Low‐flow oxygen delivery systems deliver oxygen at flow rates below the patient's inspiratory flow rate, entrain room air and provide a variable FiO2. 4 503 – 504, Clinical Practice Guidelines: The Diagnosis, Management & Prevention of Bronchiolitis. Long-term oxygen is often useful in people with chronically low oxygen such as from severe COPD or cystic fibrosis. So, when we talk about low-flow systems, we talk about systems that deliver oxygen at a rate LESS than 6 … 2020;50(1): 34-42. This article presents an overview of oxygen devices (oxygen concentrators, compressed gas cylinders and liquid oxygen) and delivery systems (high- and low-flow). Oh's Intensive care manual. Oxygen therapy: professional compliance with national guidelines. Like the simple mask, the nonrebreather mask fits snugly over the patient’s mouth and nose. c. Connect oxygen tubing to oxygen source. This system is useful in accurately delivering concentrations of oxygen (21 – 95%). Copyright 2013-2019 Oxford Medical Education Ltd. Myasthenia Gravis (MG) – Neurological Examination, Questions about DVT (Deep Vein Thrombosis), Endotracheal tube (ETT) insertion (intubation), Supraglottic airway (e.g. The equipment a victim breathes through is an oxygen delivery device. The percentage of oxygen you are receiving from a given flow rate is not a precise science, but there are some guidelines you can rely on for a relatively accurate estimate. Nasal Cannula. Where oxygen weaning is successful, continuous pulse oximetry monitoring may be discontinued. • HFNC can generate FiO2 100% and PEEP of up to 7.4 cmH20 at 60 L/min. kata_dungan. Nasal Cannula. 2. Note: Some flow meters may deliver greater than the maximum flow indicated on the flow meter if the ball is set above the highest amount. High-flow devices include aerosol masks and T-pieces that are powered by air-entrainment nebulizers or air-O 2 blenders and Venturi masks (see “ Oxygen Delivery Devices”). (2012) Current Therapies for Bronchiolitis. Documented hypoxemia In adults, children, and infants older than 28 days, arterial oxygen tension (PaO2) of < 60 mmHg or arterial oxygen saturation (SaO2) of < 90% in subjects breathing room air or with PaO2 and/or SaO2 below desirable range for specific … inspiration and expiration). ( RT203 Circuit and O2 stem - click here for instructions for use), Low Flow - Suitable for patients using the Optiflow Junior Nasal Prongs. Low-flow systems (like the trusty nasal cannula) deliver oxygen at a rate that is less than the amount of air that the patient can inhale or exhale in one minute (called “minute ventilation.”) For reference, the minute ventilation of a healthy adult male at rest is about 6 L/minute. Mosby's Skills. The Oxygen delivery devices and flow rates should be adjusted to keep the oxygen saturation in the target range. Trach-Vent's are changed daily or as required if contaminated or blocked by secretions. If oxygen wean successful perform vital sign observation, intermittent SpO2 monitoring 30 minutes later, then hourly for 2 hours. The main safety feature of the RT330 Oxygen Therapy System is the pressure relief valve. The flow rate and approximate for different FiO 2 oxygen delivery devices: Nasal cannulas are most commonly used in our day to day practice. As with the other delivery systems the inspired FiO2 depends on the flow rate of oxygen and varies according to the patient's minute ventilation. Low flow (variable performance) delivery systems. Oxygen delivery devices and flow rates should be adjusted to keep the oxygen saturation in the target range. The stand… 2 RCH Equipment Cleaning Table, Prepared by Infection Prevention and Control Team, Click to view the delivery mode quick reference table. This means that the delivered oxygen … Higher flow devices which exceed the patient’s peak inspiratory flow rate, or the nonrebreathing mask which has a reservoir of oxygen on which the patient may draw, both give a higher F I o 2 and are unaffected in our model of respiratory failure. Apply oxygen delivery device: a. Nasal Cannula (1) Set flow rate as ordered (humidity not required for < 4L/minute) (a) 1-2 L/minute provides 23-30% O2 (b) 3-5 L/minute provides 30-40% O2 (c) 6 L/minute provides 42% O2 (2) Place prongs in nostrils with flat surface against skin. Oxygen therapy (concentration and flow) may be varied in most circumstances without specific medical orders, but medical orders override these standing orders. To ensure the highest concentration of oxygen is delivered to the patient the reservoir bag needs to be inflated prior to placing on the patients face. Intensive Care Medicine. Delivery systems are classified as low-flow or high-flow equipment, which provide an uncontrolled or controlled amount of supplemental oxygen to the patient (British Thoracic Society, 2008). A variety of portable oxygen delivery systems have been designed for use in diving accidents. Normal values and SpO Where the Airvo2 is used as an oxygen delivery device the flow from this device is independent to the flow of oxygen. Delivery Device Description Common Flow Rate Oxygen Concentrations Suitable Victims Nasal cannula Held in place over the victim’s ears; oxygen is delivered at a low level through two small prongs inserted into the nostrils 1–6 LPM 24–44% Victims with breathing diffi culty Victims unable to … November, Vol.134, No.5, pge1474-e1502, Ramsey, K. (2012). Oxygen: delivery devices Oxygen therapy. Indications of O2 therapy 1. 5 Weaning and discontinuation of oxygen therapy. MR850 User Manual in conjunction with this Guideline Because this device delivers a precise oxygen concentration and carbon dioxide buildup is minimal, it is commonly used for patients who have COPD. Usually, patients are more comfortable with the nasal cannula but we should keep in mind if the fraction of inspired oxygen (FiO 2 ) delivered by the nasal cannula is sufficient for the patient. Martin, S., Martin, J., & Seigler, T.  (2015). All vital signs should be with normal limits (ViCTOR white zone or modified zone) Oxygen delivery systems are generally classified as low-flow or variable-performance devices and high-flow or fixed-performance devices. These are oxygen devices that supply you with supplemental oxygen. Fisher and Paykel Optiflow nasal cannula junior range Four sizes of prongs: See High flow (fixed performance) delivery systems. May cause drying of nasal mucous membranes, especially at high flow rates. Monitoring of SpO, Many children in the recovery phase of acute respiratory illnesses are characterised by ventilation/perfusion mismatch (e.g. (2014). If … There are also a number of face mask options, such as the simple face mask, often used at between 5 and 8 LPM, with a concentration of oxygen to the person of between 28% and … Select the appropriate size nasal prong for the patient's age and size. Clinical assessment and documentation including but not limited to: cardiovascular, respiratory and neurological systems should be done at the commencement of each shift and with any change in patient condition. Comparison of tissue oxygenation achieved breathing oxygen using different delivery devices and flow rates. Oxygen delivery devices and flow rates should always be matched to patients' individual oxygen requirements, which can be varied and dynamic. Sydney, Australia: Brink, F; T Duke, T., Evans, J. ■A delivery device. They include…, Flow rate 1-4L/min (4L will dry the nose, 2L is more comfortable), Different colours deliver different rates. Metabolism/Liver Failure/Nutrition Improving Nutritional Status • The patient with cirrhosis without ascites, edema, or signs of impending hepatic coma should receive a nutritious, high protein diet, if tolerated, supplemented by vitamins of the B complex, as well as A, C, and K. The nurse encourages the patient to eat. Reduction or Cessation of oxygen therapy. These devices deliver a variable inspired oxygen concentration to the patient, which depends on the PIFR. The type of humidification device selected will depend on the oxygen delivery system in use, and the patient's requirements. While a specific FiO2 is delivered to the patient the FiO2 that is actually inspired by the patient (ie what the patient actually receives) varies depending on: At the RCH, oxygen therapy via an isolette is usually only for use in the Butterfly neonatal intensive care unit. Tubing carries the oxygen from the regulator to the delivery device. Performance of six types of oxygen delivery devices at varying respiratory rates* T. A. J. Wagstaff1 and N. Soni2 1 Clinical Research Fellow, 2 Director Intensive Care, Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital, 369, Fulham Road, London SW10 9NH, UK Summary The administration of a known concentration of oxygen … 8. At RCH both simple face masks (in various sizes) and tracheostomy masks are available. Care and considerations of child with simple nasal prongs: If the required flow rate exceeds those as recommended above this may result in nasal discomfort and irritation of the mucous membranes. 8. Oxygen Delivery Devices Delivery Device Minimum to Maximum Liter Flow Range (Adults) Approximate O2% Delivered Notes RT assistance recommended for liter flows of 6 liters/minute or more! oxygen delivery devices-ATI. 2of 95% can be achieved with an oxygen flow rates of 10 to 15 L/min •Ideally NRM should not allow entrainment of air, but because of safety concerns one of the two exhalation ports is not provided with valve Non-rebreathing face mask are not designed to allow added humidification. and adjust flow rate. The formula to determine the F i O 2 for a nasal cannula is F i O 2 = 20 + (F l o w R a t e (L / m) × 4) per minute will deliver approximately 24 to 44 percent … The main type of oxygen deliver device are outlined below. •The oxygen flow must be run at a sufficient rate, usually 5 lpm or more to prevent rebreathing of exhaled gases. • Low flow device • Most common device used for mild hypoxia • Can be set between 1 and 6 LPM (24% to 40% FiO2) • FiO2 increases approximately 4% with each liter of O2 KorupoluR GJ, Needham DM.Contemporary CriticalCare. What are advantages of a high flow device? Weaning and discontinuation of oxygen therapy Oxygen … Clinical decisions should determine the methods of administration of oxygen therapy and device selection. conventional oxygen delivery devices fail to supply oxygen at high enough flow rates to match a patients peak inspiratory flow rate. June, Vol.97, Issue 9, pg827-830, Ricard, J. The indications, advantages and disadvantages of each device and delivery … Below is an image of the RT330 pressure relief valve. Note that saturations should be maintained at 94-98%, not 100%. Both hypoxaemia and hyperoxaemia are harmful. Supplemental oxygen relieves hypoxaemia but does not improve ventilation or treat the underlying cause of the hypoxaemia. It is interesting to note that the absolute Because the patient’s minute ventilation exceeds flow, the oxygen delivered by the device will be diluted with ambient air and thus the inspired oxygen delivery is less than anticipated. Frey, B., & Shann, F. (2003). Unless using a wide bore high flow nasal cannula, the flow rate on a nasal cannula should not exceed 6L/m. THE FOLLOWING MAY BE UNDERTAKEN BY NURSES WITHOUT MEDICAL ORDERS: Commencement or Increase of Oxygen Therapy: This direction applies to patients treated with: See below nursing guidelines for additional guidance in assessment and monitoring: Unless clinically contraindicated, an attempt to wean oxygen therapy should be attempted at least once per shift. large volume nebulizers, high flow/high FiO 2 nebulizers, and heated, humidified high flow devices using a mask or tracheostomy Our … simple face-mask. Prompt clinical assessment is required if oxygen therapy needs to be initiated or increased due to a falling saturation level. Hourly checks should be made for the following: Hourly checks should be made and recorded on the patient observation chart for the following (unless otherwise directed by the treating medical team): respiratory distress  (descriptive assessment - i.e. laryngeal mask airway [LMA], i-Gel), click here for how to start patients on NIV, Click here to learn how to prescribe oxygen, Click here to learn how to prescribe IV Fluids, Oxygen is delivered from taps above ward beds at 100% concentration, It is then put through different devices at different rates to adjust the oxygen concentration that the patient inspires, The percentage of oxygen inspired depends on the, The flow rate can be set on the wall tap: it varies from, Delivery devices work with different flow rates. Prompt clinical assessment is required if oxygen therapy needs to be initiated or increased due to a falling saturation level. The placing of mask over the patient’s face increases the size of the oxygen reservoir beyond the limits of the anatomic reservoir ;therefore a higher FiO2 can be delivered. Follow the instructions in the disinfection kit manual: For routine cleaning instructions please refer to the following link: The AIRVO 2 Humidifier flow rate should be set to meet or exceed the patient’s entire ventilatory demand, to ensure the desired FiO2 is actually inspired by the patient. Give oxygen therapy in a way which prevents excessive CO 2 accumulation - i.e. The FiO2 inspired will vary depending on the patient's inspiratory flow, mask fit/size and patient's respiratory rate. OXYGEN THERAPY – STANDING MEDICAL ORDERS FOR NURSES. There is a wide variety of devices available to provide oxygen support. Nasal cannulae. Nasal cannula [5] Description: a basic oxygen delivery system consisting of two nasal prongs [5] FiO 2 delivered: ∼ 24–40% (1–6 L/minute) Clinical applications: low oxygen saturation in patients who are not critically ill; … Low flow oxygen delivery systems are devices that do not supply all the inspired gases so the patient inhales some room air. Has two modes: Link to : Optiflow Nasal Prong Flow Rate Guide. Journal of Pediatric Nursing, (30), 888-895. (2014). Continuous pulse oximetry for 30 minutes post cessation of oxygen therapy OXYGEN DELIVERY DEVICES Dr. Himanshu 2. Bersten, A. D. & Soni, N. (2013). Due to this the following rules should be followed: Oxygen cylinders should be secured safely to avoid injury. Invasive Mode - delivers saturated gas as close to body temperature (37 degrees, 44mg/L) as possible. 94% - 98% (PaO2 between 80 and 100 mmHg) in patients without cyanotic congenital heart disease or chronic lung disease, > 70% (PaO2 37 mmHg) in patients who have had cardiac surgery of their congenital cyanotic heart disease, > 60% (PaO2 32mmHg) in unrepaired congenital cyanotic heart disease, 91 - 95% for premature and term neonates (, ≥ 90% for infants with bronchiolitis (link to, The treatment of documented hypoxia/hypoxaemia as determined by SpO, Achieving targeted percentage of oxygen saturation (as per normal values unless a different target range is specified on the observation chart.). Oxygen Delivery Systems. Delivery. Oxygen therapy should be reduced or ceased if: Mechanical ventilation (do not alter other ventilator settings), Mask-BiPaP or CPAP (do not alter pressure or volume settings. However, as compressed gas is drying and may damage the tracheal mucosa humidification might be indicated/appropriate for patients with increased/thickened secretions, secretion retention, or for generalized discomfort and compliance. Journal of Pediatrics 156:634-38, Spentzas, T., Minarik, M., Patters, AB., Vinson, B. and Stidham, G. (2009) Children with respiratory distress treated with high-flow nasal cannula. May;37(5):847-52, Mayfield, S., Bogossian, F., O’Malley, L., and Schibler, A. 2 Low-flow systems provide oxygen at flow rates that are lower than patients’ inspiratory demands; thus, when the total ventilation exceeds the capacity of the oxygen reservoir, room air is entrained. Our … Considerations when using a non-rebreathing face mask. Note: In most low flow systems the flow is usually titrated (on the oxygen flow meter) and recorded in litres per minute (LPM). Simple nasal prongs are available in different sizes. This can include for low blood oxygen, carbon monoxide toxicity, cluster headaches, and to maintain enough oxygen while inhaled anesthetics are given. Liter flow is the flow of oxygen you receive from your oxygen delivery device. When commencing therapy on a new patient, ensure the disinfection cycle was performed. Has two modes: Follow instructions in the Regardless of the patient’s respiratory pattern, high-flow systems are expected to deliver predictable, consistent, and measurable high and low F IO 2 values. As the high flow oxygen delivery devices have already been discussed, let us see what the low flow ones are. These masks are not commonly used but a non-rebreathing mask can provide higher concentration of FiO2 (> 60%) than is able to be provided with a standard face mask (which is approximately 40% - 50%)  Flow rate 5 10l min. KH: Low flow device: What device delivers up to 100% O2, if bag does not completely collapse during inhalation? ... Nasal cannulae. Fisher and Paykel Optiflow (adult) nasal cannula standard range guide). Bag on mask with valves stopping almost all rebreathing of expired air. Flow rate: Varies with colour. “Humidification during oxygen therapy and non-invasive ventilation: do we need some and how much”? Also 0-50 LPM PICU only. A ventilation bag or machine is attached to an artificial airway to ventilate lungs. • This device is used to deliver high flow rates and high concentrations of oxygen. d. Set flow on flow dial, flow tube, oxygen flow control, or flow meter at prescribed liter flow. The objectives of this study were (1) to determine current ED nursing wafting practices, and (2) evaluate the oxygen concentrations delivered by those practices. Check on the individual flow meter for where to read the ball (i.e. Log in Sign up. Updated July 2017. Feeding adequate amounts orally. The indications, advantages and disadvantages of each device and delivery … (See May, Vol 50 (5)  pp373-378, McKieman, C., Chua, L.C., Visintainer, P. and Allen, P. (2010) High Flow Nasal Cannulae Therapy in Infants with Bronchiolitis. Although “wafting” oxygen is often used by ED nursing staff, current practice varies with the use of a wide range of oxygen delivery devices, oxygen flow rates, and device positioning. A Venturi mask can deliver accurate oxygen concentrations from 24% to 50% with flow rates from 4 to 10 L/min. K Optiflow Nasal Prong junior and standard humidification and flow rate guide for Airvo. Please consult user manuals for any other models in use. The non-rebreathing mask system may also have a valve on the side ports of the mask which prevents entrainment of room air into the mask. Junior Mode – requires Junior Tube and Chamber Kit, Standard Mode – requires standard Tube and Chamber Kit, 2 LPM in infants/children under 2 years of age. 2 Low-flow systems provide oxygen at flow rates that are lower than patients’ inspiratory demands; thus, when the total ventilation exceeds the capacity of the oxygen reservoir, room air is entrained. Archives of Disease in Childhood. The Hudson Trach-Vent™ HME has a dead space of 10mL and is recommended for use in patients who have tidal volumes of 50mL and above. Oxygen therapy and oxygen delivery principles (respiratory therapy). Oxygen delivery method selected depends on: Note: Oxygen therapy should not be delayed in the treatment of life threatening hypoxia. For nasal prong oxygen withhumidification a maximum flow of: Optiflow nasal prongs are compatible for use in humidified low or high flow oxygen delivery. High flow nasal oxygen (HFNO) is delivered through specialised nasal cannula and can achieve a flow rate of up to 70 L/min and FiO2 near … Clinical observations: -A Venturi mask can deliver accurate oxygen concentrations from 24% to 50% with flow rates from 4 to 10 L/min. St. Clair, N., Touch, S. M., & Greenspan, S. (2001). OXY-VENT™ with Tubing: The adaptor sits over the TRACH-VENT™ and the tubing attaches to the oxygen source (flow meter). The AIRVO 2 Humidifier requires cleaning and disinfection between patients. Most commonly used oxygen delivery device. These include: i. Nasal cannula. Journal of Intensive Care Medicine. This system is simple and convenient to use. An orange traffic light confirms the AIRVO 2 has not been cleaned and disinfected since last use, and is not safe for use on a new patient. There are two important things to consider when delivering supplemental oxygen to your patient: The oxygen flow rate and the FiO2. Various devices are used for administration of oxygen. selection of the appropriate flow rate and delivery device. Maximum oxygen flow should not exceed 4 L/min. The image below is of the RT330 circuit. I defined this in the above linked to post. Comparing the fraction of inspired oxygen (FiO2) in the air to a portable oxygen device is expressed as a percentage. Intensive Care Med (2009) 35: 963-965. Oxygen is not a flammable gas but it does support combustion (rapid burning). HFNP nursing clinical guideline for more information. (7th ed.). post anaesthetic or surgical procedure. Secretions can become thick & difficult to clear or cause airway obstruction. Delivery devices work with different flow rates. Where considering the application of oxygen therapy it is essential to perform a thorough clinical assessment of the child. asthma, the hyperventilation of dry gases can compound bronchoconstriction. The fl ow rate can be set from 1 to 25 liters per minute (LPM). venturi mask. Low flow delivery systems are an extremely variable performance type of system. On device start up, a green traffic light confirms the AIRVO 2 is safe for use on a new patient. 2. E Every liter per minute of oxygen increases the percentage of oxygen provided to the patient by about 3-4%. The nasal cannula is a device that has two prongs that are placed in the patient s nostrils and deliver oxygen at flow rates of 1 to 6 liters per minute. Oxygen treatment is usually not necessary unless the SpO2 is less than 92%.That is, do not give oxygen if the SpO2 is ≥ 92%. For nasal prong oxygen without humidification a maximum flow of: With the above flow rates humidification is not usually required. Low-flow systems (like the trusty nasal cannula) deliver oxygen at a rate that is less than the amount of air that the patient can inhale or exhale in one minute (called “minute ventilation.”) For reference, the minute ventilation of a healthy adult male at rest is about 6 L/minute. OXYGEN DELIVERY DEVICES. … Humidification is usually unnecessary with this device. 50 Flemington Road Parkville Victoria 3052 Australia, Site Map | Copyright | Terms and Conditions, A great children's hospital, leading the way, Click here for Oxygen saturation SpO2 level targeting in neonates, Assessment of Severe Respiratory Conditions guideline, Observation and Monitoring Nursing Clinical Guideline re: pulse oximetry monitoring, Nursing Assessment Nursing Clinical Guideline, level target in neonates nursing guideline, Bronchiolitis clinical practice guideline, High Flow Nasal Prong Therapy nursing guideline, Follow the instructions in the disinfection kit manual, Appendix A for further information regarding appropriate junior range sizing: Fisher and Paykel Optiflow junior range sizing guide, RT330 circuit - click here for instructions for use, RT203 Circuit and O2 stem - click here for instructions for use, Fisher and Paykel Optiflow (adult) nasal cannula standard range guide, High Flow Nasal Prong Therapy nursing clinical guideline, PICU High Flow Nasal Prong HFNP oxygen guideline, Oxygen Saturation Sp02 Level Targeting - Premature neonates, Junior Nasal Cannula instructions for use, RCH CPG Assessment of Severity of Respiratory Issues, F&P Optiflow Junior Nasal Cannula Fitting Guide, F&P Optiflow Junior Consult Instructions For Use, Clinical Guidelines (Nursing): Nursing Assessment, evidence table for this guideline can be viewed here, Relieve hypoxaemia and maintain adequate oxygenation of tissues and vital organs, as assessed by SpO, Give oxygen therapy in a way which prevents excessive CO. Therefore, humidification of nasal prong oxygen therapy is recommended. Oxygen … Most commonly used oxygen delivery device. These systems consist of two basic operating configurations: an adjustable constant flow regulator or a patient-triggered demand valve. It can only comfortably provide oxygen at low flow rates, 2–6 litres per minute (LPM), delivering a concentration of 24–40%. 20 (6), 39-45. use of accessory muscles/nasal flaring -  see Respiratory Distress on EMR), Ensure the individual MET criteria are observed regardless of oxygen requirements, Cease oxygen therapy entirely and maintain line of sight  for approximately 5 minutes, LOC = alert, note lethargy or irritability, Non re-breather face mask (mask with oxygen reservoir bag and one-way valves which aims to prevent/reduce room air entrainment), Isolette - neonates (usually for use in the Neonatal Intensive Care Unit only), Face mask or tracheostomy mask used in conjunction with an, NB: There is separate CPG for HFNP use in the NICU (see, Cold, dry air increases heat and fluid loss. Oxygen administration in infants. FiO 2 delivered Considerations Advantages/ disadvantages Can be used with Oxygen concentrator Compressed oxygen cylinder Piped supply oxygen Nasal … Position the nasal prongs along the patient’s cheek and secure the nasal prongs on the patient’s face with adhesive tape. A nebuliser mask, tracheostomy mask with a mask interface adaptor (Fisher&Paykel RT013), or Tracheostomy Direct Connection (Fisher&Paykel OPT870) are intended for use with the AIRVO 2 Humidifier. Aerogen an award-winning, world-leading medical device company. Deliver 24-30% O2 (this is an FiO2 of 0.24-0.3) Flow rate maximum 4L/min; Comfortable and well-tolerated but can … 1L = 24%, 2L = 28%, 3L = 32%, 4L = 36%, 5L = 40%, 6L = 44%. Nasal Cannula 1-6 liters/minute 25-50%* Humidifier recommended for all flow rates > 4 liters/minute High Flow Nasal Cannula 1-15 liters/minute 25-50%* Low‐flow oxygen delivery systems deliver oxygen at flow rates below the patient's inspiratory flow rate, entrain room air and provide a variable FiO2. Another type of device used for oxygen therapy is a nonrebreather mask. (Traditional oxygen therapy is up to 16 L/min and high flow oxygen therapy is up to 60 L/min.) High Flow Nasal Prong Therapy (HFNP) in approved areas only, see the Oxygen treatment should be commenced or increased to avoid hypoxaemia and should be reduced or ceased to avoid hyperoxaemia, For children receiving oxygen therapy SpO, Nurses can initiate oxygen if patients breach expected normal parameters of oxygen saturation, A medical review is required within 30 minutes. Respiratory Distress (work of breathing) should be mild, or there should be no work of breathing. (3) If prongs are curved, direct curve downward toward floor of nostrils. Diving Hyperb Med. The patient therefore entrains room air with inspiration and does not get the desired oxygen concentration (1,2). < 40 cm H20. Oxygen (via intact upper airway) via a simple face mask at flow rates of 4LPM does not routinely require humidification. Since higher rates of flow can be more drying, using certain cannulas, masks, or humidifiers can help make you more comfortable. Additionally in some conditions (eg. prongs fit into nose, … High pressure air/oxygen with a tight-fitting mask, Positive pressure all the time to help keep airways open (split them), High positive pressure on inspiration and lower positive pressure on expiration, Fully controlled oxygen delivery up to 100%. Perfect revision for medical student finals, OSCES and PACES. KH: They are precise and stable and the patient’s rr and Vt have no effect on FIO2% What is defined as a device that does NOT meet all the inspiratory flow demands of the patient? Oxygen delivery systems are generally classified as low-flow or variable-performance devices and high-flow or fixed-performance devices. Delivery devices include nasal cannulas, resuscitation masks, non-rebreather masks and bag-valve-mask resuscitators (BVMs). 24(5): 323-8, Miyamoto, K. & Nishimura, M. “Nasal Dryness Discomfit in Individuals Receiving Dry Oxygen via Nasal cannula” Respiratory Care April (2008) Vol 35 No. Because this device delivers a precise oxygen concentration and carbon dioxide buildup is minimal, it is commonly used for patients who have COPD. Maximum oxygen flow should not exceed 4 L/min. • A nonrebreather mask has ports on each side that have one-way valves that keep the patient from breathing in room air to ensure that a high concentration of oxygen is delivered. Child’s size and tidal volume alter the oxygen concentration child receives despite same flow rate. Blenders may be used to wean oxygen titration of flow rates. Apply oxygen delivery device: a. Nasal Cannula (1) Set flow rate as ordered (humidity not required for < 4L/minute) Non-Invasive Mode – delivers gas at a comfortable level of humidity (31-36 degrees, >10mg/L). disclaimer. For respiratory patients in all hospital settings, specialised aerosol medication administration systems. The minimum flow rate through any face mask or tracheostomy mask is 4 LPM as this prevents the possibility of CO2 accumulation and CO2 re-breathing. Any patient who develops or has an increase in their oxygen requirement should be medically reviewed within 30 minutes.