Oxygen Therapy in pediatrics emergency room Powerpoint Presentation

1. Oxygen
therapy

2. Introduction
*Colorless, odorless, tasteless gas, Makes up 21% of room air ,It’s NOT
flammable but does support combustion.
*It’s Considered as a medical gas.
*Stored in bottles in liquified Form
*1L of liquified form = 860 L of Gaseous O2
The main purpose from O2 is

3. Tissues have no storage system for O2.
They rely on a continuous supply at a rate that precisely matches
changing metabolic requirements.
If supply fails, tissue hypoxemia may develop resulting in anaerobic
metabolism and production of lactate.
Hypoxemia
decrease in the arterial O2 content in the blood
Hypoxia
decreased O2 supply to the tissues.

4. Indications
1. All patients that are hypoxemic (O2 saturation less than
94%)
2. All patients with life threatening critical illness; including
shock state, major trauma, sepsis, CO poisoning

5. Treatment & Methods
* Age of the patient
Depends on:
*Oxygen requirements/ therapeutic goals
*Patient tolerance to selected interface
*Humidification needs

6. 1-Low-flow devices:
Provide oxygen at flow rates that are lower than patients’ inspiratory demands,
When the total ventilation exceeds the capacity of the oxygen reservoir, room air is
entrained
2-High-flow devices:
Provide a constant FiO2 by delivering the gas at flow rates that exceed the
patient’s peak inspiratory flow rate, and by using devices that entrain a fixed
proportion of room air
Classification

7. 1-Low flow delivery Method
*Simple face mask (without air entrainment device)
*Non re-breather face mask (mask with oxygen reservoir bag and
one-way valves which aims to prevent/reduce room air entrainment).
*Nasal prongs (low flow).
*Tracheostomy mask (without air entrainment device)
*Face tent.

8. Types
1.Nasal cannula : Low flow
oxygen device used for infants
and toddlers poorly tolerating a
mask
Consists of a tube and 2 prongs
inserted into nares and the
tube secured to the face
O2 flow rate: 0.25-4L/min
O2 concentration: 22-66%

9. 2. Simple face mask: low flow oxygen device
Consists of plastic reservoid over nose and
mouth, small holes on side of mask
O2 flow rate: 6-10L/min
O2 concentration: 35-60%
(needs to be a minimum of 6l/min to flush
accumulation of child’s exhaled CO2 from mask)

10. 3. Nonrebreather mask: low flow
oxygen device that does not permit
mixing of the child’s exhaled air with
100% oxygen
One way valve between mask and
reservoir bag prevents inhalation of room
air
O2 flow rate: 10-15L/min
O2 concentration: up to 95%

11. 2-High flow delivery Method
*CPAP/ BiPaP drivers
*Face mask or tracheostomy mask used in conjunction with an entrainment device
*High flow nasal prongs (HFNP)

12. Why Humidification?
* Cold, dry air increases heat and fluid loss
* Medical gases including air and oxygen have a drying effect and mucous membranes become dry resulting in airway damage.
* Secretions can become thick & difficult to clear or cause airway obstruction
* In asthma, the hyperventilation of dry gases can compound bronchoconstriction.
Indications:
* Patients with thick copious secretions
* Non-invasive and invasive ventilation
* Nasal prong flow rates of greater than 2 LPM (under 2 years of age) or 4 LPM (over 2 years of age)
* Facial mask flow rates of greater than 5 LPM
* Patients with tracheostomy
Humidification

13. Complications
1. CO2 Narcosis
2. Pulmonary Atelectasis
3. Pulmonary oxygen toxicity
4. Retrolental fibroplasia
5. Substernal pain-due: characterized by difficulty in breathing and
pain within the chest, occurring when breathing elevated pressures of
oxygen for extended periods.

14. Thanks