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Critical Care Pro: Advanced ICU Techniques & Procedures
About Lesson

Introduction

Oxygen therapy is the administration of oxygen at concentrations greater than ambient air with the intent of treating or preventing the symptoms and manifestations of hypoxia. This lesson will cover various oxygen delivery systems, their principles, and clinical applications.

Step 1: Understanding Hypoxia

Hypoxia is a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. Before administering oxygen, it’s crucial to understand the underlying cause of hypoxia.

  • Types of Hypoxia: Hypoxic, anemic, circulatory, and histotoxic.
  • Assessment: Pulse oximetry, arterial blood gas (ABG) analysis.
  • Clinical signs: Cyanosis, tachypnea, tachycardia, altered mental status.

Step 2: Low-Flow Oxygen Delivery Systems

Low-flow systems deliver oxygen that is diluted with room air. The patient’s breathing pattern influences the FiO2 (fraction of inspired oxygen).

Nasal Cannula

Description: Delivers oxygen through two prongs inserted into the nostrils.
Flow Rate: 1-6 liters per minute (LPM).
FiO2: Approximately 24-44%.
Clinical Use: For patients requiring low to moderate oxygen concentrations, stable patients.

Simple Face Mask

Description: Covers the patient’s nose and mouth.
Flow Rate: 5-10 LPM.
FiO2: Approximately 35-60%.
Clinical Use: For patients requiring moderate oxygen concentrations.

Reservoir Masks (Partial Rebreather & Non-Rebreather)

Description: Includes a reservoir bag for higher oxygen concentrations.
Partial Rebreather Flow Rate: 6-10 LPM, FiO2: 40-70%.
Non-Rebreather Flow Rate: 10-15 LPM, FiO2: 60-90%.
Clinical Use: For patients requiring high oxygen concentrations, acute respiratory distress.

Step 3: High-Flow Oxygen Delivery Systems

High-flow systems deliver a precise FiO2, meeting the patient’s inspiratory demand.

Venturi Mask

Description: Delivers a precise FiO2 through color-coded adapters.
Flow Rate: Varies depending on the adapter.
FiO2: 24-60% (precise).
Clinical Use: For patients requiring precise FiO2, COPD patients.

High-Flow Nasal Cannula (HFNC)

Description: Heated and humidified oxygen at high flow rates.
Flow Rate: Up to 60 LPM.
FiO2: 21-100%.
Clinical Use: Respiratory failure, acute hypoxemia, pre-intubation.

Step 4: Monitoring and Documentation

Regular monitoring and accurate documentation are essential for effective oxygen therapy.

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