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Chapter 9

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Ch 8

OXYGENATION
And oxygen መብላት
Introduction
• Oxygen is colorless, odorless, tasteless gas that is
essential for the body to function properly and to
survive.
• The air that we breath in is contains approximately 21%
oxygen and the heart relies on oxygen to pump blood.
• If not enough oxygen is circulating in the blood, it’s
difficult for the tissues of the heart to keep pumping.
• Supplemental oxygen is used to treat medical
conditions in which the tissues of body do not have
enough oxygen.
Oxygen therapy

• Oxygen therapy is an administration of oxygen at a [ ]


greater than found in the environmental
atmosphere.
Purpose –
• to provide and maintain supply of o2 for blood and
tissue
• Oxygen is a gas but when administered as a
supplement to normal atmospheric air, may also be
considered as a medication (or drug)
Oxygen is a “DRUG”
• TOO MUCH of a drug can cause overdosing
problems
• TOO LITTLE isn’t enough to treat the
symptoms
Cont….
Indications-
• Hypoxemia
• People with reduced lung diffusion of oxygen
• Heart failure
• Loss of lung tissue due to surgery
• Indicative of s/s for need of oxygen/ emergency
• Rapid, shallow respiration and dyspnea.
• Cyanosis
• The percentage of oxygen in the inspired air is
referred to as the fraction of inspired oxygen, or
FiO2, expressed as a percentage;

• normal atmospheric air has an FiO2 of 21%.

• Supplemental oxygen delivery systems are


capable of increasing the FiO2 to anywhere from
24% to nearly 100% oxygen.
• possible hazard of oxygen administration is
oxygen toxicity.
• Prolonged administration of high FiO2 (greater
than 50% for more than 24 hours) may actually
damage lung tissue and produce severe
respiratory difficulties.
• The mechanisms by which oxygen toxicity occurs
are two fold (2-WAY).

• First, it should be understood that 78% of the inspired air consists
of the gas nitrogen.

• Although nitrogen is (under normal conditions) physiologically


inert, it serve an important function in the lung: to keeps the alveoli
open by occupying space.

• High concentrations of oxygen displace nitrogen from the alveoli; as


this oxygen is absorbed by the alveolar capillary blood, the volume
of gas in the alveolar space is reduced and the alveoli collapse.

• Once the alveoli have collapsed (atelectasis), no airflow occurs and


the work of breathing increases dramatically.
• Second, oxygen in high concentrations is toxic to the type II alveolar
cells, which are responsible for the production of
surfactant(substance that assists in keeping the alveoli open by
reducing the alveolar surface tension)

• Atelectasis results when surfactant is insufficient.

• Widespread atelectasis due to oxygen toxicity may result in a


syndrome known as adult respiratory distress syndrome, which is
characterized by diffuse pulmonary edema, severe stiffness of the
lung tissue, and profound hypoxemia.
Type of oxygen administration
• Nasal cannula:- is a soft plastic material contains two
short tubes that fit in to the nostrils.
• Relatively simple and comfortable method of supplying
oxygen of low concentration(2% -30%) at flow rate of 1 to
5 liters per minutes
• Face mask:- they are made from a light weight plastic
material fit over the face, nose and mouth.
• Commonly used when the pt requires precise amount of
oxygen.
• Concentration delivered through mask is from 25% - 60% at
flow 1-8 liters per minute when fitting a pt with the mask.

Oxygen Delivery Systems: A. Single face mask; B. Open face tent;C. Reservior mask; D
Venturi mask.
Tracheostomy
• Tracheotomy is an artificial opening in to the
trachea which is to be kept open for breathing
• It can be temporary or permanent.
• Indications
– Acute laryngitis such as croup
– Foreign body impacted in the larynx
– Cancer of the larynx
– Acute edema
– Trauma
– Burn of the mouth and larynx
– Tetanus
– Certain states of coma
Purpose –
• To by pass an upper airway obstruction
• To remove tracheobronchial secretion
• To permit the use of mechanical ventilation
• To prevent aspiration of oral or gastric secretion in the
unconscious or paralyzed patient (by closing of the
trachea from the esophagus)
• Site – at the center of the neck, below the first
tracheal ring or between 3rd and 4th rings
Tracheotomy tube
• Many tracheostomy tube have both inner and outer
cannula. The outer cannula remains in place and
the inner cannula is removable and changeable.
• Source of tracheostomy tube can be metal or
plastic.
• Plastic tube are less irritant than metal and can be
cuffed or non cuffed
• cuffed plastic tube is most preferable because. It
help to guard against aspiration if secretion and
vomitus from the upper airway to the lung.
Questions?
Quiz

1.What do we mean by oxygen therapy


2. Write indication of oxygen therapy
3.What are the purposes of oxygen therapy
4.What are the indication of tracheostomy
5.Write purposes of tracheostomy

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