OXYGENATION AND

VENTILATION

Oxygenation

Oxygen Delivery Devices

1. 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 .

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.

3 – Simple Face Mask

Gives oxygen supply 40 % to 60 % when set at 6 L/min flow.

4 – Partial Rebreather mask

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 ) .

6 – Small Volume Nebulizer

Oxygen is the usual carrier but in COPD , air is preferred.

7 - Oxygen Humidifier

Used in croup , Epiglotittis , bronchiolitis .

Ventilation

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 .

Characters of the ideal mask

I. Good fit .II. One way valve .III. Made of transparent material .IV. Has oxygen insufflations port ( 15 to

22 mm ) .V. Available in all ages .

Ventilation Methods

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 .

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 )

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 )

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 :

1. Inadequate ventilations .2. Barotraumas 3. Gastric distension .

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 .

5 – Automatic Transport Ventilator

It has pop – Off valves . Provides 100 % oxygen . Not use in :1. Infant less than 5 years old .2. Patient with obstructed airway ( Because

these devices have no alarm to warn possible tube displacement or barotraumas ) .

Evaluation

Pulse Oximetry

Capnography

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 :1. High reliability . 2. Portable .3. Used in all ages and races .

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 .