Oxygen Therapy Devices – Flashcards
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Major goals of O2 therapy
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Relieve hypoxemia, decrease work of breathing, decrease work of the heart
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Effects of hypoxemia on circulatory system
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Peripheral vasodilation (patient feels warm), pulmonary vasoconstriction, and tachycardia
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Retinopathy of Prematurity
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also known as retrolental fibroplasia. Blindness occurring in premature infants as a result of high PaO2, NOT high FiO2.
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O2 toxicity signs and symptoms
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nausea and vomiting, substernal chest pain and tightness, refractory hypoxemia, tachypnea, decreased surfactant production, decreased compliance, pulmonary edema
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Can you rapidly change FiO2?
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no, this can cause atelectasis. Always wean off Oxygen in 5%-10% increments.
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Nasal Cannula
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-FIO2 of .24-.45 -FLOW of 1-6L/min -Approximate FiO2: every 1 L/min, increase PiO2 by 4% -most appropriate initial O2 device for COPD
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Simple Mask
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-FiO2 of .40-.55 -flow: 6-10L/min -flow must be at least 6L/min to flush out CO2
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Partial Rebreather Mask
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-FiO2: .60-.65 -flow: 6-10L/min -no one way flap valves
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Non-rebreather mask
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-FiO2: .21-.1 -delivers 100%O2 in emergency and for mixed gas therapy -has 2/3 one way valves
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Air entrainment/venturi mask
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-precise FiO2 concentrations, ideal for COPD patients -ideal for patients with irregular tidal volumes/rates/patterns -FiO2 increases with obstruction downstream -FiO2 does not change when flow changes
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Briggs Adapter or T piece
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FiO2: .21-1.0 -reservoir tubing should be used to maintain FiO2 -FiO2 will decrease if reservoir is removed -you should see aerosol from tubing during inspiration
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What to do if aerosol from Briggs adapter disappears
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increase the flow, add more reservoir tubing
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Oxygen Hood minimum flow
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7-14L/min to prevent CO2 buildup and maintain FiO2 without sealing infant's neck around hood
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Mist Tent/ Oxygen Tent/ Coupette
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-Controls O2 conc, temp, filtired gas, and humidity -used for pediatric patients -set flow at 12-15 L/min to wash out CO2 -FiO2 variable at .40-.50 -closely monitor infants for fluid overload
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Incubator
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-filtered gas and temperature control (neutral therm environment) -Administer O2 by cannula, Oxyhood, CPAP, etc -provides humidity -Ideal for stable newborns
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Radiant warmer (open incubator)
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Ideal for unstable newborns who require constant care. Provides a neutral thermal environment but will not decrease insensible water loss in premies due to evaporation.
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Hyperbaric Oxgen Therapy Uses
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Used for CO poisoning, the bends, tissue grafts' and anaerobic infections.
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HBO therapy average pressures
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2-6ATA
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Heliox therapy uses and concentration
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Decreases patient's WOB by delivering low density gas (moves around obstructions). He:O2 must be 80%/20% or 70%/30%.
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Heliox flow calculations
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80/20 is 1.8x flowmeter read 70/20 is 1.6x flowmeter read
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NO therapy uses
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Relaxes smooth muscle and improves ventilation/perfusion mismatch by decreasing pulmonary vascular resistance. Used for pulmonary hypertension, fibrosis, embolism, ARDS, congenital heart defects, persistent newborn pulmonary hypertension, chronic lung disease, heart and lung transplant, sepsis, and sickle cell disease
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Recommended NO doses
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starting @ 20ppm but can go up to 80ppm
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Withdrawing patient from NO therapy
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decrease to low doses and hyperoxygenate before withdrawing
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A.S.S.S
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used for high pressure connections on large cylinders (H)
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P.I.S.S.
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Pin Index Safety System, used for high pressure and small cylinders (E)
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D.I.S.S.
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used for low pressure (under 200psi) connections on quick connect/all attachments
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Duration of flow formula
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(gauge pressure x tank factor)/liter flow tank factors: E=.3 H=3
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Respiratory Equipment working pressure
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50psi
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Regulator
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flowmeter attached to a reducing valve
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Best flowmeter for patient transport
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Bourdon; it is not directionally dependent
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Thorpe flowmeter and humidifier continuous bubbling with needle valve closed
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occurs due to a worn needle valve seat; replace the flowmeter
