Exploring different ways to deliver oxygen

Mariya Menaka

Staff Nurse, Maa Kauvery, Trichy, Tamil Nadu

Introduction

Oxygen was discovered by Sir Joseph Priestly in 1774. It is in a therapeutic usage since 1907. The first oxygen delivery device used was a funnel. Oxygen administration increased the survival of many critically ill infants and children.

Low flow Nasal Cannula

  • Light weight soft prongs fits into nostrils
  • FiO2 22–40%
  • Flow 0.5–4lit/ min.

Face mask

  • Low flow, covers nose and mouth.
  • Flow rate 6–10lit/min.
  • FiO2 between 35–40℅.

Non rebreathing mask

  • Reservoir bag has 2 valves, 1 or 2 valves in exhalation port to prevent room air from entering, and mixing with air in reservoir.
  • Can deliver flow rate 10 – 25lit /min, fio2 – 95%.

Venturi mask

  • Fixed performance mask, has air entrainment port of different sizes at base to adjust to deliver a precise FiO2 24–60%.

Oxygen hood

  • Clean plastic box that covers infant head.
  • Flow rate 10lit/ min
  • Fi O2 100%
  • Nebulisation can be done.

HFNC (High Flow Nasal Cannula)

  • Humidifier and air blender are required to blend air and oxygen and create a high flow velocity.
  • Flow rate 4lit-40lit/min
  • FiO2 100%

Formula for flow rate:

  • 2lit /kg for first 10 kg of weight, balance 0. 5lit/kg shall be added
  • Choose an appropriate size & colour code for nasal cannula.

CPAP

Continuous Positive Airway Pressure is a form of positive airway pressure ventilation in which a constant level of pressure greater then atmospheric pressure is continuously applied to the respiratory tract.

BIPAP

  • Non invasive machine, it is to help to respiratory problems like chronic lung disease, COPD, heart failure, ARDS
  • In muscle weakness like GBS.
  • For Sleep apnoea.

NIV

  • Reduction in respiratory rate with improved in oxygen saturation.
  • Absence of retractions.
  • Absence of paradoxical breathing
  • Improvement in gas exchange.
  • Improved pH level
  • Reduction in paco2.

Mechanical ventilation

  • In the event of NIV support failure, connect the patient immediately in mechanical ventilation support.
  • It’s is life saving.
  • According to patient’s lung conditions set a mode of ventilation support as per doctors’ advice

Hyperbaric Oxygen Therapy

Involves breathing 100% oxygen in a pressurized chamber to increase oxygen levels in the blood and tissues, aiding in healing and treating various conditions like decompression sickness, carbon monoxide poisoning, and certain wounds like Radiation injury and Burns.

Nightingale Journals

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