1. SLSA Advanced Resuscitation
PUAEME003B Administer Oxygen In An Emergency Situation
Chapter 23 – Advanced Resuscitation and Oxygen Administration

2. UNIT 23 – ADVANCED RESUSCITATION AND OXYGEN ADMINISTRATION

3. Advanced Resuscitation
Why Use Oxygen? (pg162)
The Components Of Oxygen Resuscitation Equipment (pg162)
Administering Oxygen Therapy (pg164)
Setting Up Oxygen Resuscitation Equipment (pg165)
Equipment Maintenance (pg166)
Administering Suction* (pg167)
Automatic Oxygen-Powered Resuscitator* (pg167)
Oropharyngeal Airways (pg168)
*These 2 sections are NOT part of the SLSA Advanced Resuscitation
Certificate. They can be trained and utilised by qualified personnel ONLY
Page numbers refer to the SLSA First Aid & Emergency Care Manual

4. Prerequisites
A candidate must be a minimum age of 15 years old on the date of final assessment, AND
Hold the PUAEME001A ‘Provide Emergency Care’ Competency, found in the SLSA 32nd Edition Training Manual:
Unit 3 – Anatomy and Physiology
Unit 4 – Basic First Aid
Unit 5 – First Aid
Unit 6 –Resuscitation
Unit 7 – Basic Oxygen
Also from SLSA FAEC Manual
Chapter 8 – Respiratory Emergencies

5. Why use Oxygen?
Patients likely to benefit from oxygen include those with the following conditions:
Unconsciousness
Shock
Blood loss
Chest pain
Shortness of breath, including asthma
Circulatory distress
Severe pain
Injuries
After resuscitation
Absent breathing

6. Oxygen Safety Safety precautions when using oxygen:
Never use oxygen near an open flame
Never use oxygen near cigarettes
Never use grease or oil with oxygen equipment
Oxygen promotes combustion
Do not tamper with oxygen equipment
Store in a cool place
Store oxygen bottles lying flat, or securely fastened if upright
Use only medical oxygen
Do not use when delivering a shock via a defibrillator

7. Components of Oxygen Resuscitation Equipment
Protective case
Medical oxygen cylinder
Cylinder cradle
Cylinder yoke
Sealing washer
Locating pins
Thumb screw
Cylinder key wheel
External cylinder connection
Contents gauge

8. Components of Oxygen Resuscitation Equipment
Regulator
OP airways
Airbag
Oxygen reservoir bag
Tubing
Control valves
Anaesthetic masks
Therapy masks
Chalk
Gloves
Pens, pencils & paper
Other equipment (optional):
Automatic oxygen-powered resuscitator
Suction

9. Components of Oxygen Resuscitation Equipment
Routine check of equipment:
‘Crack’ cylinder to clean (if not attached)
Check sealing washer
Insert cylinder and locate
Ensure thumb screw is firmly done up
Check contents of cylinder
Check tubing
Check therapy and anaesthetic masks
Check oropharyngeal airways
Check for chalk, pens/pencils and paper, gloves, spare sealing washer

10. Components of Oxygen Resuscitation Equipment
Routine check of equipment (cont’d):
Check flow of oxygen
Check there is no odour from oxygen
Check operation of oxygen nipples
Check airbag (5 checks)
Close cylinder valve and drain oxygen from system
Check additional equipment (eg Suction, etc)
The SLSA Oxygen Equipment Policy is located on SLSA website at

11. Components of Oxygen Resuscitation Equipment
Checking Suction (optional):
Remove large suction tubing and hold near open end
Turn suction lever fully on
Test for suction
Turn lever off
Remove catheter and fit to large tubing
Test for suction again
Return to case in original position

12. Components of Oxygen Resuscitation Equipment
Automatic oxygen-powered resuscitator (optional):
As per oxygen equipment plus:
Block off powerhead/ demand valve outlet with 1 hand and trigger the device
Check for valve release
Check for blockages

13. Administering Oxygen Therapy
Check oxygen before each use
Place unit in appropriate position to operate
Connect therapy mask to tubing and turn on oxygen
Place mask on patient’s face
Adjust accordingly
Reassure the patient
If a conscious patient does not want to use the mask, they can hold the mask in front of their face, or remove the tubing from it and direct the oxygen flow around the mouth and nose

14. Administering Oxygen Therapy
Mouth-to-mask resuscitation with oxygen:
Increases oxygen received by patient from 16%-50%
Therapy setting (8L per minute)
Oxygen in patient’s lungs almost 45%
Resuscitation setting (14-15L per minute)
Oxygen in patient’s lungs slightly greater (i.e. >50%)
Can be one-operator operation, preferred that two operators are used

15. Administering Oxygen Therapy
Airbag checks:
Check airbags by blocking patient valve
Check function of disc membrane on patient valve
Check overflow of membrane of reservoir valve
(Laerdal bag only)
Check air-intake membrane (rear valve of airbag)

16. Administering Oxygen Therapy
Airbag oxygen resuscitator:
Will supply the patient with up to 95% oxygen with flow rate of 14-15L per minute
Possible for mouth-to-mask resuscitation with oxygen using therapy tubing whilst oxygen unit is being set up

17. Setting Up Oxygen Resuscitation Equipment
Inform others of who you are and your qualifications
Set up and place unit in appropriate position to operate
Anaesthetic mask to Airway operator
If not already being used
Quickly check:
Operation of patient valve
Valve to oxygen reservoir bag
Connection to oxygen supply
Turn on oxygen to 14-15L per minute to allow inflation of airbag reservoir

18. Setting Up Oxygen Resuscitation Equipment
Procedure:
Inform other operators airbag is ready
Attach patient valve with no change to Rescue Breathing rate
Airbag oxygen resuscitator compressed with 2 hands (for adult) using gentle squeezing motion
Squeeze airbag until chest rises
Bag released and allowed to refill
The rise and fall of the patient’s chest
should be watched at all times during this procedure by both Airway and
oxygen airbag operators

19. Setting Up Oxygen Resuscitation Equipment
Procedure (cont’d):
Remove oxygen equipment if not operating properly and continue with Rescue Breathing
Recommended that 3 operators be present for operation during CPR
Paediatric airbag (if available) should be used for children
Compressed with 1 hand
Airbag resuscitators are not designed for infants, and therefore should NOT be used on infants
Can use airbag without oxygen bottle
Remove reservoir bag

20. Setting Up Oxygen Resuscitation Equipment
Operational time:
Full ‘C’ cylinder ( L)
50 minutes on Oxygen Therapy setting (8L per minute)
30 minutes on Resuscitation setting (14-15L per minute)

21. Equipment Maintenance
General care:
Machine kept clean and free of sand/foreign materials
Checked:
After every teaching session
Before use each day
Removed from service immediately if default found
Serviced at least every 12 months

22. Equipment Maintenance
Care after use:
Used oxygen therapy masks sent to hospital or disposed of
Tube
Anaesthetic masks
Patient valve
Rear valve
Airbag
Reservoir valve
Oxygen reservoir
Washed in warm soapy water for 2 minutes, then rinsed in fresh running water

23. Equipment Maintenance
Care after use (cont’d):
Contaminated parts:
Soaked in 70% alcoholic chlorhexidine or hypochlorite solution
For at least 2 minutes
Rinsed and dried
Operate all parts before storage to ensure they are operational
After every use, the resuscitator should be
disassembled, cleaned, disinfected, reassembled and tested in an orderly sequence

24. Equipment Maintenance
Storage:
In a cool place
Spare oxygen bottles kept near equipment
Away from busy areas, sand, dust
Away from oil and grease
DO NOT:
Store in enclosed space
Allow smoking or near naked flame
Leave pressure in system
Empty cylinders should be filled without delay:
Half-full or less can be used for training

25. Administering Suction (Optional)
Types of devices:
Electric
Foot pump
Vacuum bottle
Hand pump
Oxygen-driven suction consumes considerable oxygen (20-40L/min) It is essential that you close the
valve immediately after use

26. Administering Suction (Optional)
Procedures:
Suction ONLY used in:
unconscious patient, or
Semiconscious patient
Wearing gloves:
Attach suction catheter to suction tubing
Measure appropriate distance
Lubricate the catheter
Can repeat several times but no longer than 15 seconds
Prevents hypoxia developing
Check area between teeth and cheek, and under tongue
Where they can’t cough or swallow

27. Automatic Oxygen-Powered Resuscitator (Optional)
Can ventilate a non-breathing patient with 100% oxygen
Warning
Increased risk of distension
Increased risk of over-inflation of lungs
Increased risk of damage to middle ear
Equipment only used by competent regular users

28. Automatic Oxygen-Powered Resuscitator (Optional)
Procedure:
Oxygen supply ON
Control lever ON (if necessary)
Adjust tidal flow and/or frequency (if necessary)
Clear airway
Open airway using head tilt/jaw support
Insert oropharyngeal airway (if qualified)

29. Automatic Oxygen-Powered Resuscitator (Optional)
Procedure (cont’d):
Place mask on face and hold in position
Ensure adequate tidal volume delivered
For breathing patient
Adjust control lever (equivalent)

30. Oropharyngeal Airways
Help keep airway clear in unconscious patient
Does not replace correct airway management practices
Inserted using ‘rotation’ method:
This method NOT recommended for infants, or children under 8 years old
Comes in various sizes
First Aiders must avoid direct contact with blood and other body substances
Strongly recommended to wear gloves and
use a resuscitation mask

31. Oropharyngeal Airways
Care of OP airways:
Stored in a sterile state
Easily accessible in:
First aid kit
Oxygen unit
First aid rooms
Should be checked for deformities
If used for training purposes:
Mark with ‘Training Use Only’
Washed after use in warm soapy water for 2 minutes minimum
OP airway appropriately disposed of after use on patient

32. Oropharyngeal Airways
Choosing the appropriate-sized OP Airway
Sizing:
Flange just past centre of patient’s lips
Curve run along patient’s jaw
Correct size = reaches angle of patient’s jaw

33. Oropharyngeal Airways
When to insert an OP airway:
Use is optional
<15 seconds to size and insert
Inserted into:
Unconscious patient in lateral position after airway cleared, or
During Rescue Breathing/CPR while patient on their back after stopping Rescue Breathing/CPR briefly
The OP airway should NOT be inserted during delivery of chest compressions

34. Oropharyngeal Airways
Inserting of an OP airway into:
Unconscious breathing patient = lateral position
Non-breathing patient = lateral position or back
OP airways must be inserted ONLY into deeply
unconscious or non-breathing patients

35. Oropharyngeal Airways
Inserting an OP airway:
Open patient’s airway
Ensure clear airway
Choose appropriate sized airway
Lubricate airway
Insert OP airway using ‘rotation’ method
Should slip easily into place
Precautions when inserting an OP Airway
Ensure lower lip is not pinched
Ensure OP airway does not push tongue backwards and block airway
Ensure adequate head tilt before inserting OP airway
Don’t force the OP airway

36. Oropharyngeal Airways
Removing the OP airway:
Remove immediately if signs of rejection of OP airway
Remove by:
Sliding it out following its natural curve
Do not attempt to rotate airway on removal
IMPORTANT
OP airways should not be used:
If patient is conscious or semiconscious
If correct size airway is not available
If there is a large amount of vomit

37. Thank You