Question on O2 therapy

[chacmool]

Hello all- I've been a nurse for 1.5 years and shame on me because I'm very unsure about O2 therapy. I haven't had to deal with much more than NC and I've started at a new hospital and I'm clueless and mortified to even ask. Can someone give me a quick rundown on the different face masks and how much O2 I should be using on each. It would be greatly helpful. Thanks!

[kmoonshine, RN]

ok, i'm not an expert...but here's what i use:

nasal cannula (nc):

can handle 0.5l - 6l (anything past 4l is very noxious though, as it easily dries out nasal passages). i use these for people on home therapy, or who need simple oxygen therapy (chest pain pts, pts who receive high doses of narcotics, obese pts in c-collar, etc). they do make high-flow nasal cannulas, but i've never used these.

simple face mask (its just that; simple - no bag, no adjustment devices; just a mask):

usually i set at 6l - 8l. use if pt is in moderate respiratory distress and a nasal cannula is neither appropriate or isn't tolerated.

non-rebreather mask (mask with a "balloon" bag at the end):

i usually set these between 10l - 15l. before putting on the pt, you must inflate the bag first (put your finger in the mask and cover the hole that the oxygen comes from, and wait until the bag is inflated completely). used with severe respiratory distress (spo2 below 80%), or low spo2 despite using a simple mask.

if you use an ambu bag, it needs to be hooked up to oxygen at 15l. also, i've never used a venturi mask or face tent so i don't have any input on these.

http://www.lhsc.on.ca/resptherapy/rtequip/oxygen/index.htm

do you have a respiratory therapist in your hospital? just ask them to run through the o2 delivery devices with you because you're not familiar with the new equipment. you really need to know this stuff because you may need to help someone who is in respiratory distress - being too scared doesn't exempt you from saving someone's life.

[nurseeB]

Definitely ask a RT from your facility. I have worked in many different hospitals and all the nurses have different opinions of what type of delivery device to use, whether or not it can be humidified, how high or low the flow should be when humidified, etc. In my experience, RTs are only too happy to stretch their "teaching legs" and educate a nurse. :wink2:

[wooh, BSN, RN]

Yeah, I've made a point to watch who the really good RTs are, and then hit them up when I have a question. They deal with all day every day, and know your facility's equipment and policies. And they're usually more than happy to share!