Air vs. Oxygen for breathing trt

[bnurse1988]

Pt's that receive breathing treatment, i.e. duoneb. Which outlet do we use (green vs. yellow) I've seen both used.

I feel like I may be putting my pt at risk for oxygen toxicity if I crank it up to 12-15L of O2.

Is air going to deliver the medication adequately?

Thanks for your input.

[akulahawkRN, ADN, RN, EMT-P]

Unless you have them on high PPO2 levels for extended lengths of time, I wouldn't worry too much about oxygen toxicity.

For example, because they see the highest concentrations of O2, the lungs and the rest of the respiratory tract are the first organs to show toxicity. Pulmonary toxicity starts to occur occur at a PPO2 level > 0.5 bar (50% O2 at normal atmospheric pressure). Symptoms typically appear somewhere between 4 and 22 hours after exposure to greater than 95% O2 concentration, with at least one study suggesting approx. 14 hours at this level. At PPO2 of 2 to 3 bar (100% O2 at 2-3 times atmospheric pressure) symptoms may show in as little as 3 hours.

Slightly off topic:

In scuba diving (note my user name) we deal with this all the time, because a seizure at depth is almost always fatal. Depending on the length of the dive we try to keep the PPO2 between 1.2 and 1.4 bar. Normal atmospheric O2 concentration starts to become toxic at depths greater that 184 FSW, so for dives at greater depths we actually use a hypoxic mixture - the deeper the dive the lower the O2 concentration. I rarely do any tech stuff anymore, and nothing really deep, but my deepest logged dive is 458FSW with a bottom gas of 10% O2 concentration trimix and a bottom time of 10 minutes....followed by a couple hours of staged decompression - the last of which is usually 10-15 minutes on 100% O2 at a depth of 15-20 feet.

While of course you know this, but deep divers concern themselves with partial pressures of breathing gasses. At that depth, while the gas had only 10% Oxygen, the PPO2 could easily approach a toxic level and in the water, especially at that depth, having a seizure is really bad because you can't ascend to the surface directly as that's very hazardous too.

[sharkdiver]

While of course you know this, but deep divers concern themselves with partial pressures of breathing gasses. At that depth, while the gas had only 10% Oxygen, the PPO2 could easily approach a toxic level and in the water, especially at that depth, having a seizure is really bad because you can't ascend to the surface directly as that's very hazardous too.

Yep - that's why we had a 10 minute hard limit on the bottom time on the 10/80 trimix. We preplanned it very carefully with appropriate safety reserves.

Sorry for sidetracking the thread.....