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OXYGEN THERAPY DR RASMIYA MOHIYADHEEN OXYGEN THERAPY DR RASMIYA MOHIYADHEEN

OXYGEN THERAPY DR RASMIYA MOHIYADHEEN - PowerPoint Presentation

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OXYGEN THERAPY DR RASMIYA MOHIYADHEEN - PPT Presentation

SENIOR RESIDENT DEPARTMENT OF PEDIATRICS INTRODUCTION Oxygen is a drug monitor effects and side effects 21 of room air contains oxygen adequate for healthy person Higher concentration of oxygen is required in various illness effecting oxygenation ID: 914926

flow oxygen rate mask oxygen flow mask rate reservoir fio2 patient air bag entrainment high gases gas inspiratory blood

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Slide1

OXYGEN THERAPY

DR RASMIYA MOHIYADHEEN

SENIOR RESIDENT

DEPARTMENT OF PEDIATRICS

Slide2

INTRODUCTION

Oxygen is a drug; monitor effects and side

effects.

21% of room air contains oxygen. (adequate for healthy person)

Higher concentration of oxygen is required in various illness effecting oxygenation.

Slide3

MONITORING BLOOD OXYGENATION

CLINICAL EXAMINATION

Signs of respiratory distress, cardiac failure.

PULSE OXIMETRY

(SpO2)

Non invasive

Indirectly measures arterial hemoglobin-O2 saturation by differentiating from deoxygenated hemoglobin using their respective light absorption at 660nm (red) and 940 nm (infrared)

Slide4

Most pulse oximeters recognize all types of hemoglobin as either

oxygenated

or deoxygenated hemoglobin

(inaccurate

information in the presence of

carboxyhemoglobin

and

methemoglobin)

Slide5

ARTERIAL BLOOD GAS MEASUREMENT

(pA02

)

Invasive; arterial (preferably),venous and capillary blood can also be used in children (warm and well perfused extremities).

Measures pH, pco2, pO2,

bicarb

levels and other electrolytes as well

Ideal for patients on mechanical ventilation and those with central

hypoventillation

and muscular paralysis. (indicates co2 retention)

Slide6

CAPNOGRAM

Effectiveness of

ventillation

and

pulmunory

circultation

Slide7

INDICATIONS

Oxygen saturation (SpO2 <90) or paO2<60mmHg

Cardiac dysfunction (shock, cardiac failure) ;to increase oxygen content of blood and maximize oxygen delivery

Slide8

OXYGEN DELIVERY DEVICES

LOW FLOW SYSTEMS

Not meant to satisfy entire peak inspiratory demands of the patient

Delivered FiO2 varies in relation to oxygen flow rate, tidal volume and respiratory rate of the patient

Nasal

canula

/prongs, Hudson mask(simple face mask), Mask with reservoir bags, oxygen hood/ head box.

Slide9

HIGH FLOW SYSTEMS

High enough to completely satisfy patients inspiratory needs either by high flow of oxygen or by controlled entrainment of ambient air.

Venturi

masks

Slide10

NASAL CANULA/PRONGS

Simple to use, well tolerated and provide access to patient (feeding, chest physiotherapy)

Nasal patency must be ensured and gas should be humidified

0.5-5L/minute provide Fio2 24-40%

Flow rate >5-6 L/min should not be given as it causes drying, irritation, abdominal distention and nasal regurgitation

Effective in nose breathers(oxygen entrained from

nasopharynx

)

Slide11

Slide12

HUDSON MASK/SIMPLE FACE MASK

5-10L

/minute provide Fio2 24

-55%

Fio2 determined by o2 flow rate relative to inspiratory flow rate and tidal volume

They increase anatomical dead space and flow rates must be sufficient to prevent Co2 accumulation

Exhaled gases are expelled through air entrainment pores

Slide13

Slide14

MASKS WITH RESERVOIR BAGS

Useful if FiO2 greater than 60% required.

Reservoir bag with valves is attached to oxygen mask.

Flow rate adjusted to keep the reservoir bag continuously inflated

Slide15

PARTIAL REBREATHING MASK

These have one way valves in exhalation port which permit expulsion of exhaled gases but prevent air entrainment during inspiration

No valves between mask and reservoir bag

Initial one third of exhaled gases( anatomical dead space which has not participated in gas exchange) flows into reservoir bags along with fresh gases. Rest of gases is forced out through exhalation ports.

Slide16

Fi02 ranging from 60-80% may be achieved depending on inspiratory flow rate, tidal volumes and air leaks.

Slide17

NON REBREATHING MASKS

Two system of one way valves: between bag and mask and over exhalation ports

During inspiration, patient has dual supply of oxygen from fresh gas source and from reservoir bag. (100% oxygen supply to patient)

High flow system

as flow satisfies patients inspiratory flow demands.

Exhalation only via the one way valve between mask and atmosphere.

Slide18

Delivers high Fi02 at low flow rates of oxygen but flow should be sufficient to prevent collapse of the bag during inhalation.

Slide19

OXYGEN HOOD/ HEAD BOXES

Clear

plexi

-gas boxes of various sizes placed over infants head and neck to ensure adequate and stable Fi02.

Flow rates should be adequate to prevent CO2 accumulation (>6L/min)

May achieve oxygen concentrations

upto

90-95%Disadvantage: Patient must be taken out for access and feeds

Slide20

Slide21

VENTURI MASKS

Designed to deliver specific O2 concentrations

Useful in chronic lung diseases where control of Fi02 is crucial, as coexisting problems with

hypercapnia

maybe present.

Based on Bernoulli principle (O2 flow through jet orifice at a fixed flow rate and room air enters through entrainment ports.

Fio2 depends on size of jet, O2 flow rate and size of entrainment ports.

Slide22

A predictable O2 concentration between 24 and 60%if manufacturers instructions are followed

Slide23

HAZARDS OF OXYGEN THERAPY

Retinal damage in premature infants

Damage to alveolar capillary membrane

resultiong

in increased permeability alveolar edema secondary to free radical damage.

Decreased

mucociliary

activity and risk of bacterial tracheitis

Absorption atelectasis secondary to Nitrogen washout

Slide24

THANK YOU