Term
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Definition
Clinical Practice Guidelines These guidelines provide a research based framework for the administration of oxygen and other therapeutic procedures in the practice of respiratory care. |
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Term
Hypoxemia for patients in acute care setting |
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Definition
defined in the CPGs as a PaO2 < or = 60mmHg or a SaO2 < or = 90% |
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Term
Hypoxemia patients in sub-acute or home care settings |
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Definition
PaO2 < or = to 55 mmHg or SaO2 < or = to 88% in subjects breathing room air |
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Term
| High flow oxygen delivery system |
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Definition
| the device delivers all of the patient's inspiratory flow needs. all of the inspired gas the patient breathes is delivered by the oxygen device, and none is provided from the ambient air. commonly employ viscous shearing or vorticity to mix ambient air with oxygen. |
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Term
| Low-flow oxygen delivery devices |
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Definition
| provide part of a patient's inspiratory gas flow needs. the remainder of the gas the patient inhales comes from room air. |
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Term
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Definition
High air flow oxygen entrainment. utilizes the viscous shearing effect mixing two different gases (oxygen and air), increasing the total flow for precise oxygen concentration delivery. the high flow gas from the jet forms a bounday layer, cleaving the relatively stationary room air. do not use a humidifier. |
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Term
| ratio of air entrainment to oxygen flow calculation |
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Definition
liters of air entrained = 1.0 - FI02 liters of oxygen = FI02 - 0.21 |
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Term
| anestesia bag-mask systems |
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Definition
| can be combined with ventilation masks and valves to construct a tru non-rebreathing system. one way valve prevents exhaled gas from mixing with the oxygen delivered to the bag and the other one way valve prevents the entrainment of room air during inspiration. if fit is tight & flow is adequated, can provide 100% oxygen. reservoir bag should never collapse. may be used to administer mixed gas therapy such as He/O2 or O2/CO2 |
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Term
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Definition
| low-flow oxygen device. rests on patients's upper lip, with curve of prongs directed posteriorly into the nasal passage. oxygen flow at 1-6 lpm (24-44% O2), filling the anatomic reservoir. |
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Term
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Definition
| consists of nasopharynx and oropharyns. in adults its volume is approximately 50 milliliters. |
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Term
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Definition
| operates on a similar principle to that of the nasal cannula. positioned by passing it through the nose and the turbinates with the tip resting at that level of the uvula in the oropharynx. oxygen entering the device flows directly to the oropharynx. FIO2 delivery is similar to that of the nasal cannula. |
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Term
reservoir cannula
pendant cannula |
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Definition
| tow devices designed to maintain FIO2 levels at lower flow rates. |
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Term
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Definition
| small catheter surgically inserted into the trachea at the second cartilage ring. can maintain FIO2 levels at a lower oxygen flow than a nasal cannula. used primarily for patiens who require continuous long term oxygen therapy. may use up to 59% less oxygen than cannulas. PaO2 levels (arterial oxygen tensions) may be achieved at oxygen flows as low as 1/4 liter per minute. hazards include infection, subcutaneous emphysema, hemoptysis. |
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Term
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Definition
| to add reservoir space (the mask) in addition to the anatomic reservoir. FIO2 varies depending upon tidal volume and respiratory rate. typical oxygen delivery is between 35% and 50% oxygen at 5-12 L/min. minimum liter flow should be set at 5 L/min since the patient also exhales into the mask, the mask may collect exhaled carbon dioxide. the CO2 must be flushed. |
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Term
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Definition
| has a reservoir bag attached that is open to the mask. the patient rebreaths part of his exhaled gas. when the patient inhales, a mixture of oxygen and gas and air is inhaled. oxygen delivered by this mask typically contains up to 70% oxygen. oxygen flow is adjusted so that the reservoir bag is not allowed to fully collapse during inspiration |
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Term
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Definition
| similar to the partial rebreathing mask except that one-way valves have been added to the mask's exhalation port(s) and between the mask and the reservoir bag. the one-way valve between the mask and reservoir halps to prevent exhaled gas from mixing with the oxygen in the reservoir bag. can typically deliver oxygen concentrations of up to 80%. should be set at a minimum flow rate of 10 L/min |
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Term
| HIOX80 disposable high FIO2 oxygen mask |
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Definition
| not readily used. developed to deliver high oxygen concentrations (80%) consistently with less room air entrainment. has molded vinyl facemask w/out air entrainment ports or one-way valves covering exhalation holes. the bridge of the mask is also fitted with moldable foam cushion to better seal the fit. two straps (one above the ears and one below). base has three manifolds consisting of three one-way valves. to valves fitted to a wye at the base directs inspiratory flow from the reservoir and insures exhaled air exhasts into the room. a 750-ml reservoir attached provides a source of pure oxygen during inspiration. flow rates 8 L/min which can be advantageous during transport or other applications where the O2 supply from cylinders or liquid reservoirs is limited. |
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Term
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Definition
| high-flow therapy system capable of delivering oxygen flows from 5 to 40 L/min at humidity content of 55 mg/iter at a temp. of 41 degrees celsius which equates to >95% humidity. humidification accomplished using membrane technology which only passes particles smaller than 0.01 microns, effectively eliminating bacteria and other microorganisms. operational range for temperature may be adjusted between 35 and 43 degrees celsium. may tolerate higher FIO2 levels because it's warmed and humidified via nasal cannula. up to 20 liters per minute via transtracheal catheter. |
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Definition
| transparent box used to regulate an infant's environmental temperature. rarely used for oxygen regulation. |
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Term
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Definition
| transparent box designed to enclose an infant's head. frequently used inside and isolette. provides consistent FIO2. infant will not entrain any room aire around its neck. gas entering is premixed using a blender and then humidified and heated. nebulizers not recommended b/c of noise. |
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Term
| mist tents aka croupettes |
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Definition
| plastic tents large enough to enclose a small child. primary application for aerosol therapy, oxygen environment also controlled. childs activity, opening, difficult seal contribute to variations in FIO2. powered with high-output aerosol device. |
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Term
| hyperbaric oxygen therapy |
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Definition
| as defined by the Undersea Hyperbaric Medical Society (UHMS) the exposure of a patient or patients to a pressure greater than one atmosphere absolute while breathing 100% oxygen either continuously or intermittently. |
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Term
| mechanical effects of hyperbaric oxygen therapy |
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Definition
| related to increased pressures. any trapped gas bubbles, when exposed to the increased pressures during treatment will decrease in size (Boyle's law). at a constant body temp. the increased pressure causes the volume of the trapped gas bubbles to decrease. this effect is utilized in the treatment of decompression sickness and gas embolism. |
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Term
| oxygenation effects of hyperbaric oxygen therapy |
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Definition
| include the supersaturation of plasma(due to the increased partial pressure of O2. PaO2 can reach 1500 mmHg. improves O2 transport even to areas w/ minimal perfusion), vasoconstriction, gas washout (other than oxygen), increased effectiveness of white blood cells, and neovasularizaton of tissue by improved collagen synthesis. |
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Term
| vasoconstriction during hyperbaric oxygen |
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Definition
| it is not known how this occurs, but it is important in the management of localized "compartmented" disorders. |
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Term
| increased elimination of other gases during hyperbaric treatment |
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Definition
| possible due to the high driving force (partial pressure) of oxygen. other gases such as nitrogen and carbon monoxide, can be more quickly eliminated from the body at ambient pressures. |
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Term
| white blood cells exposed to hyperbaric oxygen therapy |
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Definition
| have increased ability to fight infections. the increase in available oxygen results in increased oxidative mechanisms, which help the cells to perform their function better. |
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Term
| conditions that may benefit from hyperbaric oxygen therapy |
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Definition
| gas gangrene, radiation necrosis, carbon monoxide/cyanide poisoning, ischemic tissue transplants, necrotizing soft tissue infections, decompression sickness, refractory osteomyelitis, refractory osteomyelitis, refractory anaerobic infections, severe acute anemia or hemorrhage (blood loss anemia), crush inury/traumatic ischemia, ischemic tissue transplants, enhanced healing of problematic wounds |
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Term
| multiplace hyperbaric chamber |
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Definition
| large vessel that can accomodate more than one patient at a time. pressurized with room air, pt breaths O2 via a non-rebreathing mask. very large and very expensive to purchase and maintain |
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Term
| monoplace hyperbaric chamber |
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Definition
| small chamber capable of treatin only one patient at a time. pressurized with oxygen, although air may also be used. disadvantage: health care provider much depressurize the chamber to treat any emergincies. |
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Term
| contraindications of hyperbaric chamber |
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Definition
| untreated pneumothroax the accures during therapy. during decompression, the gas will greatly expand (Boyle's Law). it is important to provide a path for the gas to escape by placing a chest tube or needle thoracentesis. |
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Term
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Definition
| treat obstructive airway disease. less dense gas can more easily bypass the obstruction and be inspired with less effort and resistance. mixtures 20/80% and 30/70% O2 to He. |
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Term
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Definition
| administered using a non-rebreathing mask. mixtures 5/95% and 7/93% CO2 to O2. should be limited to 5-15 minutes at a time. important to monitor patients HR, RR, and BP. |
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Term
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Definition
| approved by the FDA. used to treat persistent pulmonary hypertension (PPH) of the newborn. suppled in aluminum cylinders at 99% purity combined with nitrogen. therapeutic levels range from 2-80 parts per million (ppm). deliverd via I-NOvent (interfaces with critical care ventilators to deliver the desired concentration to the inspiratory limb of the ventilator circuit. |
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