background O2 admin basics
room air is 21% oxygen, oxygen is considered a medication
Oxygen delivery systems basics
low-flow systems
variable performance
reservoir systems
High-flow systems
fixed performance
Flow meter
the part that attaches to the wall
has a green “Christmas Tree” or oxygen nipple and nut adapter, which helps the O2 tubing connect properly to the oxygen source
when reading the flow meter, you read from the center of the ball
Nasal Cannula
2 prongs (one for each nostril- POINT DOWN)
1 to 6 L/min; 24 to 44%
humidifier to 4L and above
advantages of Nasal cannula
patient able to talk and eat
safe and simple
easily tolerated
Disadvantages of Nasal Cannula
unable to use w/ nasal obstruction
can dislodge from nares easily
excessive dryness- HUMIDIFIER
High-Flow Nasal Cannula
15 to 40 L/min; 60 to 90%
humidified
high flow system
Advantages of High-Flow Nasal Cannula
more oxygen provided
patient still able to talk and eat
Disadvantages of High-Flow Nasal Cannula
same as the simple nasal cannula
Non-rebreather mask
10 to 15 L/min; 60 to 100%
valves \reservoir bag
Advantages of non-rebreather mask
delivers the highest possible O2 concentration
Disadvantages of non-rebreather mask
claustrophobia
eating and talking inhibited
malfunction can cause CO2 buildup
Partial rebreather mask
6 to 15 L/min; 70-90%
valves
reservoir bag
Advantages of partial rebreather mask
can inhale room air
Disadvantages of partial rebreather mask
eating and talking difficult
claustrophobia
Venturi Mask
accurate oxygen concentration
Venturi = very accurate O2
4 to 12 L/min; 24 to 60%
Advantages of Venturi Mask
delivers precise oxygen concentration
doesn’t dry mucous membranes
Disadvantages of Venturi Mask
uncomfortable
skin irritation
background for CPAP & BiPAP
continuous versus Bi-level
procedural concerns CPAP & BiPAP
interprofessional collaboration
Documentation concerns for CPAP & BiPAP
your overall assessment
what is oxygen toxicity
damage that happens from breathing in too much extra O2
symptoms of oxygen toxicity
coughing, dyspnea, chest pain, substernal heaviness
ways to prevent oxygen toxicity
choosing correct O2 device
titrating O2 and weaning patient
endotracheal tube (ETT)
endo = in (going into the trachea)
also called ET tube
this is most common type of artificial airway
When to use endotracheal tube
general anesthesia
congenital malformations of the upper airway
mechanical ventilation
oropharyngeal airway
oro = mouth
choose the correct size!!!!!!
too big = airway blocked
too small = airway wont open
when to use oropharyngeal airway
only when the patient is unconscious!!!!
want to prevent the tongue from covering the epiglottis
nasopharyngeal airway
naso = nose
also called nasal trumpet
great for suctioning the airway without damaging the nostrils
When to use nasopharyngeal airway
preferred over an oropharyngeal airway
soft tissue obstruction of the upper airway
if there is any mouth trauma
DONT USE WITH SEVERE HEAD INJURY OR FACIAL INJURY
tracheostomy
ostomy = surgical opening
long term option
require regular cleaning and replacement
only artificial airway that a patient can be discharged home with
tracheostomy care
top nursing priority = maintaining a patient airway
tube obstruction is high the first 72 hours postop
after NEW tracheostomy: 1 finger to fit under ties
at the bedside
manual resuscitation bag
tracheostomy tube of the same size and type
tracheostomy insertion tray
obturator
other therapies
chest physiotherapy, chest tubes, IS, TED hose, SCDs