Know your Os?

• How much Oxygen is the patient on?

• How much does the patient need?

• How’s this mask work?

• Is this thing hooked up right?

Know your Os!

• Use this quick review to answer common oxygen delivery questions.

• Please contact a Respiratory Therapist with questions.

• Working together we can make sure that every patient receives the right amount of oxygen for the right length of time.

Low-flow oxygen delivery devices

– Nasal Cannula

–Simple oxygen mask

–Partial rebreathing oxygen mask

–Nonrebreathing oxygen mask

High-flow oxygen delivery devices

– Venturi Mask (Air Entrainment Mask)

–Aerosol Mask

–trach collar

–face tent

–Briggs Adapter (T-piece)

Nasal Cannula

• 2-6 lpm Oxygen flow delivers:– 1lpm = 24%

– 2 lpm = 28%

– 3 lpm = 31%

– 4 lpm = 34%

– 5 lpm = 37%

– 6 lpm = 40%

• Use humidity for > 3lpm– and for all

pediatric patients.

Nasal Cannula

• Oxygen percentage delivered varies with patient’s breathing pattern.

• Do not use greater than 2 lpm for infants.

Simple Mask• 6-10 lpm Oxygen flow

delivers 35-55% • Flow must be >5 lpm

to avoid rebreathing of exhaled CO2 that can be retained in the mask.

• Attach O2 tubing directly to O2

flowmeter.• Do not attach to bottle

humidifier

Venturi Mask (Air entrainment mask)

• 3-15 lpm Oxygen flow delivers 24-50%

• Do not attach to humidifier bottle.

• Must set O2 flow and air entrainment port (Oxygen diluter) correctly to achieve desire FIO2

Air entrainment port(Oxygen diluter)

• Match arrow on port to desired FIO2 printed on multi-vent barrel

• Green diluter – 3 lpm used to achieve both 24 and

26%– 6 lpm used to achieve both 28 and

30%

• White diluter– 9 lpm used to achieve 35%– 12 lpm used to achieve 40%– 15 lpm used to achieve 50%

Nonrebreather mask

• >10 lpm Oxygen flow delivers 60-100%

• Must have sufficient flow to maintain distended reservoir

• Do not wean flow

• Less flow will allow CO2

rebreathing.

Nonrebreather mask

• If patient no longer requires NRB, change to a different O2 delivery device

• Notify the patients Respiratory Therapist when NRB is required to maintain oxygenation.

Bubble Humidifier

• For use with nasal cannula only.

• When utilized with other devices back pressure can be created which may result in loss of needed flow and decreased oxygen delivery.

High humidity• Must set air entrainment

dial and oxygen liter flow correctly to achieve desire FIO2

• 5-10 lpm of oxygen delivers 28% to 98% with humidity.

• Must be used with corrugated tubing connected to patient mask

• Not effective as a room humidifier

High humidity devices

• Used to deliver high humidity oxygen or air to patient.

• To be used with high humidity

Corrugated tubing

Aerosol Mask

High humidity devices

• Used to deliver high humidity oxygen or air to patients who may not tolerate aerosol mask

Trach collar

Face bucket

Connect the oxygen mask to a

GREEN

oxygen flowmeter

Yellow Air flow meter

Bag valve mask

• This is the only device capable of adequately oxygenating and ventilating an apenic patient.

• Absolute PaO2 <55 mm Hg or SaO2 <88% PaO2 >60 mm Hg or SaO2 >90% Appropriately adjusted oxygen dose during sleep and exercise

In patients with cor pulmonale PaO2 55 to 59 mm Hg or SaO2 >89% Same as above Electrocardiographic evidence of P pulmonale, hematocrit >55%, and congestive heart failure

Specific indications Nocturnal hypoxemia Appropriately adjusted oxygen dose during sleep Sleep apnea with nocturnal desaturation not corrected By constant positive bairway pressure or bilevel positive airway pressure Same as above No hypoxemia at rest, but desaturation during exercise or sleep (PaO2 <55 mm Hg) Appropriately adjusted oxygen dose during exercise

Guidelines for Long Term Oxygen In Patients With COPD

• Absolute PaO2 <55 mm Hg or SaO2 <88% PaO2 >60 mm Hg or SaO2 >90% Goal-Appropriately adjusted oxygen dose during sleep and exercise

• In patients with cor pulmonale PaO2 55 to 59 mm Hg or SaO2 >89% Goal-Same as above

• Electrocardiographic evidence of P pulmonale, hematocrit >55%, and congestive heart failure Goal-Same as above

• Specific indications Nocturnal hypoxemia oxygen dose during sleep, Goal-Appropriately adjusted

• Sleep apnea with nocturnal desaturation not corrected, by constant positive airway pressure or bilevel positive airway pressure, Goal- Same as above

• No hypoxemia at rest, but desaturation during exercise or sleep (PaO2 <55 mm Hg), Goal-Appropriately adjusted oxygen dose during exercise

Final thoughts

• Please notify your Respiratory therapist when oxygen is set up or changed.

• Please call Respiratory with any questions or concerns.

Thank You!