Post on 15-Apr-2017
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NON INVASIVE VENTILATIONLOW AND HIGH FLOW OXYGEN DEVICES
Unnikrishnan.sv90@gmail.com 9995274650
NON INVASSIVE VENTILATION WHAT IS NON INVASSIVE VENTILATION ?
ADVANTAGES • Avoids intubation• Reduces patients work load• Provides adequate oxygen• Improves quality of sleep• Allows patient to communicate • Allows patient to drink and eat • Reduces the chance of infection• Inexpensive
uses• Weaning trial• A/C Respiratory failure• Neuro muscular diseases• Copd • Pulomonary edema • Bronchiectasis• Poliomyelitis• Muscular dystrophy etc ..
Contraindications • Respiratory arrest• Uncoperative patients• Inability to protect airways• Trauma or burns in face• Facial or GI Surgery• Apnoea• Extreme anxiety• Obesity
Types of non invasive ventilators• Generally classified into 2
1. Volume pre set ventilators2. Pressure preset ventilators
Pressure pre set ventilators 2 modes• CPAP• BiPAP
NURSING RESPONSIBILITY• Check patients breath rate and ausculate • Maintain spo2 100%• Inform the physician regarding any abnormality in ABG Values• Always check for air leake• Give more importance to patients needs like suctioning ,or giving
sputum cups if secretions are present• Maintain a ABG CHART
Complications of CPAP and BiPAP• Insufficient ventillatory support• Mask leake• Skin trauma• Sputum retention • Nutritional deficiencies• Abdominal discomfort
OXYGEN DELIVERY METHODS /SYSTEMS • 2 SYSTEMS • LOW FLOW DELIVERY SYSTEMS• HIGH FLOW DELIVERY SYSTEMS
LOW FLOW OXYGEN DEVICES
• NASAL CANNULA• SIMPLE FACE MASK• PARTIAL REBREATHER MASK
HIGH FLOW DEVICES /SYSTEMS• TRANS TRACHEAL CATHETRES• VENTURI MASK• AEROSOL MASK• TRACHEOSTOMY COLLARS• T –PIECE • NON REBREATHING MASK WITH RESERVOIR AND ONE WAY VALVE• HIGH HUMIDITY FACE TENTS
Formula for calculating percentage of Fio2%• Fio2= 20% + (4 X oxygen liter flow)• 1 liters = 24 %• 2 liters =28 % etc
• Suppose if we deliver 6 litres of oxygen per min ,what is the Fio2
• ANS- Fio2 = 44% with 6 litres of O2 P/M
NASAL CANNULA • Flow rate - 2-6 litres per min• 24-45 percentage • Advantage – light weight ,comfortable,inexpensive and continuous
use with meals and activity.• Disadvantage – nasal mucosa drying
Nasal cannula
Oropharyngeal catheter• Flow rate – 1-6 Litres• Deliver 22-44 %• Adv – inexpensive and no need for tracheostomy• Dis adv – mucosal drying ,catheter should be changed frequently to
both nostrils
Oropharyngeal catheter /air way.
Simple face mask • Flow rate – 6-8 Litres• Deliver 40-60%• Adv – inexpensive and simple to use• Dis adv – mucosal drying ,poor fitting
Simple Face mask
Partial rebreather mask • Flow rate – 8-11 Litres• Deliver 50-75 %• Adv – moderate oxygen concentration • Dis adv – mucosal drying ,poorly fitting , must remove to eat.
Partial rebreather mask
Non rebreather mask• Flow rate – 10-12 Litres• Deliver 80- 100 %• Adv – High oxygen concentration• Dis adv – poorly fitting ,must remove to eat
Non rebreather mask
HIGH FLOW DEVICES
Trans tracheal catheter• Flow rate – 4 Litres/min• Deliver 60=100 %• Adv – more comfortable , concealed by clothings ,less o2 is needed to
achieve 100% saturation • Dis adv – requires frequent and regular cleaning and needs surgical
intervention
Trans tracheal catheters
Venturi mask • Flow rate – 4-6 l/min • Deliver 24-40 % • Adv – precise fio2 and additional humidity available• Dis adv – must be removed to eat
Colour Fi O2 O2 flow
Blue 24% 2 l/min
White 28% 4 l/minOrange 31% 6 l/minYellow 35% 8 l/minRed 40% 10 l/minGreen 60% 15 l/min
Trans tracheal catheter• Flow rate – 4 Litres/min• Deliver 60=100 %• Adv – more comfortable , concealed by clothings ,less o2 is needed to
achieve 100% saturation • Dis adv – requires frequent and regular cleaning and needs surgical
intervention
Aerosol mask • Flow rate – 8-10 Litres/min• Deliver 21- 100% fio2 based on nebulizer setting• Adv – good humidity and accurate Fio2• Dis adv – uncomfortable for some
Aerosol mask
Tracheostomy collar • Flow rate – 8-10 Litres/min• Deliver 30- 100 %• Adv – good humidity , comfortable ,fairly accurate Fio2• Dis adv – requires surgical intervention
Tracheostomy collar
T-piece• Flow rate – 8-10 Litres/min• Deliver 60=100 %• Adv –good humidity , comfortable ,fairly accurate Fio2• Dis adv – heavy with tubings
T-piece
Face tent • Flow rate – 8-10 Litres/min• Deliver 30- 100 %• Adv –good humidity , comfortable ,fairly accurate Fio2• Dis adv – bulky and cumbersome
Face tent
Complications Of Oxygen therapy• Infection• Combustion• Oxygen toxicity• Atlectasis• Retrolental fibroplasis• Retinal damage• Asphyxia
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