week 3 resp- oxygen management and masks

What is the main purpose of oxygen therapy?

To treat hypoxaemia (low oxygen levels in arterial blood). Oxygen is prescribed with a target saturation and delivery instructions as it is a drug.

What are five risks or complications of oxygen therapy?

Worsened hypercapnia in susceptible patients, dry or irritated airways, fire risks, absorption atelectasis with high oxygen concentrations and trips caused by oxygen tubing.

What are the usual acute oxygen saturation targets?

94-98% for adults not at risk of hypercapnic resp failure. 88-92% for patients at risk of hypercapnia. Follow prescription and local protocols.

What is the difference between a simple mask and a venturi mask?

A simple mask delivers variable oxygen concentration because oxygen mixes with room air. Venturi masks use a specified adaptor and flow rate to deliver a more controlled concentration.

When might a reservoir mask be used?

For severe acute hypoxaemia when high oxygen delivery is needed. E.g. 15L/min.

What are the advantages of nasal cannulae and high flow nasal cannulae (HFNC)?

Nasal cannulae; convenient for eating, talking and mobilisation which delivers variable oxygen concentration (common for patients after surgery). HFNC; delivers heated, humidified gas at high flow rates and requires specialist equipment and monitoring.

What is hypoxaemia and how does it differ from hypercapnia?

Hypoxaemia is abnormally low oxygen levels in arterial blood. Hypercapnia is abnormally high levels of carbon dioxide in the blood.

What is aerosolisation and which two delivery methods are covered?

Term refers to delivering medication as inhalable particles or droplets. For example nebulisers turn liquid medication into an aerosol and pressurised metered dose inhalers (MDIs).

How does a jet nebuliser work and what driving flow does it give?

Compressed gas atomises medication into droplets and delivered through a mouthpiece or mask. Many nebulisers use 6-8 L/min.

Are nebulisers always more effective than inhalers?

No. Inhalers and nebulisers can achieve comparable particle size and deposition when inhalers are used optimally.

What is a spacer and what are its main benefits?

A chamber attached to an MDI that briefly holds the aerosol. It can improve lung deposition, reduce the need to coordinate pressing and inhaling and reduce medication deposited in the mouth and throat

What must a patient be able to do to use a dry powder inhaler (DPI) effectively?

Generate an appropriate inspiratory effort. Poor inhalation technique can reduce the amount of medication reaching the lungs.

What is bronchospasm and how does bronchodilators help?

Bronchospasm is repeated uncontrollable contractions of the bronchi. This narrows the airways and increases resistance to airflow. Bronchodilators relax the smooth muscles and widens the airways.

What is the difference between short acting and long acting beta 2 agonists in the notes?

SABAs include salbutamol and terbutaline and provide rapid relief. LABA includes salmeterol as long lasting.

What are mucolytics and what are some examples?

Mucolytics reduce mucus viscosity so secretions may be easier to clear. E.g DNase and Nacetylcysteine.

How can nebulised normal saline and hypertonic saline support secretion clearance?

Normal saline (0.9%) provides airway moisture. Hypertonic saline (3%,6% or 7%) draws water into secretions and may stimulate coughing. Hypertonic saline can trigger bronchospasms in susceptible patients.

What should you know about antibiotics and resp infection?

Antibiotics treat bacterial infections and physiotherapists can assists patients with airway clearance, positioning, mobilisation and monitoring.

What is mucocilary clearance?

Mucus traps particles, while cilia move the mucus towards the throat so it can be removed. Thick and dehydrated secretions may impair this process.

Name four ways to support hydration and humidification of the respiratory tract.

Systemic hydration where appropriate, humidified inspired air, a heat and moisture exchanger (HME) and prescribed nebulised medication or saline.

What should a physiotherapist check snd monitor before snd during respiratory treatment?

Check the oxygen prescription and target saturation, delivery device and equipment and clinical stability. Monitor oxygen saturation, symptoms and response during treatment. Manage tubing safely and escalate deterioration.