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Oxygenation And Ventilation
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Oxygenation
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Oxygen Delivery Devices
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Nasal Cannula Gives oxygen supply 40 %when set at 6 L/min flow
Nasal Cannula Gives oxygen supply 40 %when set at 6 L/min flow . Indicated for low to moderate oxygen requirements and long term oxygen therapy .
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2 – Venturi Mask It is high flow face mask that uses a Venturi system to deliver relatively precise oxygen concentrations . Used for COPD who need control on inspired oxygen concentration .
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3 – Simple Face Mask Gives oxygen supply 40 % to 60 % when set at 6 L/min flow .
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4 – Partial Rebreather mask
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5 – Non – Rebreather Mask It has : one way side port + attached reservoir bag Provides the highest oxygen concentration (80 % to 95 % when set at 15 L/min flow ).
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6 – Small Volume Nebulizer Oxygen is the usual carrier but in COPD , air is preferred .
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7 - Oxygen Humidifier Used in croup , Epiglotittis , bronchiolitis .
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Ventilation
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Effective Artificial Ventilation need :
Patent airway . Effective seal between mask and patient‘s face . Enough force to overcome the elastic resistance of the lung and chest wall . Tidal volume at least 800 mL oxygen at rate 12 to 20 breaths / min . Allow patient to exhale between delivered breath. Tidal Volume : Average volume of gas inhaled or exhaled in one respiratory cycle .
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Characters of the ideal mask
Good fit . One way valve . Made of transparent material . Has oxygen insufflations port ( 15 to 22 mm ) . Available in all ages .
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Ventilation Methods
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1 – Mouth to mouth / Mouth to nose
Provide limited oxygen 17 % . It may transmit infection between the patient and rescuer . Take care not to hyper inflate the patient‘s lungs or to hyperventilate yourself .
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2 - Mouth to mask Do not use in awake patient .
It has one way valve to prevent you from patient expiration . Provide oxygen 17 % ( if no oxygen supply ) . Provide oxygen 50 % ( if oxygen supply is 10 L/min )
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3 – Bag Valve Devices Do not use in awake patient .
It has two one - way valves . Sizes : Neonatal – Child . Adult . It should be disposable ( Do not reuse them ) . Provide oxygen 21 %= room oxygen ( if no oxygen supply ) . Provide oxygen 60 % to 70 % ( if oxygen supply is 10 L/min ) . Provide oxygen 90 % to 95 % ( if oxygen reservoir is activated )
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Pediatric bag valve mask has Pop-Off Valve .
BVM ventilation can be done by : One Rescuers Two Rescuers Three Rescuers Complications of BVM ventilations are : Inadequate ventilations . Barotraumas Gastric distension .
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4 – Flow Restricted = Oxygen Powered Ventilation = Demand Valves
Provides 100 % oxygen at its highest flow rate 40 L/min . Not recommended in patients under 16 age . Use with caution with intubated patients or chest trauma patients .
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5 – Automatic Transport Ventilator
It has pop – Off valves . Provides 100 % oxygen . Not use in : Infant less than 5 years old . Patient with obstructed airway ( Because these devices have no alarm to warn possible tube displacement or barotraumas ) .
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Evaluation Pulse Oximetry Capnography
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Pulse Oximetry Used in measurement of arterial oxyhemoglobin saturation (SPo2) AND Pulse rate. Normal SPo2 = 93 % to 95 % When result below 90 % means Sever compromise of oxygen delivery to the tissues . Advantages : High reliability . Portable . Used in all ages and races .
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Capnography Can be named ( End Tidal carbon Dioxide monitoring ) .
Measures the partial pressure of carbon Dioxide in a sample of gas . A normal reading in a trauma patient is between 30 to 40 mmHg . Used as a tool to monitor endotracheal tube placement .
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