Quote from Do_Good
I used a non re-breather mask with 5L O2 with a Pt who was mottled, RR 28-32, O2Sat 88. I couldn't find a regular mask and my thought was that he was mouth breathing so a canula wouldn't have done much good.
Did I use the right O2 delivery system or should I have used the canula?
With a non-rebreather mask, you should be using O2 flows >10LPM, and more like 15 LPM. The NRB requires higher flow rates because when the patient inhales, the reservoir bag deflates, and at lower flow rates, the bag will completely deflate and cut off supplemental O2 flow. Those masks aren't completely sealed, so the patient will continue to breathe room air once the reservoir bag is empty. It will partially refill (at 5LPM) during the expiratory phase and then collapse again during the next inspiratory phase. Run the mask at around 10-15 LPM, and it'll be difficult to completely collapse the bag.
To prevent reservoir bag collapse at lower flow rates, take the rubber tabs off the side of the mask and that will make it function like a simple mask, with the typical flow rates you can use with those. "Room air" will be more easily inspired and will mix with the O2 in the mask. The concentration of O2 will be lower than with a fully-functioning NRB at a high flow rate. Depending upon the patient's work of breathing, I might start off with a nasal cannula and "upgrade" the O2 delivery device & concentration based on the response.
Personally, I'd have likely started off with a cannula and titrated up from there, if the patient's status warranted starting that low.
All the above assumes that I have orders to allow me to use oxygen to maintain SpO2 by using any of the above methods of delivery.