Oxygen Course

Nigel Singleton

Aim’s of Course To give a greater understanding about oxygen therapy Understand the Oxygen kit Understand when oxygen is contraindicated Understand COPD Explain the different illnesses and diseases that could require oxygen therapy

Health & Safety Smoking Use of AED Grease (Vaseline) Explosive atmospheres Paraquat poisoning Compressed gas cylinder

Different Cylinder types Pin index cylinder CD cylinder

Oxygen saturation

Oxygen saturation >94% Normal 86% - 93% Not well <85% Critically ill

Patient groups requiring oxygen Critically ill – 100% Seriously ill – Variable rate to maintain Sats above 94% COPD All others

Critically ill Cardiac arrest Shock Major trauma Near drowning Carbon Monoxide poisoning Major head injury Anaphylaxis Active convulsion

Critically ill 15l/min Reservoir mask Fill reservoir first

Critically ill – 100%

Seriously ill Hypoxic Acute Asthma Acute heart failure Pneumonia Pneumothorax Severe anaemia Sickle cell Lung cancer

Seriously ill SpO2 less than 85% - 15l/min reservoir mask SpO2 86%-93% - 5l/min -10l/min simple mask

Seriously ill

COPD Emphysema Bronchitis Severe Asthma

What is COPD A lung condition The lungs have become permanently altered The airways in the lungs are constantly narrowed Chronic inflammation causes difficulty in breathing

The Lungs

COPD causes Smoking 2nd hand smoking Air pollution Occupational irritants

COPD symptoms Cough with or without mucus Fatigue Frequent respiratory infections Shortness of breath Wheezing (both in and out)

Medical treatments Inhalers (Bronchodilators) Anti-inflammatory medications Oxygen therapy Antibiotics (for bacterial infections)

Complications Worldwide, COPD ranked as the sixth leading cause of death Worsens with continued smoking Can cause arrhythmias Can cause pneumonia Can cause osteoporosis

Natural history of COPD Oxygen levels CO2 levels Lung function Mild Moderate Severe Time (years)

COPD

Why do we use Venturi In a healthy person the driving trigger for breathing is increasing Carbon dioxide levels in the blood

Why do we use Venturi In a COPD person, the driving trigger for breathing is decreasing Oxygen levels

Why do we use Venturi If we continue aggressive Oxygen therapy beyond the Oxygen alert card guidelines the patient may stop breathing

Oxygen alert card

Oxygen therapy Ask for Oxygen alert card If no advice card normal is 88%-92% If Sats are below alert card guidelines 4l/min through venturi mask Re-check Sats regularly Stop Oxygen therapy once Sats are within range on alert card

Oxygen therapy If Sats are significantly below Oxygen alert card Treat casualty as critically ill and hypoxic Give 15l/min through non re-breather mask Re-check Sats and stop Oxygen therapy when Sats are within guidelines

All other MI (Myocardial Infarction) Stroke Breathing difficulty Hyperventilation Post convulsion Diabetic emergency Heat exhaustion

All other If SpO2 is less than 94% Give Oxygen until SpO2 raises above 94% Rate is dependant on condition and SpO2 reading If SpO2 is less than 85% treat as critically ill patient

Children All children requiring Oxygen should be on 15l/min with non re-breather

General rule Treat the casualty not the text book The lower the SpO2 the more Oxygen the patient requires

Cylinder life - CD 15l/min – 30 mins 12l/min – 40 mins