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What are the 3 general goals and clinical objectives for oxygen therapy?
- 1. Correct documented or suspected acute hypoxemia
- 2. Decrease the symtoms associated with chronic hypoxemia
- 3. Decrease the work load hypoxemia imposes on the cardiopulmonary system
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What are some reasons for assessing the need for O2 therapy?
- Laboratory documentation: Pao2, Sao2, SpO2
- Specific clinical problem: carbon monoxide poisoning, postperative cyanide poisoning, acute MI
- Clinical findings at bedside: tachypnea, tachycardia, confusion, etc
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What does oxygen toxicity primarily effect?
Lungs and central nervous system
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What are the determining factors in oxygen toxicity?
PO2 and exposure time
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What can prolonged exposure to oxygen toxicity do?
Cause infiltrates in lung parechyma
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What can occur with an FIO2 above 0.50?
Absorption atelectasis
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PTs breathing small tidal volumes are at the greatest risk of?
Absorption atelectasis
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What are the 3 oxygen delivery systems?
- 1. Low flow
- 2. Reservoir
- 3. High flow
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What is low flow?
PTs inspiratory flow often exceeds that delivered device resulting in air dilution
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What is reservoir?
Provides a fixed FIO2, the reservoir volume must always exceed the PTs Vt and it can not have any leaks in the system
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What is high flow?
Always exceeds the PTs flow providing a fixed FIO2
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Does high or low flow mean high/low FIO2 or high/low O2?
No
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What are the 4 low flow systems?
- 1. Nasal Cannula
- 2. Nasal Catheter
- 3. Transtracheal Catheter
- 4. Reservoir Cannula
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What does nasal cannula deliver FIO2 at?
0.24-0.40
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What flow rates - L/min does nasal cannula use?
1/4 to 6 L/min
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Is a humidifier need for a nasal cannula?
Yes, 4 L/min or greater
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What flow - L/min does a nasal catheter use?
Flows of 1/4 to 8 L/min
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How much FIO2 is delivered in a nasal catheter?
0.22-0.45
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Where is the transtracheal catheter placed?
Surgically placed in the trachea through the neck
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What is the flow - L/min for a trantracheal catheter?
Flow is 1/4 to 4 L/min
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What are some things you need to look for when dealing with a transtracheal catheter?
- Infections because of foreign object and tubing
- No humidifier because of low flow
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What are 2 types of reservoir cannulas?
- 1. Nasal reservoir
- 2. Pendent reservoir
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What do reservoir cannulas do?
Stores O2 between PT breaths. PT draws this reserve whenever the inspiratory flow exceeds O2 flow into the device
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How much O2 can the reservoir cannula reduce?
50-75%
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What are the 3 different types of reservoir masks?
- 1. Simple mask
- 2. Partial rebreathing mask
- 3. Nonbreathing mask
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What is the input flow for simple masks?
5-10 L/min
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How much O2 does partial rebreathing masks deliver?
40-70%
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How many L/mins should the partial rebreathing mask be run at?
10 L/mins
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What should the FIO2 be for nonbreathing masks?
60-80%
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What should L/mins be run at for nonbreathing masks?
10 L/mins
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What is different about nonbreathing masks and partial rebreathing masks?
Nonbreathing masks has an inspiratory valve on top of bag and expiratory valves cover exhalation ports no mask
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