Post on 16-Jan-2016
transcript
OXYGENATION AND
VENTILATION
Oxygenation
Oxygen Delivery Devices
1. Nasal Cannula
Gives oxygen supply 40 %when set at
6 L/min flow .
Indicated for low to moderate oxygen requirements and long term oxygen therapy .
2 – Venturi Mask
It is high flow face mask that uses a Venturi system to deliver relatively precise oxygen concentrations .
Used for COPD who need control on inspired oxygen concentration.
3 – Simple Face Mask
Gives oxygen supply 40 % to 60 % when set at 6 L/min flow.
4 – Partial Rebreather mask
5 – Non – Rebreather Mask
It has : one way side port + attached reservoir bag
Provides the highest oxygen concentration (80 % to 95 % when set at 15 L/min flow ) .
6 – Small Volume Nebulizer
Oxygen is the usual carrier but in COPD , air is preferred.
7 - Oxygen Humidifier
Used in croup , Epiglotittis , bronchiolitis .
Ventilation
Effective Artificial Ventilation need:
Patent airway . Effective seal between mask and patient‘s face . Enough force to overcome the elastic resistance
of the lung and chest wall . Tidal volume at least 800 mL oxygen at rate 12
to 20 breaths / min . Allow patient to exhale between delivered
breath.
Tidal Volume : Average volume of gas inhaled or exhaled in one respiratory cycle .
Characters of the ideal mask
I. Good fit .II. One way valve .III. Made of transparent material .IV. Has oxygen insufflations port ( 15 to
22 mm ) .V. Available in all ages .
Ventilation Methods
1 – Mouth to mouth / Mouth to nose
Provide limited oxygen 17 % . It may transmit infection between the
patient and rescuer . Take care not to hyper inflate the patient‘s
lungs or to hyperventilate yourself .
2 - Mouth to mask
Do not use in awake patient . It has one way valve to prevent you from
patient expiration . Provide oxygen 17 % ( if no oxygen supply
) . Provide oxygen 50 % ( if oxygen supply is
10 L/min )
3 – Bag Valve Devices Do not use in awake patient . It has two one - way valves . Sizes : Neonatal – Child . Adult . It should be disposable ( Do not reuse them ) . Provide oxygen 21 %= room oxygen ( if no oxygen
supply ) . Provide oxygen 60 % to 70 % ( if oxygen supply is 10
L/min ) . Provide oxygen 90 % to 95 % ( if oxygen reservoir is
activated )
Pediatric bag valve mask has Pop-Off Valve .
BVM ventilation can be done by :
One Rescuers Two Rescuers Three Rescuers
Complications of BVM ventilations are :
1. Inadequate ventilations .2. Barotraumas 3. Gastric distension .
4 – Flow Restricted = Oxygen Powered Ventilation = Demand Valves
Provides 100 % oxygen at its highest flow rate 40 L/min .
Not recommended in patients under 16 age .
Use with caution with intubated patients or chest trauma patients .
5 – Automatic Transport Ventilator
It has pop – Off valves . Provides 100 % oxygen . Not use in :1. Infant less than 5 years old .2. Patient with obstructed airway ( Because
these devices have no alarm to warn possible tube displacement or barotraumas ) .
Evaluation
Pulse Oximetry
Capnography
Pulse Oximetry
Used in measurement of arterial oxyhemoglobin saturation (SPo2) AND Pulse rate.
Normal SPo2 = 93 % to 95 % When result below 90 % means Sever compromise of
oxygen delivery to the tissues .
Advantages :1. High reliability . 2. Portable .3. Used in all ages and races .
Capnography
Can be named ( End Tidal carbon Dioxide monitoring ) .
Measures the partial pressure of carbon Dioxide in a sample of gas .
A normal reading in a trauma patient is between 30 to 40 mmHg .
Used as a tool to monitor endotracheal tube placement .