Hypoxia kills. Oxygen points can usually deliver up to 15 L/min of oxygen. Oxygen delivery depends on many variables including mask type, patient respiratory rate and minute volume. Just increasing flow does not always mean high FiO2. The concentration of oxygen the patient breathes in is determined by the type of mask as well as the flow from the wall and the breathing pattern. By using a fixed performance system (Venturi)
you can gauge the percentage much more accurately
Indications for use
Precautions and or possible complications: (Support saturations with least FiO2)
FiO2 of a delivery system can vary with
Adjusting Oxygen therapy
Mode About Use Image Room Air
Atmospheric air contains 21% oxygen. Even a modest increase can improve tissue oxygenation
Those with out additional oxygen requirement and SaO2 > 94% or those with hypercapnia and COPD
Nasal Cannula
[Delivers FiO2 24-44%]
A nasal cannula (NC) comprises a thin tube with two small nozzles that protrude into the patient's nostrils. It can only comfortably provide oxygen at low flow rates. Low flow delivery system. Flow rate: 1 - 6 L/min. FiO2 starts at 24% for 1L/min and increases 4% for each L/min up to 44% for 6 L/min. Usually Well tolerated - some find this preferable to a face mask. No dead space. Must be low flow as rate: > 6 L/min cause nasal mucosal drying and nose bleeds. Use: minimal or no respiratory distress or oxygenation problem
Mild hypoxia and stable. O2 sats stable and above 90% and otherwise normal observations
Simple (Hudson)
Face Mask
[Delivers FiO2 24-44%]
Low flow delivery system. Small space. Use at 5-8 l/min. Must flow at over 5L/min to flush away expired CO2. Flow rate determines FiO2: 5 - 6 is 40%, 6 - 7 is 50%, 7 - 8 is 60%. Mask doesn't need tight seal. Use as one would with nasal prongs but requires higher concentrations
Same as nasal cannulae. May be preferred for comfort
Venturi Mask
High flow delivery system with flow rate b/w 4 - 12 L/min. FiO2 can be set specifically with different flow rate and air ports. Fi02 can be 24, 28, 31, 35, and 40%. External ports must remain open to entrain room air. Use in COPD patients that require specific oxygen concentrations to administer high Fi02 but not too high such that the hypoxic drive to breath is blunted; titrate to keep sats about 88-92%
Used to give precise FiO2 so may be useful with COPD and CO2 retention and need to give 24 or 28% oxygen. Colour codes
BLUE = 2-4L/min = 24% O2
WHITE = 4-6L/min = 28% O2
YELLOW = 8-10L/min = 35% O2
RED = 10-12L/min = 40% O2
GREEN = 12-15L/min = 60% O2
Non-Rebreather
with Reservoir Bag
High flow delivery system giving high FiO2. This mask utilizes 3 one-way valves and an oxygen bag reservoir. Supplies the highest possible oxygen concentration of any of the masks. Flow rate 6 - 15 L/min supplies 50-70% Fi02. Requires tight-fitting mask Flow can set to meet the patient's maximum inspiratory needs. The bag should not completely deflate on inspiration. Should be used when over 50% oxygen required. Use in any spontaneously breathing patient who requires the highest FiO2. Indications - carbon monoxide poisoning, trauma, severe asthma, pulmonary oedema, acute PE etc
Sick patients severe Asthma, LVF, Shock, Anaphylaxis, Acute PE, Acute pneumonia
CPAP/NIV
Positive pressure throughout respiratory cycle Prevents collapse of airways recruiting more alveoli for gas exchange and reduces the work of breathing. Can be accompanied by high FIO2. Starting pressure is 5 cm H2O. See topic
Type 1/2 Respiratory failure. NIV used for COPD. CPAP for Pulmonary oedema
MEDICAL DISCLAIMER:The contents are under continuing development and improvements and despite all efforts may contain errors of omission or fact. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice by healthcare workers or laypeople. It is for educational purposes only. Please adhere to your local protocols. Use the BNF for drug information. If you are unwell please seek urgent healthcare advice. If you do not accept this then please do not use the website. Makindo Ltd |
Oxygen delivery devices
-
| About | Anaesthetics and Critical Care | Anatomy | Basic Science | Biochemistry | Cardiology | Cases | Clinical Cases | Crib | Dentistry | Dermatology | Differentials | Drugs | ENT | Electrocardiogram | Embryology | Emergency Medicine | Endocrinology | Ethics | Foundation Doctors | Gastroenterology | General Information | General Practice | Genetics | Geriatric Medicine | Guidelines | Haematology | Hepatology | Immunology | Infectious Disease | Infectious Diseases | Infographic | Investigations | Lists | Microbiology | Miscellaneous | Nephrology | Neuroanatomy | Neurology | Nutrition | OSCE | Obstetrics Gynaecology | Oncology | Ophthalmology | Oral Medicine | Paediatrics | Palliative | Pathology | Pharmacology | Physiology | Procedures | Psychiatry | Radiology | Research | Respiratory | Resuscitation | Rheumatology | Statistics | Stroke | Surgery | Surgical | Toxicology | Trauma and Orthopaedics | Twitter | Urology | Version Jan 2023