What are some of the reasons we give O2 to our patients?
Main indication for acute O2 therapy is the pressure of tissue hypoxia. This may occur due to 1) arterial hypoxaemia (inadequate arterial oxygen content) or 2) failure of the oxygen-haemoglobin transport system. E.G.
a) increased O2 demand
sepsis
increased metabolic demand
intraoperative support
post cardiac or respiratory arrestb) reduced O2 carrying capacity
hypovolaemia
anaemia
c) reduced O2 exchange
lung disease
What are some of the patient safety considerations when administering O2 therapy?
Monitor O2 sats
Titrate to lowest dose possible
88-92% for COPD/patients at risk of hypercapnoeic
respiratory failure - CO2 retainers
94-98% for others
Nurse patient upright
Humidify where possible
Limit flow of nasal prongs toDoes O2 therapy have to be prescribed?
Yes.
However, O2 cannot be denied in an emergency.
Can be nurse, midwife or physiotherapist initiated.
Medical review to be performed as soon as possible.
Prescription should include:
Indication
Target O2 sat
Delivery device
Range for O2 flow or % of inspired O2
When O2 is to be applied.
Must be signed, dated, name of prescriber and reviewed daily.
What are the different modalities that O2 therapy can be given and what are the reasons for this?
Simple nasal cannulae
Flow: 0.5-4 L/min
Approx FiO2 %: 22-40
High flow (humidified) nasal cannula
Flow: 6-40L/min
Approx FiO2 %: 22-40
Simple Hudson mask
Flow: 5-10L/min
Approx FiO2 %: 40-60
Venturi mask
Flow: Variable according to colour coded attachment
Approx FiO2 %: 24-50
Reservoir (non-rebreather)
Flow: 10-15L/min
Approx FiO2 %: 60-90
CPAP or NIV
Flow: 0.5-60L/min
Approx FiO2 %: 22-60
Swedish nose
Flow: 0.5-4L/min
Approx FiO2 %: 22-50
What is the percentage of O2 in room air?
21%
What is the % of 6L of O2 therapy and which device would you administer with this?
40-60% administered via Hudson mask.
