1. Oxygen Course

2. Nigel Singleton

3. 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

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

5. Different Cylinder types
Pin index cylinder
CD cylinder

6. Oxygen saturation

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

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

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

11. Critically ill
15l/min
Reservoir mask
Fill reservoir first

12. Critically ill – 100%

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

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

15. Seriously ill

16. COPD
Emphysema
Bronchitis
Severe Asthma

17. 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

18. The Lungs

22. COPD causes Smoking 2nd hand smoking Air pollution
Occupational irritants

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

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

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

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

27. COPD

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

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

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

31. Oxygen alert card

32. 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

33. 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

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

35. 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

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

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

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