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Discussion

I need INPUT

I am a LPN, in my last year of the RN program. I always thought for oxygen, unless you use only 2l/m via nasal canula, it should be humidified. Am I right, or can you use 4 - 6 liters also and not humidify? Also using a non-rebreather - can you use it for 10-15l/m and not use humidifier? Can a non-rebreather be used for 10l? Our instructors say one thing, then they're not sure and other RN's I work with all have different answers, and I can't find anything SET in Concrete to say when to use water and when to use a non-rebreather. Can anyone help?????? I had a patient on 13;/m and no one used humidified air with a face mask. When I asked about it, no one knew the answers or where to find any answers. Thanks.

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I was always told that if a patient is on 5/L or more of O2...that the patient needs to be placed on a humidified face mask.

As for the 13...that sounds very high not to be on humidified oxygen. :)

  • Experts

I don't think there are any hard and fast rules...I have seen many a lunger on steroids get bloody noses with no humidity at 1.5 lpm via nasal canula.

I use a water bottle for humidification if the pt is c/o dry nose, throat or bloody nose at any of the lower amounts of o2. I think our CPT policy is to put it on at 3L and above but I will do it myself for pt comfort. I was told by CPT that you cannot use our humidification water bottles at the higher levels of o2, and not with any mask that is running at 10 or more LPM since it pushes to much fluid in and can really cause a problem. Try turning up the o2 sometime when its not on a pts face and see how vigorously it bubbles up and with a lot of pressure you can see what I mean. Check with your CPT dept and see what their policy is.

  • Experts

http://www.ha.org.hk/tmh/guide/icn/Guidelines%20on%20Prevention%20of%20Nosocomial%20pneumonia.pdf

Clinical Alert on equipment use:

- Flow rate should be limited to 6L/minute because flow of oxygen greater than 6 to 8L/minute is

uncomfortable for patient.

- Humidification is not necessary for patients with oxygen therapy during short-term care

including recovery and emergency rooms. Oxygen supplied to patients via nasal cannula at flow

rate less than or equal to 4L/min need not be humidified. Unless specially indicated as

prescribed by medical officer, it is not recommended to routinely humidify oxygen because

bacterial contamination associated with humidification system is a possible risk.

c Maintenance of equipment

- Change a new set of nasal cannula between use on different patients. Do not reprocess any

piece of device that is designed for single use.

3.4.2 Simple mask

a. Indications

- Use for oxygen therapy

- It is recommended for administering oxygen at flow rate more than 5L/minute. If oxygen is

delivered at flow rate less than 5L/minute, the mask volume will form a deadspace causing CO2

rebreathing.

b. Clinical Alert on equipment use:

Humidification is recommended. Sterile water should be used for wall oxygen humidification

and should be freshly prepared and never be topped up.

I always heard humidify over 2L unless an emergency. And don't use a mask for under 5L.

I've been taught and our hospital policy is that 5-6 L/min O2 should always be humidified. I have seen low flow O2 COPD'ers have problems with lower flows; but vaseline or other such lubricants usually helps that; and those pts. always use some type of lubricant because of this.

I used to use the humidified O2 on any patient who complained about a dry nose, but our facility is now trying to cut back on expenses as much as possible, and I think the new policy is anything less than O2 @ 6L/min can't be humidified without a doctor's order. Sometimes a NSS nasal spray helps the patient some, but I'd prefer to humidify the O2.

:confused: Check with your facility. Our policy is that O2 is not humidified unless it is above 4/L

things change so fast I can't keep up.

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