Oxygen delivery systems

BY
Mahmoud Elhosiny Abou Elmagd
Assistant lecturer of pulmonary and critical care medicine

 O2 conc required by pt
 O2 conc achieved by the delivery device
 Importance of accuracy of device
 Client comfort and client mobility
DELIVERY SYSTEM- SELECTION

Prescription should include
Flow rate
Delivery device
Duration
Instruction for monitoring

O2 Delivery systems
Ambient pressure
– Variable performance devices
– Fixed performance devices
Positive pressure ventilation
– Non invasive (BIPAP, CPAP)
– Invasive

Classification
 Low flow systems
– do not provide constant FIO2
– Part of tidal volume is provided by room
air.
– Ex: nasal cannula, simple mask , rebreather
mask .
 High flow systems
– deliver specific and constant percent of
oxygen .
– Ex: Venturi mask .

Nasal cannula (prongs):
 It is a disposable.
plastic devise with two protruding
prongs for insertion into the nostrils,
connected to an oxygen source.
Used for low-medium concentrations of
Oxygen (25-45%).

Easy to use
Well tolerated
Comfortable for long period
Patient can eat and talk easily.
ADVANTAGES

Dryness of mucosa
Crusting over secretion
 Epistaxis
DISADVANTAGES

Face mask
The simple Oxygen mask
The partial rebreather mask:
The non rebreather mask:
The venturi mask:

The simple Oxygen mask
 Simple mask is made of
clear, flexible , plastic or
rubber that can be molded
to fit the face.
 It is held to the head with
elastic bands.
 Some have a metal clip that
can be bent over the bridge
of the nose for a
comfortable fit.

The simple Oxygen mask
It delivers 35% to 60% oxygen .
A flow rate of 6 to 10 liters per
minute.
Often it is used when an increased
delivery of oxygen is needed for
short periods

DisadvantagesAdvantagesPriority Nursing
Interventions
Amount
Delivered
F1o2
(Fraction
Inspired
Oxygen)
Method
Tight seal required
to deliver higher
concentration
Difficult to keep
mask in position over
nose and mouth
Potential for skin
breakdown (pressure,
moisture)
Wasting
Uncomfortable for pt
while eating or talking
Expensive with nasal
tube
Can
provide
increased
delivery of
oxygen for
short period
of time
Monitor client
frequently to
check
placement of
the mask.
Support client
if
claustrophobia
is concern
Secure
physician's
order to replace
mask with nasal
cannula during
meal time
Low Flow
6-10 Lmin
35%-60%
Simplemask

Is prescribing O2
through face mask
@ 4L/min correct??

The non rebreather mask
 This mask provides the highest
concentration of oxygen (95-
100%) at a flow rate6-15 L/min.
The bag is an oxygen reservoir
 1 L reservoir bag

The non rebreather mask
 When the patient exhales
air. the one-way valve
closes and all of the expired
air is deposited into the
atmosphere, not the
reservoir bag.
 In this way, the patient is
not rebreathing any of the
expired gas.

10 – 15 Ltr/min flow rate – 50-100 O2 conc.

DisadvantagesAdvantagesPriority Nursing
Interventions
Amount
Delivere
d
F1o2
Method
Impractical for
long term Therapy
Malfunction can
cause CO2 buildup
suffocation
Expensive
Feeling of
suffocation
Uncomfortable
Costly
Delivers the
highest possible
oxygen
concentration
Suitable for pt
breathing
spontaneous
with sever
hypoxemia
Maintain flow
rate so reservoir
bag collapses only
slightly during
inspiration
Check that valves
and rubber flaps
are function
properly (open
during expiration )
Monitor SaO2
with pulse oximeter
Low
Flow
6-15 L
min
80%-
100%
Non
rebreatherMASK

Venturi mask
 It is high flow
concentration of oxygen.
Oxygen from 40 - 50%
At liters flow of 4 to 15
L/min.
The mask is so
constructed that there is
a constant flow of room
air blended with a fixed
concentration of oxygen

The venturi mask
 is designed with wide- bore tubing and
various color - coded jet adapters.
 Each color code corresponds to a precise
oxygen concentration and a specific liter
flow.
The venturi system,
 Room air dilutes the oxygen entering the
tubing to a certain concentration
 The amount of air drawn in is determined
by the size of the orifice (jet adapter).

The venturi mask
The narrower the jet adapter,
the greater the air dilution, and the
lower the concentration of oxygen.
 Operate on Bernoulli principle
- As gas flow under pressure at rapid
flow rate an area of pressure develops
lateral to the small opening and lead to
entrainment of room air through the side
port.

COLOUR OF ADAPTER % FIO2
Blue 24
Yellow 26
White 28
Green 30
Pink 35
Orange 40

DisadvantagesAdvantagesPriority
Nursing
Intervention
s
Amount
Delivered
F1o2
Method
Uncomfortable
produce
respiratory
depression in
COPD patient with
high oxygen
concentration 50%
Delivers
most
precise
oxygen
concentrati
on
Doesn’t
dry mucous
membranes
(humidity
Requires
careful
mointoring
to verify
F1O2 at
flow rate
ordered
Check
that air
intake
valves are
not blocked
Oxygen
from 40--
50%
of 4 to 15
L/min.
VenturiMask

Oxygen Therapy
Other devices
 Enclosures
– Tents
– Hoods
– Incubators
 Others
– BVM
– Pulse Dose Cannula
– Concentrators
26

Bag – Valve – Mask assembly
(Ambu Resuscitator)
Delivers O2 during artf. Vent
O2 concentration
– 30 – 50% (without reservoir)
– 80 – 100% (with reservoir)
To deliver 100% O2
– Reservoir – as large as bag vol
– Drawback – keeps rescuer’s hands engaged

(Ambu Resuscitator)
(Ambu Resuscitator)

Device which extract O2 from the
environmental air
Deliver up to 90-95 % O2 at the flow
rate 3-5L/min
OXYGEN CONCENTRATOR

Oxygen delivery systems

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