Oxygen Thearpy Equipments used Oxygen Toxicity

1. OXYGEN
THERAPY
Presenter : Vinitha.A

2. • Definitionoftheoxygentherapy
• Typesofoxygen therapy
• purposesofusingtheoxygen therapy
• Administrationofoxygen therapy
• Complicationofoxygentherapy

5.  Hypoxia, condition of the body in which the
tissues are starved
of oxygen. In its extreme form, where oxygen is
entirely absent, the condition is called anoxia.
 There are four types of hypoxia:
 (1)Hypoxemic type, in which the oxygen
pressure in the blood going to the tissues is too
low to saturate the hemoglobin;
 (2)Anemic type, in which the amount of
functional hemoglobin is too small, and hence
the capacity of the blood to carry oxygen is too
low;

6.  3) Stagnant type, in which the blood is or may
be normal but the flow of blood to the tissues
is reduced or unevenly distributed; and
 (4)Histotoxic type, in which the tissue cells are
poisoned and are therefore unable to make
proper use of oxygen.
 Diseases of the blood, the heart and
circulation, and the lungs may all produce
some form of hypoxia.

7. ⦁ The hypoxemic type of hypoxia is due to
one of two mechanisms:
⦁ (1) a decrease in the amount of breathable
oxygen—often encountered in pilots,
mountain climbers, and people living at
high altitudes —due to the reduced
barometric pressure (see altitude sickness),
or
(2) cardiopulmonary failure in which the
lungs are unable to efficiently transfer
oxygen from the alveoli to the blood.

8. ⦁ In the case of anemic hypoxia, either the total
amount of hemoglobin is too small to supply
the body’s oxygen needs, as in anemia or
after severe bleeding, or hemoglobin that is
present is rendered nonfunctional.
⦁ Examples of the latter case are carbon
monoxide poisoning and metho-globinuria, in
both of which the hemoglobin is so altered
by toxic agents that it becomes unavailable
for oxygen transport, and thus of no
respiratory value.

9. • Stagnant hypoxia, in which blood flow
through the capillaries is insufficient to
supply the tissues, may be general or
local.
• If general, it may result from heart
disease that impairs the circulation,
impairment of veinous return of blood,
or trauma that induces shock.
• Local stagnant hypoxia may be due to
any condition that reduces or prevents
the circulation of the blood in any area
of the body.

10. ⦁ In histotoxic hypoxia the cells of the body are
unable to use the oxygen, although the
amount in the blood may be normal and under
normal tension.
⦁ Although characteristically produced by
cyanide, any agent that decreases cellular
respiration may cause it.
⦁ Some of these agents are narcotics, alcohol,
formaldehyde, acetone, and certain anesthetic
agents.

11. ⦁ Hypoxemia is an inadequate partial pressure
of oxygen in arterial blood.
• Hypoxemia has many causes,
often respiratory disorders, and can cause
tissue hypoxia as the blood is not supplying
enough oxygen to the body.
• Extreme hypoxia can be called anoxia,
extreme hypoxemia can be called anoxemia

12. ⦁ Hypoxemia is usually defined in
terms of reduced partial pressure
of oxygen (mm Hg) in arterial
blood when the partial pressure of
oxygen in blood is less than 60 mm
Hg, then hemoglobin oxygen
saturation is less than 90%.

13. • Hypoxemia refers to low oxygen in the
blood, and the more general term hypoxia
is an abnormally low oxygen content in any
tissue or organ, or the body as a whole.
• Hypoxemia can cause hypoxia (hypoxemic
hypoxia), but hypoxia can also occur via
other mechanisms, such
as anemia.

14. • There are 5 phyiological causes of
⦁ HIGH ALTITUDE
⦁ DIFFUSION
⦁ HYPOVENTILATION
⦁ SHUNTING
⦁ VENTILATION-PERFUSION MISMATCH

16. ⦁ Use of pulse oximeter for early detection
desaturation
⦁ Check a-b-c
⦁ Increase inspired oxygen saturation by 100%
⦁ Check the integrity of the breathing system by manual
ventilation of the lungs
⦁ Confirm the position and potency of the tube
⦁ Check bilateral chest movement and breathing sounds
⦁ Peep for gentle lung hyperinflation
⦁ Measure and stabilize core temperature

17. Purpose
Oxygen therapy isa key treatment
inrespiratory care.
Thepurpose istoincrease oxygen
saturationintissueswherethe
saturationlevels are too low
due to illnessor injury.

19. oxygen therapy isused to treat
Example incase :-
Documented hypoxemia
Severe respiratorydistress(acute asthma
or pneumonia)
Severe trauma
Chronic obstructive pulmonary disease
(COPD, including chronic bronchitis,
emphysema, and chronic asthma)

20. oxygen therapy isused to
treat
Pulmonary hypertension
Acute myocardial infarction (heart
attack)
Short-termtherapy, such as post-
anesthesia recovery
Oxygen may also be used totreat
chronic lung disease patientsduring
exercise .

21. Preparation
• A physician's order isrequired for
oxygen therapy, except inemergency
use.
• Clinical observations.
• indicated inArtialBlood
Gas measurements,(ABGs)
• Pulse oximetery

23. Cautions ForOxygen Therapy
• Oxygen toxicity – can
occur with FIO2 - 5
0
%
longer than48 hrs
• Danger of fire
• Infection

26. Classification of Oxygen Delivery
Systems
• Lowflowsystems
1.contribute partially toinspired gas client
breathes
• Ex:nasal cannula, simple mask , non-re
breather mask , Partialrebreather
mask
• High flow systems
• deliver specific and constant percent of
oxygen independent ofclient’s
breathing
• Ex:Venturimask,, trach collar, T-piece

27. :Methods of oxygen
administration
Nasal cannula- 1

28. Nasal cannula
I
tisa disposable.
plastic devise withtwoprotruding
prongsforinsertionintothenostrils,
connected toan oxygen source.
Used forlow-medium concentrations of
Oxygen (24-44%).

29. Method Amount
Delivered
F1o2
(Fraction
Inspired
(Oxygen
Priority Nursing
Interventions
Advantages Disadvantages
Nasal
Cannula Low flow
% 24-44
Lmin=24% 1
Lmin=28% 2
Lmin=32% 3
Lmin=36% 4
Lmin=40% 5
Lmin=44% 6
Check
frequently
that both
prongs are in
clients nares
Never deliver
more than 2-3
Lmin to
client with
chronic lung
disease
Client able
to talk and
eat with
oxygen in
place
Easily used
in home
setting
maycause
irritationto
thenasal and
pharyngeal
mucosa
oxygen flow
ratesare
above 6
liters/minute
Variable FIO2

31. Face mask
• The simple Oxygen mask
• Thepartial rebreathermask:
• Thenon rebreathermask:
• Theventurimask:

32. The simple Oxygen mask
Simplemask ismade of
clear, flexible , plastic or
rubberthatcan be molded
tofitthe face.

33. The simple Oxygen mask
It delivers 35% to 60% oxygen .
Aflow rate of 6 to 10 liters per minute.
Often it is used when an increased
delivery of oxygen is needed for short
periods
(i.e., less than 12 hours).

35. The partial rebreather mask
• Themask is witha reservoirbag must
remain inflated during both inspiration&
expiration
• I
tcollects partsof thepatients' exhaled
air.
• I
tisused todeliver oxygen concentrations
up to 8
0
%
.

36. Thepartial rebreather mask
• Theoxygen flowrate
mustbe maintained at
a minimumof 6L/min
to ensure thatthe
patient does not
rebreathe large
amountsofexhaled air.
• Theremaining
exhaled airexits
through vents.

55. T-piece
• Usedon end of
E
Ttube when
weaning from
ventilator
• Provides
accurate
FIO2
• Provides
good
humidity

57. Side effect &complication
of oxygen therapy
• Oxygen toxicity
• Retrolental fibroplasia
• Absorption atelectasis

58. oxygen toxicity
I
tisa condition inwhich ventilator failure
occurs due toinspiration of a high
concentration of oxygen fora
prolonged period of time.
Oxygen concentration greater than5
0
%
over 24to48hourscan cause
pathological changes inthe lungs.

59. :Signs and symptoms of
oxygen toxicity
. Non-productive cough
.Nausea and vomiting
.Substernal chest pain
.Fatigue
.Nasal stuffiness
.Headache
.Sore throat
.Hypoventilation
.Nasal congestion
.Dyspnea
.Inspiration pain

65. :Evaluation
• Breathingpatternregular and at
normal rate.
• pink color innail beds, lips, conjunctiva
of eyes.
• No confusion, disorientation, difficulty
withcognition.
• Arterialoxygen concentration
or hemoglobin
• Oxygen saturationwithinnormal limits.

66. :Documentation
• Date andtime oxygen started.
• Method of delivery.
• Oxygen concentration and
flow rate.
• Patient observation.
• Add oral&nasal care to the
nursing care plan

67. O2 DELIVERYDEVICES
EQUIPMENT FLOW FIO2 SPECIAL NOTES
NASAL CANNULA 1/2 - 6 L/M .24 – 44 6 L/M MAX.
SIMPLE O2 MASK
(WITHOUT BAG)
6 - 10 L/M .35 – 55 USE 5 L/M
MINIMUM
RESERVOIR MASK
(MASK WITH BAG)
10-15 L/M .60 -80 PAGE RT IF USED
(BAG TO NOT
COLLAPSE)
VENTI MASK 3 L/M
6 L/M
.24, 26, 31,
.35, .40, .50
READ ENCLOSED
INSTRUCTIONS
NEBULIZER 8 L/M OR > .28, .30, .35
.40, .50, 70
MIST MUST BE
VISIBLE
*** SHOWS THAT FIO2 VARIES WITH DIFFERENT
F, VT, INSPIRATORY FLOW RATES.