Chapter 5. Oxygen Therapy Show
Tissue oxygenation is dependent on optimal or adequate delivery of oxygen to the tissues. Increasing the concentration of inhaled oxygen is an effective method of increasing the partial pressure of oxygen in the blood and correcting hypoxemia. Simply stated, oxygen therapy is a means to provide oxygen according to target saturation rates (as per physician orders or hospital protocol) to achieve normal or near normal oxygen saturation levels for acute and chronically ill patients (British Thoracic Society, 2008). Those administering oxygen must monitor the patient to keep the saturation levels within the required target range. Oxygen should be reduced or discontinued in stable patients with satisfactory oxygen saturation levels (Perry et al., 2014). Hypoxemia or hypoxia is a medical emergency and should be treated promptly. Failure to initiate oxygen therapy can result in serious harm to the patient. The essence of oxygen therapy is to provide oxygen according to target saturation rates, and to monitor the saturation rate to keep it within target range. The target range (SaO2) for a normal adult is 92% to 98%. For patients with COPD, the target SaO2 range is 88% to 92% (Alberta Health Services, 2015; British Thoracic Society, 2008; Kane, et al., 2013). Although all medications given in the hospital require a prescription, oxygen therapy may be initiated without a physician order in emergency situations. Most hospitals will have a protocol in place to allow health care providers to apply oxygen in emergency situations. The health care provider administering oxygen is responsible for monitoring the patient response and keeping the oxygen saturation levels within the target range. The most common reasons for initiating oxygen therapy include acute hypoxemia related to pneumonia, shock, asthma, heart failure, pulmonary embolus, myocardial infarction resulting in hypoxemia, post-operative states, pneumonthorax, and abnormalities in the quality and quantity of hemoglobin. There are no contraindications to oxygen therapy if indications for therapy are present (Kane et al., 2013). Oxygen Delivery SystemsThere is a wide variety of devices available to provide oxygen support. Delivery systems are classified as low-flow or high-flow equipment, which provide an uncontrolled or controlled amount of supplemental oxygen to the patient (British Thoracic Society, 2008). Selection should be based on preventing and treating hypoxemia and preventing complications of hyper-oxygenation. Factors such as how much oxygen is required, the presence of underlying respiratory disease, age, the environment (at home or in the hospital), the presence of an artificial airway, the need for humidity, a tolerance or a compliance problem, or a need for consistent and accurate oxygen must be considered to select the correct oxygen delivery device (British Thoracic Society, 2008). Table 5.2 lists the types of oxygen equipment. Table 5.2 Types of Oxygen Equipment
Special considerations:
Increasing Oxygen in the LungsThe use of oxygen delivery systems is only one component to increasing oxygen to the alveolar capillary bed to allow for optimal oxygenation to the tissues. Additional methods to increase oxygen saturation levels in the body include (Perry et al., 2014):
What oxygen delivery device can provide specific concentrations of oxygen?A Venturi mask mixes oxygen with room air, creating high-flow enriched oxygen of a desired concentration. It provides an accurate and constant FiO2 despite varied respiratory rates and tidal volumes. FiO2 delivery settings are typically set at 24, 28, 31, 35 and 40% oxygen.
How does a Venturi mask deliver oxygen?Venturi masks are low-flow masks that use the Bernoulli principle to entrain room air when pure oxygen is delivered through a small orifice, resulting in a large total flow at predictable Fio2.
What oxygen delivery device can provide specific concentrations of oxygen quizlet?A Venturi mask can deliver oxygen concentrations from 24% to 60% with flow rates from 4 to 12 L/min. Because this device delivers a precise oxygen concentration and carbon dioxide buildup is minimal, it is commonly used for patients who have COPD.
What is the best device to deliver high concentration oxygen?For oxygen settings higher than 6 liters/minute, a high flow nasal cannula is needed. Certain oxygen face masks and reservoir cannulas can boost the delivery of oxygen and make high oxygen flows more comfortable.
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