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Oxygen administration- advantages, disadvantages of different methods

Nasal cannula

  • It is a thin tube with two small nozzles/ prongs inserted into nostrils.
  • This device is used to administer oxygen to a breathing patients with minor breathing problems
  • It can only provide oxygen at low flow rates, 1-6 litres/ min.
  • It delivers a concentration of 24-40%.
  • Flow rates greater than 4 liters per minute should also be used with a humidifcation system.

Advantages

  • Comfortable for patient
  • Ideal for claustrophobic patients.
  • Ideal for oxygen dependent patients requiring small amounts of oxygen and home use.
  • Humidification (bubble bottle) not required up to 4 lpm.

Disadvantages

  • Maximum estimated FiO2 .40.
  • Not appropriate for patients in respiratory distress.

Watch For

  • Must be ordered in litres per minute (lpm), not FiO2
  • Flow rates greater than 6 lpm can be uncomfortable for patient. (Headaches, nose bleeds)
  • Possible water in the catheter from the bubble bottle will be sprayed up the patient’s nose. (Turn flow on before applying to patient.)

Simple face mask

  • It is a basic mask used for non-life-threatening conditions but which may progress in time, such as chest pain (possible heart attacks), dizziness, and minor hemorrhage.
  • It is often set to deliver oxygen between 5-10 L/ min.
  • The final oxygen concentration delivered by this device is dependent upon the amount of room air that mixes with the oxygen the patient breathes. The general oxygen concentration is between 35% and 50%

Advantages

  • Quick and easy to setup and apply.
  • Often found at the head of the bed in emergency areas. (eg. Emergency, Dialysis, PACU)

Disadvantages

  • Nonspecific FiO2 (Dependant on patients inspiratory flows)
  • Maximum FiO2 estimated at .50
  • Not intended for long term use.

Watch For

  • Flow rates set less than 5 lpm may cause CO2 rebreathing)

Partial rebreather mask

  • It is a simple mask with a reservoir bag
  • Oxygen flow should always be supplied to maintain the reservior bag at least one third to one half full on inspiration.
  • At a flow of 6-10 L/min the system can provide 40-70% oxygen.
  • It is considered a low-flow system.

Non-rebreather mask

  • It is an effective method for delivering high concentrations of oxygen to a breathing patient.
  • It is similar to the partial rebreathing mask except it has a series of one-way valves.
  • Non-rebreather masks consist of a face mask with an attached oxygen reservoir bag and a one-way valve, which prevents the patient’s exhaled air from mixing with the oxygen in the reservoir bag.
  • Flutter valves on the side of the mask allow exhaled air to escape freely. As the patient breathes, he or she inhales oxygen from the bag.
  • One valve is placed between the bag and the mask to prevent exhaled air from returning to the bag.
  • There should be a minimum flow of 10- 15L/min.
  • The delivered FIO2 of this system is 60-80%.

Advantages

  • Fast and easy to set up.
  • Can deliver high concentration oxygen in breathing patients.

Disadvantages

  • Delivers only one FiO2: 1.00

FiO2 is extremely variable. While theoretically capable of delivering an FiO2 of 1.00, realistically it is more likely between .60 and .80 due to air entrainment around the mask.

Watch For

  • Reservoir bag must always remain inflated. If deflation occurs the oxygen flow may be too low.

This is not a long term usage mask. The patient should be switched to a 100% aerosol mask at the earliest convenience.

Venturi mask

  • Administer oxygen via a Venturi provides high gas flow with a fixed oxygen concentration
  • It provides much controlled oxygen delivery between 20 – 55%.
  • Most reliable and accurate method for delivering a precise O2 concentration.
  • Consists of a mask with a jet
  • Excess gas leaves by exhalation ports.
  • O2 flow rate- 4 to 15L/min.
  • Can cause skin breakdown; must remove to eat.
  • This type of oxygen delivery is advocated for patients with chronic hypercarbia(for the in management of moderate to severe hypoxemia.

Advantages

  • Administers a specific FiO2. (Determined by air entrainment adaptor on end of mask.)
  • Quiet

Disadvantages

  • FiO2 only available according to mask adapters. .24, .28, .31, .35, .40 and .50

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