You will learn about these major topics:
- Name five situations in which the application of oxygen is indicated.
List four key pieces of equipment in an oxygen delivery
- Describe the hazards associated with the delivery of oxygen and list the precautions while delivering oxygen.
- Describe an oropharyngeal airway, a CPR mask, a bag- valve mask, a nasal cannula and a non-rebreather mask
- Describe suction, its parts and the care required while using suction equipment.
Indications for Oxygen Use
Oxygen that is used for medical needs is colorless and non-combustible. The air we breathe contains 21% oxygen. ^ The oxygen used in medicine has a concentration of 100%.
A patient can require oxygen for a variety of medical needs. There are five typical examples in which the application of oxygen is indicated:
Hazards Associated with Oxygen Use
- Fire: Do not allow smoking or the use of a flame when using oxygen. Oxygen is not combustible, but it does increase the intensity of a fire and will cause the fire to flare up.
- Explosion: Never use oil or grease around an oxygen cylinder. Oil and grease near high concentrations of oxygen can cause an explosion.
- Valve damage: Avoid dropping or placing a cylinder where it can fall. The regulator or valve can be damaged and the cylinder can become a projectile.
Oxygen is considered a medication.
2. Oxygen Delivery System
An oxygen delivery system consists of the following parts:
- Oxygen cylinder with the valve
- Low-pressure regulator
- Appropriate oxygen delivery device
- Oxygen cylinder with the valve
When providing oxygen in the field, the standard source is seamless steel or lightweight alloy cylinder filled with pressurized oxygen. A green (steel) or gray (aluminum) cylinder identifies oxygen.
The cylinders should be inspected daily and pressure-tested annually due to the high-pressure contents (2,000 psi).
Valve: The control located at the top of the cylinder, used to turn the bottle on and off. Keep in mind that a certain valve type might
not work with different types of regulators.
- Low-Pressure Regulators and Flowmeters
Regulators reduce the high pressure (2,000 psi) from the oxygen cylinder and decrease it to between 40 and 70 psi. Flowmeters control the flow of oxygen, which is usually administered at between 2 and 20 liters per minute.
- Precautions When Giving Oxygen
- The pressure in a full cylinder is between 2,000 and 2,200 psi. Reduce the pressure to 40-70 psi before administering the oxygen to the patient.
- The appropriate delivery of oxygen to the patient is achieved by the use of a flowmeter and regulator. They are almost always connected as one piece.
2.4 Accessories for Ventilation
In combination with the respiratory system, the circulatory system supplies the oxygen necessary for life and eliminates carbon dioxide from the body.
An oropharyngeal airway is a device usually made of plastic, which can be inserted into the patient’s mouth, and curves back into the throat. The airway holds down the patient’s tongue and provides an air passage. The airway comes in several sizes, from 0 for newborns, to number 7 for adults.
See also: Human Body Anatomy
Use the following procedure for inserting an oropharyngeal airway:
- Select proper size. If the patient is a child, use a tongue depressor to help insert the device.
- Open the patient’s mouth.
- Insert the adjunct upside-down (tip facing the roof of the mouth).
- Advance the adjunct gently until you encounter slight resistance (when the adjunct touches the back of the roof of the mouth).
- Turn the airway 180 degrees.
- Advance the adjunct until the flange rests on the patient’s teeth, then secure it with tape.
If the patient exhibits a gag reflex during or after insertion, remove the adjunct immediately.
The pocket face mask is designed to aid the rescuer when providing ventilations during CPR. It is made of a soft plastic that conforms to the patient’s face. The mask can come both with or without an oxygen inlet. Its use avoids direct contact with the patient’s mouth and decreases the chance of contamination.
Bag-Valve-Mask (BVM) (manual resuscitator)
Many different types are available. The bag-valve mask is a hand-held device you squeeze to ventilate a patient. It comes in adult, child and infant sizes. All have the same basic parts: face mask, non-rebreather patient valve, a bag (rubber or vinyl), intake valve/ oxygen reservoir valve, oxygen supply connection tube, and oxygen reservoir.
2.5 Adjunct Equipment for Oxygen Administration
Description: Has two stems that are placed into the patient’s nostrils. Used most often in the hospital setting. Most patients tolerate it well and it is the best accessory for the administration to giving low-concentration oxygen.
Flow Rate: Ipm
02 Delivered: Approximately___________ % oxygen concentration.
Description: Face mask with an oxygen reservoir bag and oneway valves. Requires a tight seal to ensure high oxygen concentration delivery.
Flow Rate:________ Ipm
02 Delivered: Approximately______________ % oxygen
The reservoir must always contain enough oxygen so that it does not deflate by more than one third when a patient inhales (must maintain proper flow rate).
Description: Non-breakable jar of water attached to the flowmeter.
Provides moisture to the dry oxygen coming from the supply cylinder.
Notes: Must be kept clean. Can become a breeding ground for algae, harmful bacteria, and fungal organisms.
2.6 Mechanical Suction
- Maintain airway at all times – keep free of blood, vomit, secretions and other liquids or objects. Use mechanical suction to remove these substances or objects.
- Solid objects such as food, teeth or very thick secretions cannot always be removed with suction and may require alternative equipment or a finger sweep.
• Suction should be performed rapidly to decrease the chance of blood or other foreign matter from moving into the lungs, which may cause pneumonia or complete airway obstruction.
A suction unit consists of a suction source, a collection container, tubing, and suction tips. Maybe portable or truck-mounted.
- Suction devices use negative pressure. Manual or electrically powered, air or oxygen powered.
- Must have a wide bore, thick walls, non-kinking tubing to fit a suction catheter.
- Several disposable catheters should be available, made of either rigid or flexible plastic.
- Unbreakable collection container with water for rinsing and cleaning.
- Enough vacuum power and flow to be effective.