03 Hazards of Oxygen Therapy

8/9/2019 03 Hazards of Oxygen Therapy

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Hazards of Oxygen Therapy

First year Respiratory Therapy

MJC 220


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Oxygen Therapy

The RCP is the primary member of the

healthcare team responsible for oxygen

administration.

RCP must be well-versed in its goals and

objectives


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Oxygen is a DRUG

Must be considered as a drug

TOO MUCH of a drug can cause overdosing

problems

TOO LITTLE isnt enough to treat the symptoms


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Goals of Oxygen Therapy

Correct hypoxemia

Decrease symptoms associated with

hypoxemia Decrease workload on cardiopulmonary

system


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Indications for Oxygen

Documented hypoxemia

PaO2 less than 60 torr or SaO2 less than 90% in

adults and infants older than 28 days while

breathing room air

Acute care situation where hypoxemia is

suspected

Severe trauma Acute myocardial infarction

Short term therapy i.e. Post-op anesthesia


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Monitoring the Patient

Clinical assessment including but not limited

to cardiac, pulmonary, and neurological

status

Assessment of physiologic parameters:

measurement of oxygen tensions or

saturation in any patient treated with oxygen


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Clinical Signs of Hypoxia

Respiratory

Increased respiratory rate (Tachypnea), dyspnea, cyanosis,

acc muscle use

Cardiac Increased heart rate (Tachycardia), hypertension

Neurological

Confusion or panic

Cyanosis Diaphoresis

Somnolence, confusion, blurred vision, loss of coordination,

impaired judgment


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Long Term Sign

Clubbing


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Precautions of Supplemental

Oxygen

1. Oxygen toxicity

2. Depression of ventilation

3. Retinopathy of Prematurity4. Absorption atelectasis

5. Bacterial infection with humidifiers


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Oxygen Toxicity

Patients exposed to high oxygen levels for a

prolonged period of time have lung damage.

First damage is capillary epithelium, leading to

edema, thickened membranes and finally to

pulmonary fibrosis and hypertension.


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A Vicious Cycle


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Depression of Ventilation

COPD patients with CO2 retention have

blunted stimuli to breathing

Hypoxic drive theory

They have a different stimulus to breathe then normal

GOLDEN RULE: You should never stop

giving oxygen to a patient in need.


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Retinopathy of Prematurity

Is an abnormal eye condition in some

premature infants who receive high FIO2s

Retinal arteries hemorrhage and scaring cause

retinal detachment and blindness.


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Absorption Atelectasis

The alveoli in the lungs collapse and cause

shunting in the capillary lung fields.

Loss of nitrogen in the blood causes less total

venous pressure. This leads to the collapse of of

the alveolus.


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Pressure gradients that cause

absorption atelectasis


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Infection Control

Therapist must use an aseptic technique

when handling supplemental oxygen and

humidity equipment

Never drain water from the tubing back into the

heated humidifier

Always date the opened container

Only use sterile liquids in reservoirs


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Oxygen: a fire hazard

NEVER smoke while using supplemental

oxygen

Severe facial burns can and do happen


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Clinical Guidelines

Consider Oxygen as a drug

Use the lowest FIO2 .

Use it for the shortest possible time

Keep oxygen below 50% if

If you have to - accept lower saturations thannormal in some situations

Check equipment regularly for contaminants


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Thats all folks!

Any questions?


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Typical Question

Administration of high oxygen concentrations toa neonate for prolonged periods of time mayresult in which of the following:

Atelectasis CO2 retention

Retinopathy of Prematurity

Pneumothorax


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Another?

Typically, which are the precautions ofadministering oxygen to patients in thehospital EXCEPT:

Retinopathy of Prematurity Oxygen narcosis

Absorption atelectasis

Depression of ventilation

03 Hazards of Oxygen Therapy

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