Know your Os? How much Oxygen is the patient on? How much does the patient need? How’s this mask work? Is this thing hooked up right?

Know your Os! Use this quick review to answer common oxygen delivery questions. Please contact a Respiratory Therapist with questions. Working together we can make sure that every patient receives the right amount of oxygen for the right length of time.

Low-flow oxygen delivery devices –Nasal Cannula – Simple oxygen mask – Partial rebreathing oxygen mask – Nonrebreathing oxygen mask

High-flow oxygen delivery devices –Venturi Mask (Air Entrainment Mask) – Aerosol Mask – trach collar – face tent – Briggs Adapter (T-piece)

Nasal Cannula 2-6 lpm Oxygen flow delivers: –1lpm = 24% –2 lpm = 28% –3 lpm = 31% –4 lpm = 34% –5 lpm = 37% –6 lpm = 40% Use humidity for > 3lpm –and for all pediatric patients.

Nasal Cannula Oxygen percentage delivered varies with patient’s breathing pattern. Do not use greater than 2 lpm for infants.

Simple Mask 6-10 lpm Oxygen flow delivers 35-55% Flow must be >5 lpm to avoid rebreathing of exhaled CO 2 that can be retained in the mask. Attach O 2 tubing directly to O 2 flowmeter. Do not attach to bottle humidifier

Venturi Mask (Air entrainment mask) 3-15 lpm Oxygen flow delivers 24-50% Do not attach to humidifier bottle. Must set O 2 flow and air entrainment port (Oxygen diluter) correctly to achieve desire F I O 2

Air entrainment port (Oxygen diluter) Match arrow on port to desired F I O 2 printed on multi-vent barrel Green diluter –3 lpm used to achieve both 24 and 26% –6 lpm used to achieve both 28 and 30% White diluter –9 lpm used to achieve 35% –12 lpm used to achieve 40% –15 lpm used to achieve 50%

Nonrebreather mask >10 lpm Oxygen flow delivers % Must have sufficient flow to maintain distended reservoir Do not wean flow Less flow will allow CO 2 rebreathing.

Nonrebreather mask If patient no longer requires NRB, change to a different O 2 delivery device Notify the patients Respiratory Therapist when NRB is required to maintain oxygenation.

Bubble Humidifier For use with nasal cannula only. When utilized with other devices back pressure can be created which may result in loss of needed flow and decreased oxygen delivery.

High humidity Must set air entrainment dial and oxygen liter flow correctly to achieve desire F I O lpm of oxygen delivers 28% to 98% with humidity. Must be used with corrugated tubing connected to patient mask Not effective as a room humidifier

High humidity devices Used to deliver high humidity oxygen or air to patient. To be used with high humidity Corrugated tubing Aerosol Mask

High humidity devices Used to deliver high humidity oxygen or air to patients who may not tolerate aerosol mask Trach collar Face bucket

Connect the oxygen mask to a GREEN oxygen flowmeter Yellow Air flow meter

Bag valve mask This is the only device capable of adequately oxygenating and ventilating an apenic patient. Absolute PaO2 60 mm Hg or SaO2 >90% Appropriately adjusted oxygen dose during sleep and exercise In patients with cor pulmonale PaO2 55 to 59 mm Hg or SaO2 >89% Same as above Electrocardiographic evidence of P pulmonale, hematocrit >55%, and congestive heart failure Specific indications Nocturnal hypoxemia Appropriately adjusted oxygen dose during sleep Sleep apnea with nocturnal desaturation not corrected By constant positive bairway pressure or bilevel positive airway pressure Same as above No hypoxemia at rest, but desaturation during exercise or sleep (PaO2 <55 mm Hg) Appropriately adjusted oxygen dose during exercise

Guidelines for Long Term Oxygen In Patients With COPD Absolute PaO2 60 mm Hg or SaO2 >90% Goal-Appropriately adjusted oxygen dose during sleep and exercise In patients with cor pulmonale PaO2 55 to 59 mm Hg or SaO2 >89% Goal-Same as above Electrocardiographic evidence of P pulmonale, hematocrit >55%, and congestive heart failure Goal-Same as above Specific indications Nocturnal hypoxemia oxygen dose during sleep, Goal- Appropriately adjusted Sleep apnea with nocturnal desaturation not corrected, by constant positive airway pressure or bilevel positive airway pressure, Goal- Same as above No hypoxemia at rest, but desaturation during exercise or sleep (PaO2 <55 mm Hg), Goal-Appropriately adjusted oxygen dose during exercise

Final thoughts Please notify your Respiratory therapist when oxygen is set up or changed. Please call Respiratory with any questions or concerns. Thank You!