Oxygen and Delivery Methods

100% O2 is delivered via a non-rebreather or Ambu bag because they have do not allow for the O2 to mix with room air prior to being delivered to the patient. {yes it comes from the flow meter at 100%}

Nasal biprongs deliver between 22-44% O2.

Between biprongs and NRB one could use a simple face mask, partial re breather, or a ventrui mask -- all deliver different O2 concentrations.

Good afternoon! I was wondering if someone could help me? I am a recent grad (WHOO HOO) and I am studying for the NCLEX.

In the hospital where I did my clinicals, anything more than a nasal cannula is preformed by respiratory therapy so I feel like my oxygen education is a little behind from where I need to be to take the NCLEX.

• Nasal Cannula is MAX 6L correct?
  
• What does an NCLEX question mean when it says 100% oxygen. Is the oxygen coming from the wall of the hospital different?
  
• After nasal cannula, non-rebreather mask is the next step up? What are the benefits / risks.
  

Those are the questions I have for this minute - feel free to add anything else that a "nurse with two weeks of vast nursing knowledge" should know. Thanks for your time to answer this question! I am embarrassed as I feel like this goes in the "crap I should know" pile

All oxygen comes out of the tank or the wall unit (which is attached to a really large tank) at 100%. It costs enough to store oxygen without paying to store regular old air too. :)

However, the percentage of oxygen that is delivered to the patient is regulated by mixing plain air into that pure oxygen, which obviously lowers the percentage. It is possible to deliver 100% oxygen (also called FIO2=1.0, for fraction of inspired oxygen = 1) using a nonrebreather mask or endotracheal tube if it is set for that. So when NCLEX (or anybody else) says that a patient is getting 100% oxygen, then he's getting, well, 100% oxygen and nothing else.

The reason nasal cannulae are maxed out at 6 lpm is because it's too uncomfortable to have more breeze than that blowing up your nose. There's really no way to quantify how much oxygen in terms of FIO2 a patient gets with prongs; it's a supplement, and more is, well, more, but there is no "X LPM = Y FIO2" equivalency chart.. Also, if someone is a mouth breather for some or all of the time, he might not even be getting any, or little, depending on how much O2 is floating around his face. Meh.

Risks and benefits are related to oxygen demand, respiratory drive, and oxygen carrying capacity of the blood. There's a difference in oxygen delivery to the tissues depending on hematocrit/hgb. Someone with a SpO2 (% of hemoglobin saturated c oxygen) of 95%, normal, who has a hematocrit of 20 is delivering half the amount of oxygen to his tissues as his roommate with a sat of 95% and a crit of 40.

Chronic lungers whose respiratory drive depends on hypoxia should not get a lot of supplemental oxygen unless they are being watched like hawks (it's not "never," but it's "with great caution"), because if their blood oxygen goes up high enough (and that's not all that high), they will stop breathing until it comes down again; in the meantime, though, their CO2 can rise to lethal levels.

That oughta get you started.

The attached document I have made will help you.

Excellent resource -- Thank you.

Ah ha! I see something that I learned in first semester and remembered! COPD patients sometimes can't handle high oxygen levels because their bodies have gotten used to lower oxygen levels and they can build up toxic Co2 levels. I can't believe I actually retained something.

Thanks everyone! I love all nurses for being a safe place to ask questions without judgement (I can't believe you don't know that). Merry Christmas!!