Trach with oxygen

I wouldn't turn it off to listen to breath sounds. You can still hear them pretty decently during auscultation. It just takes some getting used to with the background noise of the machine.

I think the first step is having a good stethoscope. While I don't think every nurse needs a crazy expensive one, it's certainly best to have the most upscale one you can afford. I upgraded from a $40 steth to a $140 steth and the difference is profound. The hospital-issue ones hanging at the bedside are cheap and not great for general use, in my opinion.

Second, make sure the ear pieces are seated properly in your ears. You want the ear pieces to be tilted slightly forward; imagine them both pointing through your head to the tip of your nose.

Third, make sure you're putting it in the right places. If you're over bone, like the scapulae or ribs, you won't hear as well. Move over a litte. Have the patient take deep breaths if able.

As far as oxygen conversion, room air has an FiO2(percentage of oxygen) of about 2o%. For every liter of o2 you add, add 4%. so 1 liter is about 24%, 2LPM is 28% and 3LPM would be 32%. If you work with a lot of o2 setups that work in Fi02, then you can print out a little cheat chart and keep it on your badge reel til you know them by heart.

I hope this helps!

The order for the O2 says 3lpm. I thought trach oxygen was ordered in %. There is no order what the blue dial should be at (on top of the humidification bottle)

If you are running the trach aerosol off an air compressor, that little blue dial is NOT what your O2 percentage is. That dial is used for O2 percentage only if you are running it directly off an oxygen flow meter with the manufacturer's recommended liter flow to deliver that dialed in FiO2.

If you are using an air compressor, that blue dial controls the amount of aerosol delivered (moisture or humidity). You place an O2 line from an oxygen source to the aerosol tubing to deliver the oxygen. The actual percentage of oxygen delivered to the patient will depend on how the tubing is attached to the patient, patient's respiratory rate and overall delivery flow.

A compressor only delivers RA. No matter what you set that dial on the aerosol bottle you will only get 21%. So it sounds like this pt is not on O2 but is on RA with humidity.