oxygen therapy and toxicity
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Oxygen therapy involves administering oxygen at concentrations greater than room air (21%) to treat or prevent hypoxia. There are various devices that deliver oxygen at different concentrations, including low flow devices like nasal cannulas (25-45% oxygen), reservoir systems like simple face masks (35-60% oxygen), and high flow devices like venturi masks that use air entrainment to deliver higher concentrations (35-40% oxygen). Proper nursing care is required to monitor patients receiving oxygen therapy and address any potential complications like oxygen toxicity from overexposure.
oxygen therapy and toxicity
- 1. OXYGEN THERAPY -Dr. Raghavendra Babu S 01/31/14 1
- 2. Definition: *Oxygen therapy is the administration of oxygen at concentrations greater than room air ( 21%) *With goal of treating or preventing the symptoms and manifestations of hypoxia(a state of oxygen deficiency reaching the tissues) 01/31/14 2
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- 9. DEVICES The oxygen delivery devices can be categorized as Low flow systems Reservoir systems High flow systems Enclosure systems 01/31/14 9
- 10. Oxygen Therapy Design & Performance ◦ Low flow Devices Flow does not meet inspiratory demand O2 is diluted with air on inspiration Devices deliver Fio2 ranging from 22-60% E.g Nasal cannula Transtracheal catheter 10
- 11. Nasal Cannula 11
- 12. NASAL CANNULA low oxygen device This device delivers an unpredictable amount of oxygen ranging from 25-45 % at 1 - 6 L/min depending on how much the patient inhales through the mouth Higher flow rates are uncomfortable for the patient A high flow rate can quickly dry out the nasal mucosa and become rapidly uncomfortable 12
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- 14. Method Nasal Cannula Amount Delivered F1o2 (Fraction Inspired (Oxygen Priority Nursing Advantages Disadvantages Interventions Check frequently Low flow that both % 24-44 prongs are in Lmin=24% 1 clients nares Lmin=28% 2 Lmin=32% 3 Never Lmin=36% 4 deliver more Lmin=40% 5 than 2-3 Lmin Lmin=44% 6 to client with chronic lung disease Client able to talk and eat with oxygen in place may cause irritation to the nasal and pharyngeal mucosa Easily used if oxygen flow rates are in home above 6 setting liters/minute Variable FIO2
- 15. Reservoir System Simple oxygen face mask Partial rebreathing mask Nonrebreathing mask 01/31/14 15
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- 17. SIMPLE FACEMASK low oxygen device The simple facemask at an oxygen flow of 6 L/min delivers approximately 35-60 % oxygen Increasing the flow to 10 L/min may increase oxygen concentration to about 50 % If the flow rate is less than 6 L/min (as cylinder nears empty), the patient may re-breathe much of his own exhalation and thus, the concentration of oxygen delivered will be low, possibly severely hypoxic 17
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- 20. Partial Rebreathing Mask with reservoir Moderate oxygen device Delivers 35-60% Oxygen at 6-10 L/min flow rate Ω First third of exhaled gases mix with reservoir Ω Exhaled gases from upper airway are oxygen rich Reservoir 20
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- 24. High Flow system It provide oxygen at flow rates high enough to satisfy patient’s inspiratory demands. Such high flows( i.e. 35-40 lit approx) are possible by 1. Entrainment of room air 2. High flow rates and reservoirs E.g Venturi masks 01/31/14 24
- 25. Oxygen Therapy High Flow Devices - Entrainment AE Devices ◦ AEM (Venti-Mask) ◦ AE Nebulizer (Large Volume Nebulizer) cool/heated Aerosol 25
- 26. Oxygen Therapy High Flow Devices Air Entrainment system ◦ What is Entrainment? 26
- 27. VENTURI EFFECT Oxygen is forced through a jet orifice entering the mask. As there is pressure drop across jet orifice, room air entrainment occurs through side ports 01/31/14 27
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- 30. Bateman, N T et al. BMJ 1998;317:798-801 Copyright ©1998 BMJ Publishing Group Ltd.
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- 36. T-piece Used on end of ET tube when weaning from ventilator Provides accurate FIO2 Provides good humidity
- 38. Oxygen Hood High oxygen device Clear plastic shell encompasses the baby's head Well tolerated by infants Size of hood limits use to younger than age 1 year Allows easy access to chest, trunk, and extremities Allows control of Oxygen Delivery: o Oxygen concentration o Inspired oxygen temperature and humidity Delivers 80-90% oxygen at 10-15 liter per minute 38
- 39. CPAP Administering oxygen by CPAP(continuous positive airway pressure): 1-Nasal CPAP. 2-Endotracheal CPAP. 01/31/14 39
- 40. Nasal CPAP: Nasal CPAP: It consists of a single nasopharyngeal tube that deliveries 2-8 cm of positive pressure with or without o2. Nursing care : - Frequent suction . - Tube care. - Change the nasal tube. 01/31/14 40
- 41. Endotracheal CPAP Endotracheal CPAP: Positive pressure delivering via an ETT. Nursing care : - Use sterile suctioning techniques - Mouth care - Change the ETT every seven days . 01/31/14 41
- 42. Oxygen is a drug and should be administered keeping following things in mind: mode of administration, flow rate, FiO2 (venturi), treatment goal, monitoring, when to stop.
- 44. What is free radical? A free radical is an atom or group of atoms possing one or more unpaired electrons. Radical + radical reactions typically very fast Radical + Non-radical reactions twide range of reaction rates. 01/31/14 44
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- 46. What is an Antioxidant? A substance that, when present at a low concentration compared with that of an oxidizable substrate, inhibits or prevents oxidation of the substrate. 01/31/14 46
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