1. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley CHAPTER Oxygen Therapy 9

2. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 1.Define the following terms: a.blow-by method b.humidifier c.hydrostatic test d.liter flow e.nasal cannula f.nonrebreather mask g.O ring Objectives (continued)

3. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 1.Define the following terms: h.oxygen concentration i.oxygen supply tubing j.pin index system k.pressure gauge l.pressure regulator m.reservoir bag n.supplemental oxygen Objectives (continued)

4. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 2.Explain the benefits of supplemental oxygen. 3.Explain the indications of supplemental oxygen. 4.Explain the potential hazards of working with high-pressure cylinders. 5.Explain the safe practices when working with high-pressure cylinders. 6.Differentiate between the common sizes of oxygen cylinders used in EMS. Objectives (continued)

5. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 7.Describe the purpose and functions of an oxygen regulator. 8.Explain the indications for the use of a nasal cannula. 9.Explain the indications for the use of a nonrebreather mask. 10.Demonstrate the proper use of a nonrebreather mask. 11.Demonstrate the proper use of a nasal cannula. Objectives (continued)

6. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 12.Demonstrate the ability to add supplemental oxygen to a pocket mask and/or bag-mask device. 13.Demonstrate the proper technique for attaching a regulator to a cylinder. 14.Demonstrate the ability to identify and troubleshoot a leaky oxygen cylinder/regulator. 15.Recognize the value that supplemental oxygen might offer for most ill and injured patients. Objectives

7. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Topics Importance of Oxygen Hazards of Oxygen Oxygen Therapy Equipment Administering Oxygen

8. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley IMPORTANCE OF OXYGEN

9. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Importance of Oxygen Oxygen is a drug. The air we breathe contains 21 percent oxygen(O 2 ). Supplemental oxygen is 100 percent O 2. Oxygen concentration: amount of oxygen being delivered to patient.

10. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Importance of Oxygen Patient may need oxygen for: – Respiratory or cardiac compromise – Cardiac arrest – Shock – Major blood loss – Injury to lungs or chest – Airway obstruction – Stroke

11. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Importance of Oxygen Common Indicators – Abnormal signs and symptoms – Significant mechanism of injury – Increased level of distress

12. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It What physiological needs are met by adequate breathing? What are some causes of inadequate breathing? What are the signs of inadequate breathing?

13. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley HAZARDS OF OXYGEN

14. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Hazards of Oxygen Oxygen tank has approximately 2,000 pounds per square inch (psi) of pressure (full tank). If tank is punctured or valve breaks off, supply tank and valve can become deadly projectiles.

15. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Hazards of Oxygen Oxygen itself is nonflammable, but it greatly increases (supports) rate and intensity of combustion. Oxygen and oil do not mix, causes an explosion.

16. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It Do not underestimate the dangers of oxygen! What safety precautions should the EMR take when working with oxygen cylinders? Which placards are used by the U.S. Dept. of Transportation for pressurized oxygen?

17. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley OXYGEN THERAPY EQUIPMENT

18. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen-delivery System: – Oxygen source – Regulator – Delivery device Oxygen Cylinders – Aluminum cylinders filled with pressurized oxygen. – Are green or have a green band (continued)

19. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley An oxygen-delivery system.

20. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen Cylinders – Various sizes, identified by letters.  D cylinder (425 liters oxygen)  Jumbo D cylinder (640 liters oxygen)  E cylinder (680 liters oxygen) (continued)

21. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Various-size portable oxygen cylinders.

22. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen Cylinders – Pressure gauge determines pressure remaining in tank. – Never allow to go completely empty. – Never allow pressure in oxygen cylinder to fall below 200 psi.

23. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen System Safety – Never allow smoking. – Never use around open flames or sparks. – Never use grease or oil. – Never put tape on cylinder. (continued)

24. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen System Safety – Never store near high heat or in a closed vehicle parked in the sun. – Keep portable cylinders lying flat. – Use pressure gauges and regulators. – Ensure O ring is in good condition. (continued)

25. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen System Safety – Valves/connections hand-tight only. – Open and close all valves slowly. – Store in cool, ventilated room. – Have hydrostatically tested.

26. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen Regulators – Pressure in full oxygen cylinder: 2,000 psi. – Regulators have three functions:  Reduce tank pressure  Display tank pressure (pressure gauge)  Control delivery of oxygen (flow meter) (continued)

27. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Pressure regulators, one on and one off the tank.

28. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen Regulators – Connecting the Regulator – Pin index system: safety system used to ensure proper regulator is used for specific gas.  Largest pin is oxygen port.  O ring ensures airtight seal between regulator and tank valve. (continued)

29. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley The PIN safety system.

30. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen Regulators – Humidifiers- moistens the air  Unbreakable container of sterile water.  Oxygen becomes more comfortable for patient to breathe.  Many EMS systems no longer use humidifiers due to infection risk.

31. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen-Delivery Devices – Nasal cannula Used to deliver low concentrations of supplemental oxygen to breathing patient. – Delivers 25-45% O 2 at 2-6 LPM – Non-rebreather mask.  Used to deliver high concentrations of supplemental oxygen.  Delivers 90-100% O 2 at 12- 15 LPM. (continued)

32. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen-Delivery Devices

33. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Example of a nasal cannula.

34. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley A nasal cannula properly placed on the face of the patient.

35. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen-Delivery Devices – Non-rebreather mask  Face mask, one-way valve, reservoir bag. – Inflate bag before placing on patient's face. – Always ensure adequate oxygen flow (12– 15 lpm). (continued)

36. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Example of a nonrebreather mask.

37. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley A nonrebreather properly placed on the face of a patient.

38. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen-Delivery Devices – Venturi mask  Adjustable “jets” that allow user to more accurately determine specific oxygen concentration. (continued)

39. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Oxygen Therapy Equipment Oxygen-Delivery Devices – Blow-by Delivery  Used for patient who will not tolerate traditional mask or cannula placed on face.  Especially good for small children.

40. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It What is the length of time an oxygen cylinder can be used? How often should the oxygen regulator be checked for adequate pressure?

41. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley ADMINISTERING OXYGEN

42. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Administering Oxygen Step-by-step process of preparing oxygen-delivery system and administering oxygen. Three devices: – Pocket mask with oxygen inlet – Bag-valve mask device – Demand-valve device

43. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Remove the plastic wrapper or cap protecting the cylinder outlet.

44. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Keep the plastic washer that is used in some setups.

45. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley “Crack” the main valve for one second.

46. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Place cylinder valve gasket on regulator oxygen port.

47. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Tighten T-screw hand-tight. Do not over-tighten because this can crush or crack the O-ring, thus causing a leak.

48. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Attach tubing and delivery device.

49. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Explain the need for oxygen therapy.

50. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Open the main valve.

51. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Attach the delivery device and adjust flow meter.

52. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Be sure to fill the reservoir bag prior to placing it on the patient by turning on the flow and placing your finger over the valve in the mask.

53. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Position the oxygen-delivery device on the patient.

54. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Secure the cylinder during transfer.

55. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Administering Oxygen Pocket Mask with Oxygen Inlet – Delivers higher concentrations of oxygen than pocket mask alone (16% O2). Bag-valve Mask Device – Capable of accepting supplemental oxygen. – Works best when used by two rescuers.

56. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley One mask without and one with an oxygen inlet.

57. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Rescuer delivering her own breath through the mask's chimney plus oxygen through the inlet. (Photo courtesy of Laerdal Medical Corporation)

58. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Bag-mask device connected to an oxygen supply. (Photo courtesy of Laerdal Medical Corporation)

59. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Administering Oxygen Demand-Valve Device – Delivers oxygen through regulator that can deliver 100 percent oxygen “on demand” when patient inhales. – Monitor patient carefully when providing assisted ventilations. – Use only on adults, never on children – Delivers 40 LPM

60. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Demand-Valve Device

61. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Administering Oxygen Patients with Tracheostomy 8-10 Lpm

62. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Administering Oxygen General Guidelines for Oxygen Therapy – Explain you would like to provide oxygen; it will help the patient feel better. – Show device; explain how it works; and how it will fit on face. – Gently place device on face and confirm patient is comfortable; adjust as necessary. (continued)

63. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley General Guidelines for Oxygen Therapy Patients who may benefit from supplemental O2 include Apnea (not breathing) Heart Failure Shock

64. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Administering Oxygen General Guidelines for Oxygen Therapy – Remind patient to breathe as normally as possible. – If patient is anxious and reluctant to accept device, provide extra reassurance. – Monitor patient closely.

65. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Think About It What are the advantages and disadvantages of each type of oxygen delivery device? Why is it important, if at all possible, to explain to a patient what you are doing during oxygen administration? When is it appropriate NOT to administer oxygen?

66. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley SUMMARY

67. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Summary Most ill or injured patients will benefit from supplemental oxygen. Oxygen is stored and transported in portable containers called cylinders. Important to keep high-pressured cylinders lying flat on ground to minimize damage.

68. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Summary Cylinders should be stored in cool environment and away from sources of flame or heat. Commonly used cylinders in EMS are the D, Jumbo D, and E cylinders. Pressure regulator used to reduce pressure of oxygen coming out of cylinder.

69. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Summary Two devices used to provide supplemental oxygen: – Nasal cannula can deliver oxygen concentrations up to 44 percent. – Nonrebreather mask capable of delivering oxygen concentrations up to approximately 90 percent.

70. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Summary Amount of supplemental oxygen provided to patient determined by: – Mechanism of injury – Signs and symptoms – Level of distress

71. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Summary When a patient is not breathing adequately, provide positive pressure ventilations. Can be performed by using: – Pocket mask. – Bag-mask. – Demand-valve device.

72. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley REVIEW QUESTIONS

73. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 1.What are the benefits of supplemental oxygen? 2.What are the potential hazards of working with high-pressure cylinders? 3.When working with high-pressure cylinders, what safe practices should you employ? 4.What size oxygen cylinder is commonly carried in an O 2 bag by EMS? Review Questions (continued)

74. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley 5.What is the purpose and function of an oxygen regulator? 6.What are the indications for the use of the following: a.Nasal cannula? b.Nonrebreather? c.Pocket mask? d.Bag-mask? Review Questions

75. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Emergency Care, Twelfth Edition Daniel J. Limmer O’Keefe Grant Murray Bergeron Dickinson Emergency Medical Responder: First on Scene, Ninth Edition Le Baudour Bergeron Wesley Please visit www.bradybooks.com and follow the Resource Central links to access content for this text. www.bradybooks.com