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Review & Airways, High Flow, and Optiflow/Airvo Oxygen Therapy

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With low flow oxygen the rate coming from the device
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is lower than the patient’s inspiratory flow rate/demand *Low-flow systems don’t provide all the gas needed to meet the patient’s total The patient also has to draw in room air
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Low flow oxygen devices
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NP SM NRM Bi-flow mask
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High flow oxygen devices provide
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enough air flow to meet the patient’s entire inspiratory needs (above 40 LPM)
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High flow devices can be single or
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double flow
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IH requires all high flow devices to have the Oxygen flowmeter set to at least
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15L/min
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High flow devices deliver
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fixed amounts of oxygen
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Benefits of high flow
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– Consistent and predictable FiO2 – Apparatus flow exceeds the peak inspiratory flow of the client – Changing ventilatory pattern does not affect the FiO2 – Easy to meet the humidity requirements of the patient’s airways
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Use high flow devices only as long as needed because
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the longer they are used there is Increased risk for oxygen toxicity and infection
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double flow system may be used when the patient needs
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a very high FiO2 – may need a flow rate above 15 L/min (the basic flowmeter does not go higher) *Two oxygen flowmeters deliver oxygen, one at 15 L/min and the other according to needs *The system is joined by a “100% O2 Tee”, which has a port to connect a line from the second flowmeter
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High flow mask
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Aerosol Mask (Venturi) Star Wars Mask Face Tent Trach Mask “T” Piece
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Aerosol Mask (or Venturi Mask) requires
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15L/min *Administers a specific FiO2 (determined by air entrainment port on nebulizer) – generally used for “Precise Medium FiO2” delivery
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Star wars mask delivers
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precise higher FiO2 & Generally requires double flow system
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Face tent delivers
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15L/min & Imprecise FiO2 *Should not be used on patients requiring high oxygen level
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Trach mask can be
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single or double flow *placed properly around the neck and tracheostomy to ensure adequate oxygen and humidification delivery
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“T” Piece can be
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single or double flow *Should have a 6 inch reservoir tubing attached to the other side of the “T” *Can be used to attach to endotracheal tubes or tracheostomy tubes
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Put an oral airways in by
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Lubricate the oropharyngeal airway with water-soluble jelly With the airway distal tip pointing up, open the clients mouth and insert the airway along the tongue When the distal end reaches the soft palate rotate the airway 180 degrees
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DO NOT attach bronchodilators to a
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high flow device! it is ineffective *In order to effectively deliver bronchodilators to the patient you MUST use a Metered Dose Inhaler, (MDI) with an aerochamber.
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nasal airways are used when
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can’t get an oral airway in or may be somewhat conscious but not quite
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measure a nasal airway tube from
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earlobe to tip of nose *must use lubrication when inserting
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O2 Concentrator versus o2 tanks
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Oxygen tanks have a limited amount of oxygen compressed within them, inhaled by the user until it runs out. Oxygen concentrators filter (removes nitrogen and other agents to purify the air) and generate medical grade oxygen, at an unlimited supply so long as the battery that powers this mechanism has life.
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PSI
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what is left in the tank multiplied by the conversion factor divided by the L/min client requires
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How do you decide whether to increase or decrease the amount of oxygen administered?
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Based on patient condition Oxygen saturation Hemoglobin level
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Low flow we document in
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L/min
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High flow we document in
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percentage
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for oral airways do NOT
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tape airway in place
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OPTIFLOW/Airvo OXYGEN THERAPY provides
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heated and humidified gas at 37 degrees at both low and high flows through a nasal, mask, or tracheostomy interface at a flow range of 10 to 60 L/min and an FiO2 range of 0.28 to 1.0 (Optiflow); 2 to 60 L/min and an FiO2 range of 0.21 to 1.0 (Airvo 2)
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Optiflow/Airvo is a high flow oxygen delivery system used for
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clients with profound hypoxemia and/or mucocilitary clearance difficulties
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can’t transport pts if they are on
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optiflow *can’t take the wall with you Technically you can transport pts on airvo because it can be used with an oxygen tank
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when titrating a client off of a high flow nebulizer you should decrease in increments of
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5-10%
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when collecting a sputum sample the client should cough up
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15-30ml of sputum
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nebulizer tubing and mask/NP should be changed every
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7d and PRN