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Oxygen Delivery Devices. they’re not what you think. Indications for oxygen use. Low ambient O 2 Hypoxemia Suspected hypoxemia Increased work-of-breathing Flaring Tachypnea Increased myocardial work Acute head injury. O 2 delivery systems. High-flow

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oxygen delivery devices

Oxygen Delivery Devices

they’re not what you think

indications for oxygen use
Indications for oxygen use
  • Low ambient O2
  • Hypoxemia
  • Suspected hypoxemia
    • Increased work-of-breathing
    • Flaring
    • Tachypnea
  • Increased myocardial work
  • Acute head injury
o 2 delivery systems
O2 delivery systems
  • High-flow
    • Venti-masks (air entrainment masks)
    • Mechanical aerosol systems
    • High-flow humidifier systems
  • Low-flow
    • Nasal cannula
    • Simple masks
    • Partial rebreathing masks
    • Non-rebreathing masks
what s my pao 2
What’s my PaO2?
  • a: On room air?
  • b: On 0.50 FiO2?
  • c: On 0.80 FiO2?
the answers
The answers:

PaO2 = FiO2 x (barometric pressure - water vapor pressure) - PaCO2/RQ

PaO2 = FiO2 X (760 - 43) - PaCO2/0.8

a: PaO2 = .21 X 713 - 40/0.8 = 100

b: PaO2 = .50 X 713 - 40/0.8 = 306

c: PaO2 = .80 X 713 - 40/0.8 = 520

resorption atelectasis
Resorption atelectasis

100% O2

nitrogen

oxygen

After ~15 minutes,

blood N2 is depleted.

Poorly ventilated &

well perfused units (A)

become atelectactic.

B

A

PO2 =673

PCO2 = 40

PH2O = 47

non rebreathing system
Non-rebreathing system

Room air

Gas source

Expiratory

gas

Reservoir

To patient

One way valves

o 2 hgb dissociation curve shift
O2Hgb dissociation curve shift

¯pH

­ CO2

­ temp

% Sat

PO2 mmHg

what happens to your po 2 and sats when your ph changes

What happens to your pO2 and sats when your pH changes?

ph = 7.4, pO2 = 100, sat 96%

ph = 7.0, pO2 = ?, sat = ?

oxygen delivery trucks x how full they are loaded x how fast they go

Oxygen delivery = # trucks X how full they are loaded Xhow fast they go

DO2 = 1.38(hgb X sat X CI)

+ (pO2 X 0.003)

simple mask
Simple mask
  • Open ports for exhaled gas
  • Air entrained through ports if O2 flow through does not meet peak insp flow
  • 35-55% O2 at 6-10 L/min

Exhalation

ports

O2inlet

partial rebreather mask
Partial rebreather mask
  • O2 directed into reservoir
  • Insp: draw gas from bag & ? room air
  • Exp: first 1/3 of exhaled gas goes into bag (dead space)
  • Dead space gas mixes with ‘new’ O2 going into bag
  • Deliver ~60% O2

Exhalation

ports

O2

Reservoir

non rebreathing mask
Non-rebreathing mask

One-way valves

  • Valve prevents exhaled gas flow into reservoir bag
  • Valve over exhalation ports prevents air entrainment
  • Delivers ~100% O2, if bag does not completely collapse during inhalation

O2

Reservoir