What are the sources of oxygen
Oxygen therapy care
In the case of many (lung) diseases with a reduced oxygen content in the blood, it makes sense to increase the oxygen concentration in the blood by enriching the inhaled air with oxygen.
Oxygen (O2) is a drug and may only be administered on a doctor's order. The doctor's prescription includes the form of administration of the oxygen therapy, the amount and the duration. Because of the Risk of explosion handling pure oxygen requires special safety precautions.
On many wards, oxygen is over one central reservoir (Wall connections in the patient rooms) available. The alternative are transportable Oxygen bottles from 10 - 50 l volume, which contain compressed oxygen. The pressure of a full bottle is 150 - 200 bar. The high pressure is caused by a Pressure reducer regulated and can be read on a manometer.
In both cases it is pure oxygen (100%). For comparison: the normal room air contains 20% oxygen.
Oxygen bottles are always blue.
Safety measures when handling oxygen (bottles)
· Bottles must not fall! Fix full bottles lying or standing (e.g. chain) and do not store them in stairwells, corridors or patient rooms
· Beware of fire! Smoking ban! Oxygen itself is not flammable, but it promotes combustion. Store only in rooms with windows, but not in rooms at risk of explosion or in exposure to sunlight (windows) or heat (heating)
· Beware of fat! The valves must not come into contact with grease or oil (risk of explosion)
· Only transport with the valve closed and the protective cap attached
· Do not use force when opening the bottles
· Do not change bottles in the patient room
· Always keep the bottles ready for use and check them before each use
· Store full and empty bottles separately
· Leave a residual overpressure of at least 0.5 bar in empty bottles. The inside of the bottles is lined with a film that otherwise collapses
· Call technical service in the event of a fault. Do not try to repair yourself.
Calculation formula for the content of oxygen bottles
(Remaining volume in liters)
Bottle volume in liters x indicated pressure on the manometer (in bar) = supply in liters (at normal atmospheric pressure of 1 bar)
Example: 50 l x 150 = 7500 l
Formula for calculating the oxygen supply in a cylinder in minutes
The supply in the oxygen bottle is sufficient with a consumption of 2 l / min. so 450 minutes (= 7.5 hours). With a consumption of 6 l / min. On the other hand, it only lasts 150 minutes (= 2.5 hours).
Principles of the O2-Therapy
· Since the oxygen in both the central reservoir and the oxygen cylinder is dry, it must always be moistened with distilled water to avoid damage to the mucous membrane.
· Strictly aseptic work prevents contamination. New hose systems must be used for each patient and the aqua dest. to be changed daily in the vessels (exception: single-use items such as AquaPack® are used until they are empty)
· From a dosage of 6 l / min. the oxygen must also be warmed up to avoid breathing disorders
· The patient should blow his nose before giving oxygen.
Most commonly, oxygen is delivered through a O2Nasogastric tube administered with foam rubber pads. The probe is advanced approx. 1 cm into the nostril and is fixed by the foam rubber pad. Up to 5 l O2/ Min. be given, whereby oxygen concentrations of the inhaled air of 30 - 40% are achieved. The carers ensure that the probe does not kink and check its permeability closely. The tube does not bother the patient very much, he can eat and drink. It is also advantageous that the inhaled air is further moistened through the nasal mucosa when the patient inhales through the nose as usual. However, the tube often slips out of the nose and irritation of the nasal mucosa is common.
With Oxygen glasses can hold up to 8 l O2/ Min. given (oxygen concentration of the inhaled air 30 - 50%). The 1 - 2 cm long inlet ports are inserted into the patient's nostrils on both sides, the loops of the O2-Glasses (are also the O2-to-be-fed tubes) lie behind the ears like glasses temples and are brought together again under the chin. The patient can breathe through his mouth and nose. Since many patients find the oxygen cannula uncomfortable and make it difficult for them to speak and eat, they are only used for short periods of time. In addition, the O2-Glasses for pressure points behind the ears as well as in and under the nose when lying down for a long time.
The simple O2-Maskallows a high O for a short time2-Dosing from 6 - 10 l / min. It is placed loosely on the nose and mouth and attached to the back of the head with a rubber band. The exhaled air escapes through the side holes in the mask. Many patients are afraid, insecure and feel constricted because speaking is impeded and food cannot be consumed. The oxygen flow must not be less than 6 l / min. decrease, otherwise there will be a CO2- There may be a jam in the mask.
Oxygen concentrations up to almost 100% are just through O2-Masks with valve or Reservoir bag to achieve.
Monitoring of the patient under oxygen therapy
Oxygen therapy patients require special attention. Patient observation and documentation extend to:
· State of consciousness
Skin (cyanosis? Pressure points?)
· Nasal and oral mucosa
· Oxygen dosage, probe position and distilled water quantity.
Attention! Breathing paralysis due to the administration of oxygen
Particular caution is required in patients with chronic obstructive pulmonary disease. Your body has to deal with the constantly increased CO2-Content in the blood "used". The only one Respiratory drive represents the lack of oxygen in the blood. If this is now remedied by the oxygen therapy, the last breathing stimulus is omitted. This can lead to extreme CO2-Increase and to Respiratory paralysis ("CO2- Anesthesia "), which requires intubation and, if not noticed, is fatal. If a patient becomes increasingly cloudy during oxygen therapy, this must be a sign of CO2- ascent are counted - O2 switch off immediately and call a doctor!
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