Oxygen Therapy - Dr. Satish Deopujari

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A presentation on Oxygen Therapy by the renowned pediatrician Dr. Satish Deopujari of the Child Hospital Nagpur.

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Oxygen Therapy - Dr. Satish Deopujari

  1. 1. 2
  2. 2. Oxygen therapy Dr.Deopujari
  3. 3. O2 36 A.T.P. 2 A.T.P. L.ACID
  4. 4. BODY OXYGEN STORES ALL SMALL AND IF DEPLETED THEY ARE INSUFFICIENT TO SUSTAIN LIFE FOR MORE THAN FEW MINUTES
  5. 5. RESP. C.V.S. C.N.S. SEPS. M. O. F.
  6. 6. Oxygen was first used as a remedy for illness in 1783 in France by Chaussier. In December of 1907, it was used in surgery on a woman who had tremendous internal damage. It was administered directly into the abdomen and marked recovery was noted.
  7. 7. 25 50% 60 90%
  8. 8. 0 10 20 30 40 50 60 70 80 90 100 SO2 0 10 20 30 40 50 60 70 80 90 100 110 pO2(mm Hg) O.D.CURVE
  9. 9. O.D.CURVE 0 20 40 60 80 100 120 0 10 20 30 40 50 60 70 80 90 100 110 PO2 SO2
  10. 10. Rt..
  11. 11. HB% 12 SAT 100% HB% 12 SAT 50% HB 6 GR SAT 100% HB 13 GR SAT 90% PaO2 SATURATION
  12. 12. 2 TISSUES CaO2 = (SAT x Hb x 1 . 3 4 ) + .0 0 3(PaO2)
  13. 13. PaO2 / FiO2 Ratio or "P/F” Ratio  Another much friendlier method ( because it doesn't use the alveolar gas equation) used to predict shunt.  Just like the name says, PaO2 is divided by FiO2  Normal is 286; lower indicates a shunt.
  14. 14. CLINICAL D. OF HYPOXIA DISPRAP. BRADY / TACHY . ALTERED SENSORIUM / SEI. SHOCK. G.I.BLEED MULTISYSTEM INV. ANTICIPATE HYPOXIA
  15. 15. ROVING EYES
  16. 16. UNRESPONSIVE PUPIL
  17. 17. • PERFUSION DEPNDENT  SAT. NOT CONTENT  SHAPE OF O.D.CURVE  HYPEROXIA NOT DIAG.  POSITION OF CURVE  ABNORMAL HEMOGLOBIN  VENTILATORY STATUS ? P U L S E 0 X.
  18. 18. SIMPLE OX. MASK FIO2 VARIABLE 30 TO 60 % FEEDING PROBLEM REBREATHING……
  19. 19. NASAL CANNULA MAX FLOW……2LIT/MIN FIO2 DIF. TO CONTROL HUMIDI. NOT NEC. MOUTH / NOSE BREAT.?
  20. 20. NASOPHARYN. CATH.  OROPHARYNX….ANAT. RES.  OCCL. OF DIST. OPENING.  GASTRIC DISTENSION  FIO2 DIFFICULT TO CONT.  SECRETIONS  CATHER MORE THAN 8 FR.
  21. 21. 2
  22. 22. AIR ENTRAINMENT V. PRE. O2 CONC. <50 % T. FLOW WITH FIO2 NOISE LEVEL ++++ HUMIDIFICATION ?
  23. 23. 24% 4lit 105 28 6 68 31 8 63 35 10 56 40 12 50 50 12 33 FI O2 O2/L/MIN FLOW
  24. 24. YOU ALMOST NEVER NEED 100 % OXYGEN
  25. 25. HEAD BOX
  26. 26. LOW PRESSURE OUTLET OXYGEN CONCENTRATOR
  27. 27. PATIENT O2 PARTIAL REBREATH. M. RES. BAG
  28. 28. O2 NON REBREATH. M. RESE. B. PATIENT 100% OXYGEN
  29. 29. Non-Rebreather masks achieve close to 100% oxygen by minimizing room air entrainment and by attaching a reservoir bag filled with 100% oxygen. The reservoir bag has a flap valve to block exhaled gas from entering. Exhaled gas is directed out the side ports with flap valves to block air entrainment on inspiration.
  30. 30. TRANS TRACHEAL CATHETER
  31. 31. BLENDED HUMIDIFIED OXYGEN/AIR SOURCE
  32. 32. The unconscious patient who "looks at heaven" will soon be going there. (--The supine unconscious patient is predisposed to airway obstruction.)
  33. 33. OXYGEN TOXICITY R . O . P. PULMONARY CARDIAC NEUROTOXICITY REPERFUSION INJURY FREE RADICLES MISCLENOUS
  34. 34. Prescription of oxygen
  35. 35. ABGPaO2 <60 >60 >7.2 <7.2 pH PaCO2 FIO2 >40 % ADD CPAP 6 INC. 5%NO CH.%RED. 5% >70 50 TO 70 < 50 PaO2 >70 50 TO 70 < 50 INC. 5%NO CH.%RED. 5% FIO2 >50% CPAP 8 C.M. FIO2 < 30 % RED. CPAP 1 CM CONSIDER M.V. PaCO2
  36. 36. RESPIRATION GOOD DEEP R . POOR SAT 93 %SAT 94% SAT 92 SAT 90 % FIO2 50% CPAP 5 CPAP 8 M.V.
  37. 37. EATH IS USUALLY DUE TO THE PHYSI. DIST. CAUSED BY THE DIS. RATHER THAN THE DIS. PER SE………... D E A T H
  38. 38. 2

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