oxygenation “part of the dumb-it-down lecture series”
TRANSCRIPT
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Oxygenation“Part of the Dumb-It-Down Lecture Series”
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How do we support a patient’s pulmonary function?• Oxygenation• Nasal Cannula• Mask/Venti-Mask• Partial Non-Rebreather/Full Non-Rebreather• Supplemental O2 given through a device helping maintain
ventilation• Ventilation• Ambu-bag• Mouth to Mouth• BiPAP/CPAP• Invasive Mechanical Ventilation
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The Most Misunderstood Equipment in the Hospital…
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What is the FiO2 of a Nasal Cannula?
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Guess-ta-mation
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Why isn’t 100% FiO2 Achieved?
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Why isn’t 100% FiO2 Achieved?• Normal Flow Rate is 25L/min, so if a nasal cannula is delivering
2L/min…
FiO2 = [(% of flow from NC) + (% of flow from RA)]/ total flow
FiO2 = [(2)(1) + (23)(0.21)]/25 = 0.27
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Why isn’t 100% FiO2 Achieved?
But the percent of flow obtained from the nasal cannula is variable…
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Monitoring Oxygenation
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Pulse Oximetry
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When is Pulse Oximetry Wrong?• Carbon Dioxide/Cyanide (falsely high)• Nail Polish (falsely low)• Methemoglobinemia (falsely low)• Hypoxia (falsely low)• Hypotension (wont pick up arterial pulsations)
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Pulse Oximetry is not PaO2
The 40-50-60, 70-80-90 Rule:
PaO2 SaO2
40 70
50 80
60 90
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Pulse Oximetry is not PaO2
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Pulse Oximetry is not PaO2