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TOPIC: BASIC CONCEPTS OF OXYGENATION
(Care of Client with Problem in Oxygenation - NCM112)
When assessing a patient’s oxygenation status, it is important for the nurse to have an understanding of the underlying structures of the respiratory system to best understand their assessment findings.
Respiratory System Anatomy & Physiology
Respiratory System Anatomy & Physiology
The main function of our respiratory system is to provide the body with a constant supply of oxygen and to remove carbon dioxide. To achieve these functions, muscles and structures of the thorax create the mechanical movement of air into and out of the lungs called ventilation. Respiration includes ventilation and gas exchange at the alveolar level where blood is oxygenated and carbon dioxide is removed. When completing a respiratory assessment, it is important for the nurse to understand the external and internal structures involved with respiration and ventilation.
Mechanisms of Breathing
Mechanisms of Breathing
Breathing or Pulmonary Ventilation
Inspiration
Expiration
External Respiration
Transport of Oxygen to Tissues
Internal Respiration
Transport of Carbon Dioxide from tissue to lungs
Transport of Carbon Dioxide in the Blood
Transport of Carbon Dioxide in the Blood
When the red blood cells reach tissues that need oxygen, the oxygen is released from the haemoglobin and diffuses into the cells where it is used to make energy. At the same time, red blood cells will pick up waste carbon dioxide that has been released from the cells and entered the blood stream. Red blood cells carrying less oxygen are a duller red colour, which is why deoxygenated blood in our veins is a darker red than oxygenated.
Red blood cells then travel within veins back to the right side of the heart. From the heart the blood is pumped back to the lungs where the carbon dioxide is released from the blood into the air sacs to be breathed out. Air is breathed in, oxygen is picked up by the blood and the journey begins again.
Assessing Oxygenation Status
Assessing Oxygenation Status
An arterial blood gas analysis (ABG) measures the balance of oxygen and carbon dioxide in your blood to see how well your lungs are working. Arterial blood gas tests can help healthcare providers interpret conditions that affect a patient's respiratory system, circulatory system and metabolic processes (how the body transforms the food they eat into energy), especially in emergency situations.
Oxygenation Equipments
Oxygenation Equipments
Pulse Oximeter
measures the oxygen saturation of hemoglobin in a patient’s red blood cells, referred to as SpO2.
Oxygen Flow meter -
used to control oxygen flow delivery in patients undergoing oxygen therapy.
Portable Oxygen Supply Devices
used to provide oxygen therapy to people that require greater oxygen concentrations than the levels of ambient air.
Nasal Cannula
simplest oxygenation device and consists of oxygen tubing connected to two short prongs that are inserted into the patient’s nares.
High flow Nasal Cannula
Low flow Nasal Cannula
Simple Face Mask
usually used to deliver a low to moderate amount of oxygen. A simple mask contains holes on the sides to let exhaled air through and to prevent suffocation in case of a blockage.
Non-rebreather Mask
a special medical device that helps provide you with oxygen in emergencies. These masks help people who can still breathe on their own but need a lot of extra oxygen. A non-rebreather mask has a face mask that is connected to a reservoir bag that is filled with a high concentration of oxygen.
Partial Rebreather Mask
it is for people who have difficulty breathing or are not able to get enough oxygen on their own. It has a two-way valve present between the reservoir bag and mask.
Venturi Mask
an air-entrainment mask, is a medical device to deliver a known oxygen concentration to patients on controlled oxygen therapy.
Continuous Positive Airway Pressure (CPAP)
used for people who are able to breathe spontaneously on their own but need help in keeping their airway unobstructed, such as those with obstructive sleep apnea.
Bilevel Positive Airway Pressure (BiPAP)
similar to a CPAP device in that it is used to prevent airways from collapsing, but BiPAP devices have two pressure settings. One setting occurs during inhalation and a lower pressure setting is used during exhalation.
Bag Valve Mask (Ambu Bag)
handheld device used in emergency situations for patients who are not breathing (respiratory arrest) or who are not breathing adequately (respiratory failure).
Endotracheal Intubation
to maintain a secure airway. When a patient is receiving general anesthesia prior to a procedure or surgery or is experiencing respiratory failure or respiratory arrest.
Mechanical Ventilator
a machine attached to an endotracheal tube to assist or replace spontaneous breathing. Mechanical ventilation is termed invasive because it requires placement of a device inside the trachea through the mouth, such as an endotracheal tube.
Flow rates and oxygen percentages
Flow rates and oxygen percentages
REFERENCES/SUPPLEMENTAL MATERIALS
REFERENCES/SUPPLEMENTAL MATERIALS
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