oxygen therapy dr sohail.pptx by dr sohail khan cmh nowshera

oxygen therpy by dr sohail khan resident medicine cmh nowshera

1. oxygen therapy Dr sohail Trainee medicine, cmh nsr

2. outline Definition of oxygen therapy Types of oxygen therapy Purposes of using the oxygen therapy Administration of oxygen therapy Complications of oxygen therapy

3. Definition Oxygen therapy is the administration of oxygen at a concentration of pressure greater than that found in the environmental atmosphere. The air that we breathe contains app; 21% of oxygen. The heart relies on oxygen to pump blood

4. Purpose Oxygen therapy is the key treatment in respiratory care. The purpose is to increase oxygen saturation in tissues where the saturation levels are too low due illness or injury.

5. Oxygen therapy is used to treat: Documented hypoxemia Severe respiratory distress (acute asthma or pneumonia) Severe trauma COPD, Chronic bronchitis, emphysema and chronic asthma Pulmonary HTN Acute MI Short term therapy such as post anesthesia recovery Oxygen may also be used to treat chronic lung disease patient during exercise

6. Preparation A physician’s order required for oxygen therapy, except in emergency use. Clinical observation is required. Indicated in arterial blood gas measurement. Pulse oximetory

7. Pulse oximetry

8. Cautions for oxygen therapy Oxygen toxicity can occur if FiO2 is more than 50% longer than 48 hours Danger of fire Infection (aerobic bacteria)

9. Classification of oxygen delivery system LOW FLOW SYSTEMS: Contribute partially to inspired gas patient beathes Examples: nasal cannula, simple mask, NRM, partial rebreather mask 2. HIGH FLOW SYSTEMS: Deliver specific and constant percent of oxygen independent of patient’s breathing Examples: venture mask, tracheostomy collar, T-piece

10. Nasal cannula

11. Nasal cannula It is a disposable plastic device with two protruding prongs for insertion into the nostrils, connected to an oxygen source. Used for low-medium concentration of oxygen (24-44%)

12. Face masks types The simple oxygen mask The partial rebreather mask The non rebreather mask The venture mask

13. The simple oxygen mask Simple mask is made of clear, flexible, plastic or rubber material that can be molded to fit the face. It delivers 35-60% oxygen at a flow rate of 6-10 l/min. Often it is used when an increased delivery of oxygen is needed for short periods (less than 12 hours)

14. The partial rebreather mask The mask has a reservoir bag that must remain inflated in both during inspiration and expiration. It is used to deliver oxygen concentration upto 80% The oxygen flow rate must be maintained at a minimum of 6l/min to ensure that the patient does not rebreathe large amount of exhaled air The remaining exhaled air exits through vents.

15. The Non rebreather mask This mask provides the highest concentration of oxygen (95-100%) at a flow rate of 6-15 l/min. It is similar to partial rebreather mask except two onw -way valves which prevent concentration of exhaled air. The bag is an oxygen reservoir.

16. Method : Partial rebreather mask Amount Delivered Fio2 (fraction of inspired oxygen ) Interventions advantages disadvantges low Flow 6 L\ min •75%- 80% oxygen set flow rate so mask remains tow- thirds full during inspiration Keep reservoir bag free of twists or kinks PT can inhale room air through openings in mask if oxygens S upply is briefly interrupted Requires tight seal (eating and talking difficult, uncomfort able Not as drying to mucos membranes

17. Venturi mask It is high flow concentration of oxygen from 40-50% at flow rate of 4-15 l/min. It is mostly used in COPD Patients where controlled oxygen delivery is required.

18. T-Piece It is used on end of ET tube when weaning from ventilator. It provides accurate FiO2 and good humidity.

19. Side effects and complications of oxygen therapy Oxygen toxicity It is a condition in which ventilator failure occurs due to inspiration of a high concentration of oxygen for prolonged period of time Oxygen concentration greater than 50% over 24-48 hours can cause pathological changes in lungs Retrolental fibroplasia Absorption atelectasis

20. Signs and symptoms of oxygen toxicity: Non-productive cough Nausea and vomiting Sub sternal chest pain Fatigue Nasal stuffiness Headache and sore throat Hypoventilation Nasal congestion Dyspnea Inspirational pain

21. Evaluation Breathing pattern regular and at normal rate.  pink color in nail beds, lips, conjunctiva of eyes.  No confusion, disorientation, difficulty with cognition.  Arterial oxygen concentration or hemoglobin Oxygen saturation within

22. Documentation Date and time oxygen started. Method of delivery.  Oxygen concentration and flow rate.  Patient observation. Add oronasal care