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    Oxygenation Objectives Recognition and Use of Oxyg EN

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    This document discusses oxygenation and hypoxia. It defines oxygenation and hypoxia, and describes the causes and types of hypoxia including hypoxemic, anemic, stagnant, and histotoxic hypoxia. It discusses signs and symptoms of hypoxia, and covers topics like oxygen delivery devices, levels of hypoxemia, target saturations, and how the cardiovascular and respiratory systems work together to oxygenate tissues. The key points covered are the definition of oxygenation and hypoxia, the four types of hypoxia, signs and symptoms of hypoxia, appropriate use and settings of various oxygen delivery devices, and how the cardiovascular and respiratory systems interact to oxygenate tissues.

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    Oxygenation Objectives Recognition and Use of Oxyg EN

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    Flame St
    33 views45 pages
    This document discusses oxygenation and hypoxia. It defines oxygenation and hypoxia, and describes the causes and types of hypoxia including hypoxemic, anemic, stagnant, and histotoxic hypoxia. It discusses signs and symptoms of hypoxia, and covers topics like oxygen delivery devices, levels of hypoxemia, target saturations, and how the cardiovascular and respiratory systems work together to oxygenate tissues. The key points covered are the definition of oxygenation and hypoxia, the four types of hypoxia, signs and symptoms of hypoxia, appropriate use and settings of various oxygen delivery devices, and how the cardiovascular and respiratory systems interact to oxygenate tissues.

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    This document discusses oxygenation and hypoxia. It defines oxygenation and hypoxia, and describes the causes and types of hypoxia including hypoxemic, anemic, stagnant, and histotoxic hypoxia. It discusses signs and symptoms of hypoxia, and covers topics like oxygen delivery devices, levels of hypoxemia, target saturations, and how the cardiovascular and respiratory systems work together to oxygenate tissues. The key points covered are the definition of oxygenation and hypoxia, the four types of hypoxia, signs and symptoms of hypoxia, appropriate use and settings of various oxygen delivery devices, and how the cardiovascular and respiratory systems interact to oxygenate tissues.

    Copyright:

    © All Rights Reserved
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    Download as pptx, pdf, or txt
    33 views45 pages

    Oxygenation Objectives Recognition and Use of Oxyg EN

    Uploaded by

    Flame St
    This document discusses oxygenation and hypoxia. It defines oxygenation and hypoxia, and describes the causes and types of hypoxia including hypoxemic, anemic, stagnant, and histotoxic hypoxia. It discusses signs and symptoms of hypoxia, and covers topics like oxygen delivery devices, levels of hypoxemia, target saturations, and how the cardiovascular and respiratory systems work together to oxygenate tissues. The key points covered are the definition of oxygenation and hypoxia, the four types of hypoxia, signs and symptoms of hypoxia, appropriate use and settings of various oxygen delivery devices, and how the cardiovascular and respiratory systems interact to oxygenate tissues.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    of 45

    OXYGENATION

    OBJECTIVES
    D US E OF O XY G E N
    RECOGNITION AN

    G EN DE LI VE RY DE V IC ES
    HOW TO TO USE OXY
    F OR D/ T D E LIV ER Y D EV IC ES
    INDICATION
    BASIC PRINCIPLE'S

    • OXYGEN IS A DRUG

    • IF ABUSED IT CAN CAUSE COMPLICATIONS

    • WHY IS OXYGEN BEING ADMINISTERED

    • WHAT ARE THE HAZARDS

    • HIGH FLOW VERSUS VS LOW FLOW


    DELIVERY EQUIPMENT

    • NASAL CANNULA

    • SIMPLE FACE MASK

    • VENTURE MASK

    • RESERVOIR BAG MASK


    • OXYGEN REQUIRED TO PRODUCE ATP PROCESS OXIDATIVE PHOSPHORYLATION
    • NO ENOUGH OXYGEN NO ATP= CELL DAMAGE CONDITION CALLED HYPOXIA
    • HYPO: LESS THAN NORMAL OXIA=OXYGENATION

    • SODIUM POTASSIUM PUMP STOPS


    • ANAEROBIC GLYCOLYSIS STARTS 2ATP+LACTIC ACID(DENATURES PROTIEN) AND ACIDIC ENVIR
    • CALCIUM PUMP STOPS(ENZYME ACTIVATION)
    • FINALY ACTIVATES CYTOCHROME C APOPTOSIS(SELF DISRTUCTION)
    HYPOXIA
    • SYMPTOMS HEAD ACHE SIGNS TACHYCARDIA
    CONFUSION HYPOTENSION
    BEHAVIORAL CHANGE PULMONARY HYPERTENSION
    BREATHLESSNESS CARDIAC ARRHYTHMIA
    DROWSINESS METABOLIC ACIDOSIS WITH RESPIRATORY
    TIREDNESS ALKALOSIS
    CYANOSIS ANAEROBIC GLYCOLYSIS
    HYPOXIA

    • CONDITION IN WHICH BODY IS DEPRIVED OF OXYGEN

    • A DECREASE BELOW NORMAL LEVELS OF OXYGEN IN INSPIRED GASES, ARTERIAL BLOOD OR TISSUE WITH
    OUT REACHING ANOXIA
    CAUSES OF HYPOXIA
    • HIGH ALTITUDE
    • DECREASED O2 SUPPLY TO AN AREA
    • LOW HEMOGLOBIN LEVEL
    • LOW OXYGEN CARRYING CAPACITY
    • POOR TISSUE PERFUSION
    • IMPAIRED VENTILATION
    • DECREASED DIFFUSION OF O2
    TYPES OF HYPOXIA
    TERMS: ARTERIAL PO2,O2 CARRYING CAPACITY OF BLOOD(HB VALUE),A-V D/CE OF PO2
    PERCENTAGE SATURATION OF HEMOGLOBIN SAO2

    • HYPOXEMIC HYPOXIA

    • ANEMIC HYPOXIA

    • STAGNANT HYPOXIA

    • HISTOTOXIC HYPOXIA
    HYPOXEMIC HYPOXIA
    • DECREASED AMOUNT OF BREATHABLE O2- DECREASED PARTIAL PRESSURE OF 02
    - DECREASED O2 CONCENTRATION
    CAUSES LEAKING MASK IN ADEQUATE REGULATOR FUNCTION,FAULTY HOSE CONNECTIONS

    • PULMONARY FAILURE IMPAIRED GAS EXCHANGE IN THE LUNGS


    - PNEUMONIA
    - INTERSTITIAL LUNG DISEASE
    -DIRECT BLOCK AGE
    - COPD
    CHARACTERISTICS
    • DECREASED O2 SATURATION IN BLOOD

    • A-V PO2 D/CE IS LOW

    • LOW ARTERIAL O2 CONTENT

    • LOW ARTERIAL PO2

    • TISSUE UTILIZATION IS NORMAL

    • BLOOD FLOW TO TISSUES NORMAL

    • O2 CARRYING CAPACITY IS NORMAL


    ANEMIC HYPOXIA
    • DECREASEAD NO OF RBCS
    • DECREASED HEMOGLOBIN CONTENT IN THE BLOOD
    • FORMATION OF ALTERD HEMOGLOBIN
    • COMBINATION OF HEMOGLOBIN WITH OTHER GASSES THAN O2 & CO2
    • RBC’S TRANSPORT O2
    DEC NO OF RBCS= LESS O2 AVAILABLE TO THE TISSUES
    RBCS FULLY SATURATED BUT LESS O2 AVAILABLE TO THE TISSUES
    CO POISONING DISPLACES O2 AND BINDS HEMOGLOBIN
    RESULTS FROM SPO2 ARE MISLEADING IN THIS CASE
    CHARACTERISTICS

    • 02 CARRYING CAPACITY OF THE BLOOD IS LOW


    • ARTERIAL PO2 NORMAL
    • A-V D/CE NORMAL
    • NORMAL TISSUE UTILIZATION
    STAGNANT HYPOXIA
    • BLOOD CIRCULATION THROUGH THE TISSUE IS REDUCED(DISTRIBUTION PROBLEM)
    • GENERALIZED: PUMP FAILURE –HEART ATTACK (FAINTING,SHOK)
    • HIGH G FORCES
    --ABNORMAL RHYTHM
    --VALVULAR HEART DISEASE
    --OUT FLOW OBSTRUCTION
    LOCALIZED: BLOOD SUPPLY REDUCED TO LOCAL AREA –ARTERIOSCLEROSIS
    -- THROMBUS
    --EMBOLUS(FAT,GAS,CLOT)
    -- COLD
    -- SEVER INFECTION
    • NORMAL PO2

    • NORMAL SAO2

    • A-V D/CE IS HIGHER THAN NORMAL


    HISTOTOXIC HYPOXIA
    • UTILIZATION PROBLEM(TISSUES CANT USE SUPPLIED O2)

    • MITOCHONDRIA UNABLE TO UTILIZE OXYGEN(NO ATP)

    • CAUSES: CYANIDE POISONING-MURDER MYSTERY(CYTOCHROME OXIDASE)

    • ALCOHOL &BARBITURATE

    • O2 TOXICITY(INHIBITION OF CERTAIN ENZYMES HAMPERING O2 METABOLISM)CYTOCHROME OXIDASE


    - BURN FROM PLASTICS OR FABRICS
    STOPS OXIDATIVE PHOSPHORYLATION
    CHARACTERISTICS

    • NORMAL PO2

    • NORMAL SAO2

    • A-V D/CE IS NIL


    LEVELS OF HYPOXEMIA
    • MILD PAO2 OF 60-80 MMHG SPO2 OF 91-95 %

    • MODERATE PAO2 OF 40-60 MMHG SPO2 OF 74-91 %

    • SEVERE PAO2 OF < 40 MMHG SPO2 0F < 74 %

    • PHYSICAL ASSESSMENT INSPECTION


    PALPATION
    AUSCULTATION
    TARGET SATURATIONS

    • AIM FOR 94%-98% IN MOST PATIENTS


    • 88%-92% IF AT RISK OF TYPE II RESPIRATORY FAILURE (HIGH CO2 & LOW O2)
    • ADAPT OXYGEN DELIVERY DEVICE & FLOW RATE
    NASAL CANNULA
    • EXACT FIO2 DELIVERED?
    • 1L/MIN =24% THEN EACH L ADDS APPROX 4%
    • USE 1-6 L/MIN THAT GIVES APPROXIMATELY 24%-50% FIO2
    • CONSIDER HUMIDIFICATION FOR >4 L/MIN
    • INDICATION: LOW TO MODERATE OXYGEN REQUIREMENT
    • ADVANTAGES: ALLOW ORAL FREEDOM,EASILY TOLERATED ,NO REBREATHING, LOW COST
    • DISADV: EASILY DIALOGED & MOUTH NOT COVERED
    SIMPLE FACE MASK
    • INDICATION : LOW FLOW DELIVERY DEVICE
    FOR LOW TO MODERATE OXYGEN REQUIREMENT

    • FLOW RATE: 5-10 L/MIN

    • OXYGEN DELIVERY VARIABLE(40%-70%)

    • ASSES FACIAL SKINS AND BEHIND THE EAR

    • MAY MAKE THE PATIENT FEEL CLAUSTROPHOBIC


    VENTURI MASK
    • INDICATION: HIGH FLOW O2 DELIVERY
    • SPECIFIC MODERATE OXYGEN REQUIREMENT (EG. COPD)
    • FLOW RATE SPECIFIC TO ADAPTOR(4-12)
    • OXYGEN DELIVERY: MORE PRECISE FIO2 DELIVERY
    24%-60% BASED ON THE ADAPTER USED
    HAVE COLOR CODED ADAPTER FOR SPECIFIC PERCENTAGE
    ENSURES EXACT PERCENTAGE OF O2 DELIVERY
    USED WITH THE PATIENT WHO RETAIN CO2
    BEST FOR COPD
    RESERVOIR BAG

    • INDICATION: HIGH OXYGEN REQUIREMENT

    • FLOW RATE: 12-15L/MIN

    • OXYGEN DELIVERY: 60%-80%


    NON REBREATHER MASK
    • LOW FLOW DELIVERY DEVICE
    • VALVES ON MASK MAKE EXHALED AIR TO LEAVE THE MASK
    • THE RESERVOIR CONTAINS ONE WAY VALVE PREVENT EXHALED AIR FROM ENTERING
    • FITS SNUGLY TO THE FACE
    • FLOW RATE: 10-15 L/MIN
    • OXYGEN DELIVERY: 60%-100%
    OXYGEN THERAPY IN ACUTE HYPOXIA
    IS THE PATIENT
    CRITICALLY ILL OR IN A
    PERI-ARREST CONDITION

    IS THE PATIENT AT RISK OF TYPE II COMMENCE TREATMENT


    (HYPERCAPNIC) RESPIRATORY FAILURE WITH RESERVOIR BAG

    TARGET SATURATION IS 88%-92% WITH


    TARGET SATURATION
    AWAITING BLOOD GAS RESULTS
    94%-98%
    FRACTION INSPIRATORY O2 FROM FLOW RATE(L/MIN)
    Nassal cannula(low flow) Simple mask (low flow) Venturi mask(low flow) Partial non breather(high
    flow)
    l/min %o2 l/min %o2 l/min %o2 l/min %o2
    1 24 5-6 40 4 24 6 60
    2 28 6-7 50 4 28 7 70
    3 32 7-8 60 8 35 8 80
    4 36 8 40 9 90
    5 40 12 50 10-12 >95
    6 44 12 60
    TRACHEAL AIR WAYS

    AIR WAYS THAT GO IN TO TRACHEA

    • ENDO TRACHEAL TUBE :SEMI RIGID CURVED TUBES WITH CUFF AT THE DISTAL END

    • TRACHEOSTOMY TUBE : PLACED DIRECTLY ON THE TRACHEA TO CONTROL THE AIR WAYS
    SUCTIONING

    • DONE WHEN THE PATIENT ARE HAVING DIFFICULTY OF CLEARING AIR WAYS
    • SECRETIONS ARE REMOVED VIA A CATHETER CONNECTED TO SUCTION SOURCE
    • OROPHARYNGEAL/NASOPHARYNGEAL WHEN THE PATIENT CANNOT EFFECTIVELY COUGH SECTIONS
    • OROTRACHEAL/NASOTRACHEAL USED WHEN THE PATIENT UNABLE TO MANAGE SECRETIONS
    • TRACHEOSTOMY/ENDOTRACHEAL USED WITH ARTIFICIAL AIR WAYS
    • ASSUMES NORMAL RESPIRATORY RATE OF 12-20 BREATHES PER MINUTE

    • LOW FLOW SYSTEMS: FIO2 DELIVERED TO PATIENT IS VARIABLE & UNPREDICTABLE

    • HIGH FLOW DEVICES: FIO2 DELIVERED TO PATIENT IS CONSISTENT & RELIABLE


    • VENTILATION: INSPIRATION & EXPIRATION

    • RESPIRATION: EXCHANGE OF GASSES IN THE LUNG

    • COMPLIANCE: LUNGS ABLE TO INFLATE(EDEMA)

    • ELASTIC RECOIL: FIBERS ABLE TO RETURN TO ORIGINAL POSITION (EMPAYSEMA)

    • AIRWAY RESISTANCE: RESISTANCE TO FLOW AIR IN THE AIR WAYS


    ADEQUATE OXYGENATION OF TISSUES IS DEPENDENT ON

    CARDIOVASCULAR AND RESPIRATORY SYSTEM WORKING TOGETHER TO OXYGENATE SYSTEMS

    • TO DELIVER OXYGEN TO BLOOD STREAM REQUIRES HEALTHY RESPIRATORY SYSTEM


    • TO CIRCULATE OXYGEN BODY REQUIRES INTACT CARDIOVASCULAR SYSTEM
    CV ALTERATION ON OXYGENATION

    • HEART NOT GOOD= LOW CIRCULATION=DECREASED O2 LEVEL IN TISSUES

    • INTERRUPTION OF BLOOD FLOW CAUSED BY


    CARDIAC RHYTHM IRREGULARITIES
    HEART FAILURE
    NARROWING OF ARTERIES(ARTHEROSCLEROSIS,SPASM,ONGENTIAL MALFORMATIION)
    RESPIRATORY ALTERATIONS
    • CHRONIC OBSTRUCTIVE PULMONARY DISEASE( COPD)
    DISORDERS CHARACTERIZED BY IMPAIRED AIR FLOW IN THE LUNGS
    EMPHYSEMA
    BRONCHITIS
    PNEUMONIA
    ATELECTASIS
    SYMPTOMS OF CARDIO PULMONARY ALTERATIONS

    • DECREASED OXYGENATION

    • SHORTNESS OF BREATH

    • DIFFICULTY WHEN BREATHING

    • CARDIAC AND RESPIRATORY PROBLEM HISTORY


    OBJECTIVE DATA
    • VITAL SIGN: BP,SPO2,PR,TEMP

    • ARTERIAL PO2,OXYGEN CARRYING CAPACITY OF BLOOD(HB VALUE), PERCENTAGE SATURATION OF HEMOGLOBIN

    • CHEST VISUAL INSPECTION

    • PALPATION FOR CARDIAC ENLARGEMENT OR ABNORMAL VIBRATION

    • AUSCULTATION OF HEART SOUNDS

    • AUSCULTATION OF THE LUNGS

    • ASSESSMENT OF VASCULAR(EDEMA)ON EXTREMITIES

    • ASSESSMENT OF PULSES, SKIN COLOR & PULSES


    LABORATORY DIAGNOSTIC TEST
    • CBC: PROVIDE INFORMATION FOR BLOOD O2 & CO2 TRANSPORT CAPACITIES AND STATUS OF IMMUNE
    RESPONSE

    • ABG: ASSES OXYGENATION & ACID BASE IMBALANCE

    • CARDIAC ENZYMES: IF CHEST PAIN OR RELATED SYMPTOM TO DETERMINE HEART DAMAGE

    • LIPIDS: HYPERLIPIDEMIA RISK FACTOR FOR CORR HEART DISEASE


    NORMAL ARTERIAL BLOOD GAS LEVELS
    Pao2 80-100 mmhg
    Paco2 35-45 mmhg
    Ph 7.35-7.45
    Hco3 22-26 meq/l
    Base excess 2
    PROMOTING OPTIMAL CARDIO PULMONARY

    • GOAL OF OXYGEN THERAPY : DECREASE SYMPTOMS RELATED TO LOW OXYGEN LEVEL & CV SYSTEM
    OVERLOAD

    • ASSESSMENT INCLUDES LAB RESULTS TO DOCUMENT HYPOXEMIA


    • HYPOXEMIA MANIFESTED BY HIGH RESPIRATORY , HEART RATE OR CYANOSIS DECREASING O2
    SATURATION AND DISTRESS
    PRECAUTIONS IMPORTANT WHEN ADMINISTERING O2

    • PATIENT WITH CHRONIC HYPERCAPNIA MAY HAVE A RESPIRATORY DIPRESSION WHEN SUPPLEMENTAL
    O2 LEVELS ARE TO HIGH

    • WHEN FIO2 LEVELS >50% ATELECTASIS OR OXYGEN TOXICITY MAY OCCUR

    • HIGH LEVELS OF OXYGEN POSE A FIRE HAZARD

    • NEBULIZERS & HUMIDIFIERS MAY HAVE BACTERIAL CONTAMINATION LEADING TO INFECTION


    DEVICES USED TO DELIVER O2

    • CATEGORIZED IN TO LOW FLOW (ROOM AIR IS BREATHED IN)


    RESERVOIR
    HIGH FLOW
    HYPOVENTILATION
    • DELIVERY OF AIR TO ALVEOLI OF THE LUNGS IS INSUFFICIENT TO MEET THE BODY NEEDS OF GETTING OXYGEN AND
    REMOVING CO2

    • DECREASED RATE & DEPTH OF BREATHING


    • THUS IT RESULTS INCREASED LEVELS OF CO2(45 MMHG) & RESULTANT HYPOXEMIA DUE TO HIGH LEVEL OF CO2
    DISPLACING ALVEOLAR O2
    SYMPTOMS
    BREATHLESSNESS & CHEST TIGHTNESS
    CAUSES: PARALYSIS OF RESP MUSCLES, OBSTRUCTIVE SLEEPING APPNEA, OBESITY DRUGS
    HYPERVENTILATION
    • INCREASE IN THE AMOUNT OF AIR ENTERING ALVEOLI RESULTING REDUCED LEVEL OF CO2 IN THE
    BLOOD(HYPOCAPNIA)

    • WHEN PERIPHERAL CHEMORECEPTORS ARE ACTIVATED BY HYPOXIA WE HAVE HYPER VENTILATION


    SYMPTOMS
    SHORTNESS OF BREATHE(25-40),LIGHTHEADED, RAPID HEART RATE
    COUSE :PAIN, FEVER, ANXIETY, OBSTRUCTIVE& RESISTIVE LUNG DISEASES,SEPSIS,
    TREATMENT OF HYPOXIA

    • 100% OXYGEN
    PREVENTION OF OXYGEN
    • INCREASING CONCENTRATION/PRESSURE OF OXYGEN

    • PRICE CHECK PRESSURE

    • REGULATOR
    INDICATOR
    CONNECTION
    EMERGENCY O2 SYSTEM

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