Definition Administration of oxygen at concentration greater than ambient air Main Goal To treat and prevent hypoxemia Oxygen Hypoxemia Therapy Decreased PaO2 in the blood below the normal range. i.e., PaO2: < 60 mm Hg or SaO2 < 90% in patients breathing room air PaO2 or SaO2 below desirable range for the specific clinical situation What is the difference between Hypoxia and Hypoxemia?  Severe Hypoxia trauma Indications for Oxygen Therapy Acute myocardial Post-Op infarction   Absorption atelectasis  Depression of ciliary  FiO2 > 50% may cause function atelectasis  Retinopathy of Precaution –  Depression of ventilation Prematurely (ROP) Complication  PaO2 > 60 mmHg may  Oxygen toxicity depress ventilation with  Fire hazard chronic hypercapnia  Contamination Clinical practice guidelines 4-1, 4-2 and 4-3 10  Low Flow High Flow  Variable performance  Fixed performance  Devices supply oxygen at  Devices provide oxygen at flow flow rates that are lower rates high enough to Low- Flow than a patient’s inspiratory completely satisfy a patient’s Versus demands inspiratory demands High- Flow  Deliver fractional inspired  Deliver fixed fractional inspired oxygen (FiO2) levels that oxygen (FiO2)levels *(i.e., from Devices can vary from 0.22 to 0.24 to 1), regardless of the approximately 0.8 patient’s breathing pattern  FiO2 varies depending on:  Patients’ inspiratory flow  Tidal volume  Oxygen flow  Misconception Low -Flow and High-Flow Low FiO2 and High FiO2 Oxygen LOW FLOW Therapy O2 DELIVERY SYSTEMS Devices 14  Uses To treat spontaneously breathing Hypoxemic patients in emergency departments Nasal In general and critical care units Cannula During exercise in cardiopulmonary rehabilitation For long-term oxygen therapy in the home care setting  Nasal Cannula  Nasal Cannula  Problems Mucosal irritation Pressure sores Nasal Skin irritation Cannula Twisting of the tubing  Flow rates and FiO2: Adults Flow: 1 – 6 L/min FiO2: 0.24 - 0.44 Nasal Neonates Cannula Flow: 0.25 – 2 L/min FiO2: 0.35 - 0.7 Add humidity (bubble humidifier) over 4 L/min to minimize mucosal irritation  Actual FIO2 delivered is influenced by The patient's tidal volume The patient’s respiratory rate Actual FIO2 Total respiratory time Inspiratory time Inspiratory flow and pattern Whether breathing is occurring predominantly through the nose or the mouth  How to Estimate the FiO2 for Nasal Cannula 1 l/min will give 24% For each one-liter O2 increment there is increase by 4% in FiO2 Nasal Flow FiO2 1 24 Cannula 2 28 3 32 4 36 5 40 6 44  Adjusting the flow rate of oxygen according to the patients’ oxygen needs , based on the observation: Patient’s breathing pattern Level of comfort Nasal Pulse oximetry Cannula Arterial blood gas data (if available) High flow nasal cannula?   For short-term O2 administration during specialized procedures such as a bronchoscopy  It’s a soft plastic tube with several small holes at the Nasal tip Catheter  Once in position, the catheter is taped to the bridge of the nose   It can be placed blindly, by measuring the distance from the nose to the earlobe Nasal  Usual FiO2 22-45% Catheter  Flow of 0.25-8 L/min 24