Supplemental O2

Goals and indications for O2 tx

-increased survival

-decreased dyspnea

-eliminated exercise induced hypoxia

-improved QOL

-decrease R heart strain

Indications for medicare coverage

-PaO2

Normal PaO2

-80-100mmHg

PaO2 60-80

-tachycardia

-dyspnea

PaO2 50-60

-malaise

-central cyanosis

-lightheadedness

-vertigo

-incoordination

-poor judgement

PaO2 35-50

-resp. distress

-arrhythmia

-confusion

PaO2 25-35

-acidosis

-LOC

PaO2 <25

-apnea

-shock

-cardiac arrest

O2 systems have 2 components

-storage

-delivery

O2 storage for hospital

-piped storage from wall

-portable cylinders

pts on long term O2 tx often use

-portable units with

-O2 conserving devices

O2 conserving devices

-control flow of O2 releasing gas from the source only when the pt initiates inspiration

-increase duration of O2 delivery and allow pts to be away from fixed O2 source for longer pd of time

types of O2 conserving devices

-fixed pulse unit

-demand pulse unit

-nasal cannula with reservoir (ex: oximizer)

nasal cannula

FiO2 formula

-for every liter you add .04

high flow nasal cannula

-uses mechanical aerosol system

-delivers meds and warmth

-provides small amt of positive pressure which allows higher Fio2 delivery

-not portable

-larger bore tubing

-flow up to 50-60L/min

simple mask

-Delivered FiO2: 0.35-0.55

-Flow: 5-10 L/min

reservoir mask non-rebreather

-Fio2 60-80%

venturi mask

-flow: 4-10L/min

-Fio2: 0.24-0.50

tracheostomy collar

Precautions

-prescription: 2L/min vs maintain SpO2 >88%

-O2 toxicity

-cellular injury to parenchymal tissue

-retinopathy

-atelectasis

-Irritation to mucosa

-epistaxis (bloody nose), drying

-Safe use

-burns

-potential user or equip failure