Question

. Define the following oxygen delivery methods and identify advantages and disadvantages.

Method of delivery	Advantages	Disadvantages
Nasal cannula	A nasal cannula is a simple, comfortable device u ed for oxygen delivery (Skill 40-4). The two cannulas, about 1.5 cm (0.5 inch) long, protrude from the center of a disposable tube, and are inserted into the nares.
Venturi mask	The Venturi mask delivers oxygen concentration of 24% to 60% with oxygen flow rates of 4 to 12 L/min, depending on the flow- control meter selected.
Face mask	An oxygen face mask is a device used to administer oxygen, humidity, or heated humidity. It fits snugly over the mouth and nose and is secured in place with a strap. It assists in providing humidified oxygen.
Non-rebreather mask

18. What are the ABCs of CPR? Briefly provide an explanation for each.

A	Airway
B	Breathing
C	Chest compression

19. How does the following improve ventilation and oxygenation?

Premature atrial contractions

Coughing
Respiratory muscle training

Answer 1

17. The different oxygen delivery methods and it's advantages and disadvantages :-

1. Nasal cannula :-

FiO2 delivered: 1 L/min: 24%; 2 L/min: 28% (continue to go to 6 L/min: 44%. Add 4% per level).

Advantages: safe and simple, easily tolerated, good for long-term use, doesn't interfere with mouth functions such as eating or talking, delivers low concentrations with allowing patient to eat.

Disadvantages: easily dislodged, can't use with nasal obstruction, dries mucous membranes, can cause irritation or breakdown, and patient breathing pattern will affect exact FiO2

2. Face mask :-

FiO2 delivered: 5-6 L/min: 40%; 6-7 L/min: 50%; 7-8 L/min: 60%

Advantages: Help to provide humidified O2

Disadvantages: Exact FiO2 difficult to estimate, requires high FiO2 levels to prevent rebreathing of CO2, patient breathing pattern will affect exact FiO2

3. Venturi mask

FiO2 delivered: 4 L/min: 24%-28%; 8 L/min: 35%-40%; 12 L/min: 50%-60%

Advantages: Controls amount of specified oxygen concentration, delivers percentages of FiO2 from 24%-60%,, doesn't dry mucous membranes and delivers humidity with oxygen concentration

Disadvantages: Hot and confining; increased humidification levels can irritate skin, specific flow rate necessary to deliver specific FiO2, and is decreased if mask doesn't fit, and interferes with eating and drinking

4. Non -rebreather mask :-

FiO2 delivered: 15 L/min: 60-90%

Advantages: Valve closes during expiration, so exhaled air doesn't enter reservoir and mix with inhaled air

Disadvantages: requires tight seal; difficult to maintain and uncomfortable; can irritate skin, and bag should not totally deflate

18. ABC 's of CPR :-

A- Airway ( opening the airway using head tilt chin life manuever for patients without spinal injury and jaw thrust method for spinal injury patients )

B- Breathing ( look ,listen and feel for breathing )

C- Circulation ( chest compression to support circulation in those who are non responsive without meaningful breaths )

Steps of CPR :-

STEP 1:

Determine unresponsiveness: Tap the patient's shoulder and shout: "Are you okay, are you okay?" Speak loudly and clearly.

STEP 2:

Activate EMS/obtain the AED: Direct someone to call 911 and get the AED. (For an adult victim, phone first: for a child phone after one minute of CPR.) If you witness a child going unconscious, activate EMS, then begin CPR if necessary.

STEP 3:

Open the airway: use the head-tilt/chin-lift maneuver. Place one hand on the forehead, the other under the chin. The mouth should not be completely closed.

STEP 5:

Provide two full breaths (each breath should take one second): Put mouth over patient's mouth and pinch the nostrils. Use a pocket mask if available. If the chest does not rise, re-position the airway and try again. If the patient has a loose denture, remove it. If the denture fits, leave it in, because it will help with the mouth-to-mouth seal.

STEP 6:

Check the pulse: Place two to three fingers on windpipe (Adam's apple) and slide fingers into the groove on the side of the neck nearest you. Check the carotid artery for 5 to 10 seconds along with signs of circulation/movement.

STEP 7:

If no pulse, begin chest compressions: Deliver chest compressions in less than 23 seconds. Using the heel of one hand with the other hand clasped on top, place the hands on the lower half of the sternum. Push hard and fast. Allow the chest to return to normal between compressions.

STEP 8:

Continue the compression-to-ventilation ratio of 30:2 until the emergency crew arrives. After three cycles; check the pulse and reassess.

STEP 9:

Document the emergency information and procedures in the patient's dental health record.