1 oxygen gas administration م. م زيد وحيد عاجل. 2 oxygen therapy general...
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Oxygen Gas AdministrationOxygen Gas Administration
وحيد. زيد م م عاجل
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Oxygen TherapyGeneral Goals/objectives– Correcting HypoxemiaCorrecting Hypoxemia
By raising Alveolar & Blood levels of OxygenBy raising Alveolar & Blood levels of Oxygen
Easiest objective to attain & measureEasiest objective to attain & measure
– Decreasing symptoms of HypoxemiaDecreasing symptoms of HypoxemiaSupplemental O2 can help relieve symptoms Supplemental O2 can help relieve symptoms of hypoxiaof hypoxia
– Less dyspnea/WOBLess dyspnea/WOB– Improve mental funxImprove mental funx
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Oxygen TherapyOxygen TherapyDesign & Performance Design & Performance
Flow does not meet inspiratory demandFlow does not meet inspiratory demand
O2 is diluted with air on inspirationO2 is diluted with air on inspiration
Nasal CannulaNasal Cannula
Nasal CatheterNasal Catheter
Xtracheal CatheterXtracheal Catheter
Resevoir CannulasResevoir Cannulas
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Nasal CannulaNasal Cannula
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Oxygen TherapyOxygen TherapyLow Flow DevicesLow Flow Devices
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Oxygen TherapyOxygen TherapyLow Flow DevicesLow Flow Devices
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Oxygen TherapyOxygen TherapyLow Flow DevicesLow Flow Devices
Xtracheal catheterXtracheal catheter– Surgically inserted in tracheaSurgically inserted in trachea– Uses trachea/upper airway as reservoirUses trachea/upper airway as reservoir
Requires very low flows to meet needsRequires very low flows to meet needs
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Oxygen TherapyOxygen TherapyLow Flow DevicesLow Flow Devices
– Reservoir CannulaReservoir Cannula
– Frequent replacementFrequent replacement– No humidificaxNo humidificax– Requires nasal exhalaxRequires nasal exhalax
NasalNasal– Stores ~20mlStores ~20ml– Aesthetically displeasingAesthetically displeasing
PendantPendant– Better aestheticallyBetter aesthetically– Extra weight can irritate Extra weight can irritate
ears/faceears/face88
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Low Flow DevicesLow Flow DevicesReservoir MasksReservoir Masks
Simple MaskSimple MaskGas gathers in maskGas gathers in mask
Exhalax portsExhalax ports
Air entrained thru ports & around Air entrained thru ports & around maskmask
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Partial rebreather Non-rebreatherPartial rebreather Non-rebreather
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AEMAEM
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Oxygen TherapyOxygen TherapyMore ReservoirsMore Reservoirs
EnclosuresEnclosures– TentsTents– HoodsHoods– IncubatorsIncubators
OthersOthers– BVMBVM– Pulse Dose CannulaPulse Dose Cannula– ConcentratorsConcentrators
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Oxygen TherapyOxygen TherapyMore Reservoirs – EnclosuresMore Reservoirs – Enclosures
Oxygen TentsOxygen Tents– RareRare– Air conditioned to provide constant Air conditioned to provide constant
desired Tempdesired Temp– Frequent opening & constant leakage Frequent opening & constant leakage
Make FiO2 variableMake FiO2 variable
Analyze FiO2 @pt head level (layering)Analyze FiO2 @pt head level (layering)
– Primarily for pediatric aerosol therapy Primarily for pediatric aerosol therapy for Croup or CFfor Croup or CF
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Oxygen TherapyOxygen TherapyMore Reservoirs – EnclosuresMore Reservoirs – Enclosures
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Oxygen TherapyOxygen TherapyMore Reservoirs – EnclosuresMore Reservoirs – Enclosures
Incubator (isolette)Incubator (isolette)– Plexiglas enclosurePlexiglas enclosure– Servo controlled convex Servo controlled convex
heating with supplemental O2heating with supplemental O2– Freq opening & dilution Freq opening & dilution
makes it hared to deliver high makes it hared to deliver high O2O2
– Hoods are used in Incubators Hoods are used in Incubators to provide supplemental O2to provide supplemental O2
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Oxygen BlenderOxygen Blender
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Oxygen TherapyOxygen TherapySelecting Delivery ApproachSelecting Delivery Approach– Purpose (Objective)Purpose (Objective)
Increase FiO2 to correct hypoxemiaIncrease FiO2 to correct hypoxemia
minimize symptoms of hypoxemiaminimize symptoms of hypoxemia
– PatientPatientCause & severity of hypoxemiaCause & severity of hypoxemia
AgeAge
Neuro status/orientaxNeuro status/orientax
Airway in place/protectedAirway in place/protected
Regular rate & rhythm Regular rate & rhythm 1717
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Oxygen TherapyOxygen TherapyPrecautions & HazardsPrecautions & Hazards
– O2 ToxicityO2 ToxicityPrimarily affects Lungs & CNSPrimarily affects Lungs & CNS
2 determining factors of O2 tox2 determining factors of O2 tox– PO2PO2– Time of exposureTime of exposure– i.e., higher the PO2 & exposure time the greater i.e., higher the PO2 & exposure time the greater
the toxicity.the toxicity.
CNS effects occur with Hyperbaric PressuresCNS effects occur with Hyperbaric Pressures
Pulmonary effects can occur @ clinical PO2 Pulmonary effects can occur @ clinical PO2 levelslevels
– Patchy infiltrates on x-ray, prominent in lower Patchy infiltrates on x-ray, prominent in lower lung fieldslung fields
– Major alveolar injuryMajor alveolar injury1818
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Oxygen TherapyOxygen TherapyPrecautions & HazardsPrecautions & Hazards
– Retinopathy of Prematurity (ROP) Retinopathy of Prematurity (ROP) retrolental fibroplasiaretrolental fibroplasia
Up to 1month of ageUp to 1month of age
excesive Blood oxygen level causes retinal excesive Blood oxygen level causes retinal vasoconstrixvasoconstrix
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Oxygen TherapyOxygen TherapyPrecautions & HazardsPrecautions & Hazards
– FireFire Newspaper!Newspaper!Fire TriangleFire Triangle
– O2, Heat, & FuelO2, Heat, & Fuel
increase risk of fire increase risk of fire – High Concentrax of O2High Concentrax of O2– High Pressures of O2High Pressures of O2
Reduce O2 buildup in enclosed Reduce O2 buildup in enclosed environmentsenvironments
– Under drapesUnder drapes– Operating rooms, etc.Operating rooms, etc.
Be cautious when using electronic Be cautious when using electronic equipmentequipment
– Scalpels, Cardioverx, Cardio ShockScalpels, Cardioverx, Cardio Shock2020