The document discusses oxygen delivery devices and their indications, methods, and complications. It outlines two primary systems: low flow and high flow, detailing various delivery methods such as nasal cannulas, face masks, and Venturi masks, along with their advantages and disadvantages. Additionally, it covers essential clinical goals of oxygen therapy, complications, and safety considerations related to oxygen use.

1. JD SIR 1

2. OXYGEN DELIVERY
DEVICES BY
• JAGDISH CHOUDHARYJD SIR 2

3. Indications of O2 therapy
1. Documented hypoxemia
 In adults, children, and infants older than 28
days, arterial oxygen tension (PaO2) of < 60
mmHg or arterial oxygen saturation (SaO2) of <
90% in subjects breathing room air or with PaO2
and/or SaO2 below desirable range for specific
clinical situation
 In neonates, PaO2 < 50 mmHgand/or SaO2 <
88% or capillary oxygen tension (PcO2) < 40
mmHg
JD SIR 3

4. .
2.Severe trauma
3.Acute myocardial infarction
4. Short-term therapy (e.g., post-
anesthesia recovery)
5. Increased metabolic demands,
i.e. burns, multiple injuries, and severe
infectionsJD SIR 4

5. Three clinical goals of Oxygen therapy
1. Treat hypoxemia
2. Decrease work of breathing (WOB)
3. Decrease myocardial Work
JD SIR 5

6. O2 DELIVERY METHODS
• Low flow oxygen delivery system
(variable performance, Pt dependent )
• High flow oxygen delivery system
(fixed performance, Pt independent)
JD SIR 6

7. LOW FLOW O2 DELIVERY SYSTEM
Stable breathing pattern Minute Venti-<8-10L/min RR- <20
/min VT-<0.8 l Normal insp. Flow – 10-30 l/min
Nasal cannula
 Nasopharyngeal catheter
 Nasal mask
Simple face mask
 Partial rebreathing mask
Non -rebreathing mask
•No capacity
•Small capacity
•High Capacity
JD SIR 7

8. NASAL CANNULA
• Simple plastic tubing + prongs with an over the ear
adjustments.
• Sizing available for adults children and infants( 4-6
French).
• Fio2 increases app. 1-2% with every increase in o2
flow per liter
• Flow > 1-6 lt/min is less tolerated due to flow jet
in nasal cavity ( COPD pt. 1-2)
• Concentration of oxygen received by nasal cannula
1 -24% 2 -28% 3 -32% 4 -36% 5 -40% 6 -44%
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9. NASAL CANNULA IMAGE
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10. .
Advantages Disadvantages
Inexpensive Pressure sores
well tolerated, comfortable Crusting of secr.
easy to eat, drink Drying of mucosa
used in pt with long term
therapy(COPD)
Epistaxis
used with humidity 80% of O2 gets wasted during
expiration
JD SIR 10

11. NASAL CATHETER
• Nasal catheter most common method of oxygen
administration.
• Size > 4-6 French.
• Position > high fowler position/rose position.
• Measurement > tip of nose to ear lobe.
• Insert in left nostril.
• Change catheter every 8 hr. to prevent
stenosis.
• Flow rate > adult 3-4Lt/min, child 1Lt/min
• Concentrating of oxygen > 22-30 %JD SIR 11

12. Nasal catheter image
JD SIR 12

13. Nasal Mask
Hybrid of nasal cannula and a face mask .
 Applied by either an over the ear lariat are a
headband strip .
Lower end rests on upper lip covering the external
nose .
Advantage- comfortable , no air jetted in nares.
Disadvantage – sores on long term use.
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14. Nasal mask image
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15. Simple face mask
• Simple or non reservoir, oxygen free mask is a
disposable plastic devise that covers both nose
and face.
• The oxygen flow must be run at a sufficient rate,
usually 5 liter/min. or more to prevent re-
breathing of exhaled gases.
• Best suited for those who require more o2 than
prongs.
• Oxygen therapy for short period like post
operative in recovery Room, transport of
patients.
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16. Simple O2 face mask image
JD SIR 16

17. RESERVOIR MASK
Two types are commonly used:
1) Partial re-breathing mask
2) Non re-breathing
 Both are disposable, light wt., transparent plastic
under the chin reservoirs.
 Difference. between two is placement of a valve
between mask and bag and over mask.
 “Partial re-breather” part of a patients expired air
refilling the bag.
 “Non re-breather” same as above except for the
position of the valves.
 Inboard leaking is common, lack of good facial seal
system can affect o2 concentration.JD SIR 17

18. 1. PARTIAL RE-BREATHING MASK
• Simple mask with reservoir bag.
• Small quantity of CO2 again inhale by patient after
exhale.
• Oxygen flow to maintain the reservoir bag should
be at least 1/3 to ½ full on inspiration.
• Reservoir bag capacity of O2 >1.5 lt
• Oxygen concentration Of exhaled gas combined
with supply of fresh oxygen, permits the lower flow
than non re-breathing masks.
• Flow rate 8-10L/min provides 40-80% of
concentrate oxygen JD SIR 18

19. Partial RE-BREATHER MASK image
JD SIR 19

20. JD SIR 20

21. 2.NON RE-BREATHING MASK
Also known as higher concentration
mask
•Sufficient flow of o2 is used so the
reservoir bag is at least partially full
during inspiration
•Minimum flow-10-15 l/min
•O2 concentration– >90 to 100% at 15
lt/min.
•Either style of mask indicated for pts
suspected for significant hypoxemia ,
with relatively normal spont.
Respiration.JD SIR 21

22. HIGH FLOW O2 DELIVERY SYSTEM
Patient with variable ventilator level and breathing
pattern
Profoundly Dyspnia and hypoxemia patient.
For those who require consistent high fio2 and with
late inspiratory flow of gas(>40 lt/min)
 Venturi mask
 Face tent
 Aerosol mask
Tracheotomy collar
 T-piece
JD SIR 22

23. VENTURI MASK
• Also called “Air entrainment venture masks” OR
“High Air Flow with Oxygen-Entrainment” (HAFOE).
• Goal is to create an open system with high flow
about the nose and mouth, with a fixed FIo2.
• O2 is directed by a small bore tubing to a mixing
jet.
• Final conc. depends on the ratio of air drawn in
through environment ports.
• Due to high flow , excess gas flushes out the
expired co2 through the holes on the sides of mask.
• Good for those with hypoxemia cannot be
controlled with low fio2.JD SIR 23

24. JD SIR 24

25. JD SIR 25

26. Venturi valves
JD SIR 26

27. COLOR CONCENTRATION
OF O2 %
O2 FLOW
BLUE 24% 2 LT/MIN
WHITE 28% 4LT/MIN
ORANGE 31% 6LT/MIN
YELLO 35% 8LT/MIN
RED 40% 10LT/MIN
GREEN 60% 15LT/MIN
MASK USED ACCORDING TO COLOURS
JD SIR 27

28. Aerosol Mask
HIGHER HUMIDIFY MASK
 Use for patient who has thick secretion of mucus in airway.
 Delivers 21-100% FiO2 depending on nebulizer setting Flow rates of 8
to 15 L/min.
JD SIR 28

29. OXYGEN TANT
• Transparent enclosures in larger sizes for adult pts.
• Co2 is removed by soda lime and water vapour by
calcium chloride.
• Temperature is regulated by flowing oxygen and air
over ice.
• 60-70% O2 conc. Achieved by flow rates of 6-12Lt/min.
• The air changes 20 times/hour.
Limitations:
Confining and isolating .
concentration can vary from 0.21 to 1.0 .
Fungal infection risk. JD SIR 29

30. JD SIR 30

31. HOOD METHOD
• Covers only head allowing access to the lower body.
• Use for short term use for neonates and infants.
• O2 and air premixed passed through heated
humidifiers.
• Nebulizers should be avoided.
• Mini. Flow >7 lt/min. average flow 10-15 lt/min
results in 80-90% oxygen concentration.
JD SIR 31

32. Bag Valve Mask systems
 Self inflating bags are AMBU bags, with an oxygen inlet
reservoir
 Anesthesia bag is a non self inflating reservoirs with gas
inlet and valve.
 Mask are designed to provide comfortable leak free
seal for manual ventilation.
 Flow to the reservoirs should be kept high so bags do
not deflate substantially.
 These devices have a potential for a constant FiO2 of
>90%.
 Limitation:
In spont. Breathing person flow has to be adjusted with
the valve, chances of aspiration, constant adequate
flow of gases has to be maintained.JD SIR 32

33. JD SIR 33

34. COMPLICATIONS
• Induced apnea(temporary cessation or stopping of respiration)normal>10-
15sec.
• Atelectosis collops of alveoli of lung
• Retronatal fibroplasia
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35. About O2
• 21 % oxygen concentration in environment.
• Oxygen haviour gas than air.
• Supportive inflammable gas.
• Pressure of oxygen in cylinder> 2200
pound/inch/2seq.
• Open in anticlock direction .
• Humidifying bottle also known as wolf bottle.
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36. O2 CYLINDER
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37. JD SIR 37

38. O2 CYLINDER REGULATOR
JD SIR 38

39. CO2 CYLINDER
Use nephrotic surgery
nephroscopy
JD SIR 39

40. N2O GAS CYLINDER
Also known as laughing gas and use in general anesthesia and administer by inhalation
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41. THANK
YOU
JAGDISH CHOUDHARY
JD SIR 41