Group members

NUR AMIRAINI BT ISMAIL

NUR FATIHAH BT AHMAD YAZID

NURUL AMIRA IZZATI BT MATSALLEH

SITI NOR SYAFAWANI BINTI MOHD SYAH

Definition

• Administration of oxygen at concentration

higher than that in room air to prevent

hypoxemia.

Purpose

• To increase oxygen saturation in tissues

where the saturation level are too low due

to illness or injury.

Indications

• Hypoxemia and hypoxia

• Severe respiratory distress

eg : acute asthma

pneumonia

• Severe trauma

• Acute MI

• Short term therapy, such as post-

anesthesia recovery.

Types of Oxygen Therapy

(i) Compressed oxygen

cylinders

An oxygen concentrator

produces oxygen by

concentrating the oxygen that is

already in the air and removing

other gases. The concentrator is

powered by electricity

(ii) Liquid oxygen system

Liquid oxygen is made by

super cooling oxygen gas,

which changes it to liquid

form. When in liquid form,

the oxygen takes up much

less room and can be stored

in special thermos

(iii)Oxygen concentrator

Oxygen is compressed

into a metal cylinder

under high pressure.

Oxygen may be stored

in either large or small

cylinders

O2 DELIVERY SYSTEM

Low Flow

System

High Flow

System

• Supplies flow of oxygen which

deliver only a portion of

inspired gas

• Provide a flow rate that is less

than the patients inspiratory

flow and allow room air to be

sucked in through the edges of

the mask to dilute the oxygen

All of gases the patient

breathe is delivered by a

mask or tube which allow

of precise control of FiO2

(1) Nasal Cannula

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

• Can quickly dry out the nasal mucosa and become rapidly uncomfortable

Delivers 25-45% FIO2 at 1-6 L/min

flow

Flow 0 liters per minute 21% (room air)

Flow 1 liters per minute 25%

Flow 2 liters per minute: 29%

Flow 3 liters per minute: 33%

Flow 4 liters per minute: 37%

Flow 5 liters per minute: 41%

Flow 6 liters per minute: 45%

(2) Nasal Catheter

• Inserted into 1 nostril to reach just behind the uvula or resting

on oropharynx

• It is used for patients who tend to breathe through the mouth or

experience claustrophobia when a mask covers their face

• It is infrequently being used as nasal catheter tends to irritate

nasopharynx and caused uncomfortable to patient

• Should be change every 8 hours

• Taped to the face.

• Not practical for infant.

• Flow : 3- 4L/min (30% -40% O2 concentration)

• Tube length : 40 cms

(3) Transtracheal catheter

• Delivers oxygen directly into the lungs by a small, flexible

catheter which passes from the lower neck into the trachea or

windpipe.

BENEFITS

• More comfortable to use than face masks and nasal cannulas

• Reduce the volume of oxygen required by the patient

• Greater value of oxygen conservation during exercise

• Reduce the cost of oxygen treatment

DISADVANTAGES

• Require an initial and more complex insertion procedure

• Mucus plugs may form on the end of the transtracheal

catheters

• Surgical

• Increased risk of infections

(4) Reservoir Cannula

• Reservoir cannulas are oxygen-conserving devices

• Store 20 mL of oxygen during exhalation and make that

oxygen available for the beginning of the next inhalation

• Require one half to one fourth the flow rate of standard

cannulas at settings of 0.5 to 2 L/min

• Devices are available in 2 configurations: the Oxymizer

• and the Oxymizer Pendant.

BENEFITS

• Improve the efficiency of oxygen delivery

• Reduces the cost of providing oxygen at home

• Patients receive more oxygen than they would receive at

the same flow rate from a standard cannula

(5) Pendant cannula

• Consists of nasal prongs attached to tubular conduit leading

to oxygen reservoir

• The bag stores 40 mL of gas and is available for oxygen

enrichment

• Has vent at side

• Allows CO2 to escape

• Dilute O2

• Devices are available in 2 configurations: the Oxymizer and

the Oxymizer Pendant.

(6) Simple Oxygen Mask

It seals poorly and its large ventilation holes allow the oxygen flow to be diluted with air

The simple facemask at an oxygen flow of 6 L/min delivers approximately 35-40 % 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

(7) Partial Rebreather Mask

• An oxgen delivery mask in which patient inhales a mixture of

atmospheric air, oxygen from its sources, and oxygen

contained within a reservoir bag.

• Provides a means for recycling oxygen and venting all CO2

during expiration from the mask

• 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

(8) Non-rebreathing Mask

• An oxygen delivery device in which all exhaled air leaves the

mask rather than partially entering reservoir bag

• Contains one-way valves that allow only O2 from its source

and reservoir bag to be inhaled

• All the air that is exhaled is vented from mask, none enters

the reservoir bag

• Non-rebreathing mask are used for those who require high

concentrations of O2

• Delivers 95% Oxygen at 10-12 L/min

• Two valves added to Rebreathing mask prevents:

– Entrainment of room air during inspiration

– Retention of exhaled gases during expiration

1. Venturi Mask

• patients who are in or are at risk of acute type 2 respiratory

failure.

• deliver oxygen at a rate above the peak inspiratory flow rate.

• deliver fixed concentrations of O2, the device mixes specific

volume room air with oxygen via an air entrainment regulator

(Bernoulli Principle).

•different sized colour coded valves. Each requires a certain

gas flow to deliver the oxygen concentration stated.

•Venturi masks deliver fixed oxygen levels as follows

i. 24%

ii. 28%

iii. 31%

iv. 35%

v. 40%

vi. 50%

2. Pediatric Mist Tent

Mist tents have an electrically powered fan that circulates cool

air and nebulized water particles inside a canopy which covers

the entire child or infant.

Purpose:

1. Provide continuous cool mist with oxygen if needed.

2. Relieve laryngeal, tracheal, or bronchial edema.

3. Help promote and improve cough mechanism.

4. Hydrate dried secretions.

3. Hyperbaric Oxygen

• Definition: a painless treatment that increases the amount of

oxygen in the body. This is done by breathing pure oxygen

while in a hyperbaric oxygen chamber.

• The increased pressure inside the chamber allows the

tissues to take up more oxygen. More oxygen in tissues help

body heal faster by speeding up the formation of new tissue

and fighting infection.

Hyperbaric oxygen therapy is used to treat:

• poor wound healing

• carbon monoxide poisoning

• gas gangrene, soft tissue infection

• diving accidents or the “bends”

• air and gas embolism

• burns

• soft tissue radiation injury

• osteomyelitis

• osteoradionecrosis

• acute blood loss anemia

• intracranial abscess

• skin grafts and flaps

• thermal burns

• crush injury

• compartment syndrome

• acute traumatic ischemias

Before start the treatment:

• go to the bathroom

• remove underwear, nylons and socks

• put on the special gown

Do not wear:

• contact lenses, dentures, and/or hearing aids

• jewellry

• hair spray

• ointments

• makeup

• creams

• nail polish

• perfume or cologne

• lotions or petroleum jelly

• deodorant

• velcro

• watch

• hair elastic bands

4. Aerosol and bland system

• Aerosol is a liquid or solid particle that is suspended in a

gas

• Bland aerosol therapy includes delivery of hypotonic,

hypertonic, or isotonic saline, or sterile water in

aerosolized form.

• Oxygen may be used in conjunction with bland aerosol

therapy.

• Bland aerosol therapy can be continuous in conjunction

with oxygen therapy.

Tonicity

Hypertonic (10%)

• Greater tonicity then surrounding tissues

• Tend to draw fluid from surroundings

Isotonic (Normal Saline) 0.9%

• Neither gains or loses water but maintains a steady size

Hypotonic

• Water

Particle Deposition

• Humungous in size are filtered in nose : 100

microns

• Large in throat: 10 - 20 microns

• Medium in small airways: 2 - 5 microns

• Small in alveoli: 1 - 3 microns

• Exhale: <0.5 microns

MMAD Particle deposition

5 - 10 µm Pharyngeal / Laryngeal

2 - 5 µm Tracheobronchial

0.5 - 2 µm Alveolar

< 0.5 µm Exhaled

5. Infant Head Hood

What it is?

A clear plastic hood that fits over an infant’s head. Different

design & sizes, some with potential ports for monitoring gas

content.

What it is used for?

1. To deliver a constant concentration of oxygen.

2. As support in cases as:

• mild respiratory distress syndrome (RDS)

• transient tachypnea of the newborn (TTN)

• meconium aspiration

• neonatal pneumonia

• Oxygen hood provide a stable concentration, visibility and

access to most of the body

• It recommend for acutely ill or unstable infants who require a

FiO2 > 0.40

• a minimum flow rate of 3 LPM is recommended in order to

prevent CO2 retention.

6. Infant incubator

Infant incubator is a biomedical device which provides

warmth, humidity, and oxygen all in a controlled

environment as needed by the new born.

Functions:

1. Protection ("The Pearson General Studies Manual 2009" by

Showick Thorpe and Edgar Thorpe)

• Fully temperature controlled, shielding infants from harmful

cold, provide insulation from outside noise, protecting infants

from germs and minimizing the risk of infection as well as

keeps out all airborne irritants like dust and other allergens.

2. Oxygenation

• provide a stable concentration, visibility and access to most

of the body.

• recommend for a FiO2 < 0.40

• recommend for a stable infant in the incubator

3. Monitoring & Observation

• cardiac monitors, brain-scan equipment, blood-monitoring

equipment, thermometers and other instruments for

observing vital signs.

1. Hyperbaric oxygen therapy. (2003). Retrieved December 26th, 2012 from

http://www.hamiltonhealthsciences.ca/documents/Patient%20Education/Hyp

erbaricPORTRAIT-trh.pdf

2. Baum, J. (2010). What Are the Functions of an Infant Incubator? Retrieved

December 26th, 2012 from http://www.livestrong.com/article/233496-what-

are-the-functions-of-an-infant-incubator/

3. Fraction of Inspired Oxygen (FiO2). (n.d.). Retrieved December 29th, 2012

from http://web.missouri.edu/~danneckere/pt316/case/pulm/FiO2.htm

4. What Is Oxygen Therapy? (n.d.). Retrieved December 27th, 2012 from

http://www.nhlbi.nih.gov/health/health-topics/topics/oxt/

5. Oxygen Therapy – Definition, Purpose, Description and Preparation. (2009).

Retrieved from December 27th, 2012 from

oxygenconcentratorinc.com/…/oxygen-therapy-definition-purpose-

description-and-preparation/