David Lucas MS, RRT- NPS

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1 David Lucas MS, RRT- NPS At the end of this module, the student should be able to: 1. Calculate the durabon of an E and H cylinder of gas. 2. IdenBfy the proper regulator for a large and small gas cylinder. 3. Recognize the connecbons used for DISS systems. 4. Discuss the oxygen equipment required when using a blender. 5. Determine the different types of oxygen conserving devices, and state why they are used. 6. IdenBfy the relabonship between flow vs. FI0 2 when using an oxygen concentrator. 7. Explain the uses of air compressors. 8. Define point- of- care- tesbng and what it measures. 1

$State the Bme durabon on a fully charged ba\ery for portable oxygen concentrators. 12.$ $State 4 indicabons and 4 concerns regarding the use of incubators (isole\es).$

2 9. Recognize correcbve acbon if the concentrator fails. 10. Calculate the liters of oxygen found per pound of liquid oxygen and its associated Bme durabon. 11. State the Bme durabon on a fully charged ba\ery for portable oxygen concentrators. 12. State 4 indicabons and 4 concerns regarding the use of incubators (isole\es). Gas cylinders Currently under the Dept. of TransportaBon Maximum filling pressure 2015 psi + 15% (2200) DuraBon? Must remember cylinder factor 28.3 L/d 3 X d psi Large H or K: 3.14 Small E:

Solve for durabon: Large H or K: Current cyl psi x factor (3.14) liter flow Ex: 2200 x 3.

3 Solve for durabon: Large H or K: Current cyl psi x factor (3.14) liter flow Ex: 2200 x L/min 6908 = 1151 minutes = 19 hours 60 Solve for durabon: Small E: Current cyl psi x factor (0.28) liter flow Ex: 2200 x L/min 616 = minutes = 1.7 hours or 1 hour and 42 minutes 60 3

$a\aching the regulator Known as cracking the cylinder Clears dust and debris$ $before a\aching a regulator Reducing valves Reduces cylinder pressure (2200$

4 Regulators Large cylinders Hexagonal nut connecbons American Standard Safety System Small cylinders Yoke connecbons Pin Index Safety System Leaks usually stem from replaceable washer Cylinder valve should be opened slowly prior to a\aching the regulator Known as cracking the cylinder Clears dust and debris before a\aching a regulator Reducing valves Reduces cylinder pressure (2200 psi) Safe pressure (50 psi) Preset Adjustable Regulator One reducing valve One flowmeter 4

$A\achment for many pneumabcally$ $devices Quick connectors A\ach$ pneumabc devices to wall outlet

5 50 psi wall connectors Diameter Index Safety System (DISS) A\achment for many pneumabcally powered devices Flowmeters VenBlator hoses Blenders Vacuum devices Quick connectors A\ach pneumabc devices to wall outlet Many different shapes Ohmeda style Puritan style Chemetron style 5

dose) Reservoir cannulas Conserves gas usage Two styles Mustache cannula Holds 20 ml O 2 Heavy and large

6 Air/oxygen blenders Precision metering used to deliver specific FIO 2 Used with high flow devices Non- rebreather Oxyhood Low inlet pressure alarm (<40 psi) O 2 conserving devices (reservoir cannula, pulse dose) Reservoir cannulas Conserves gas usage Two styles Mustache cannula Holds 20 ml O 2 Heavy and large Pendant cannula Holds 40 ml O 2 Can be concealed Illustrations courtesy of Elsevier's Electronic Image Collection

$HumidificaBon not required Ba\ery$ $required without ba\ery Can be pulse$ dosed or conbnuous flow Electrically

7 O 2 conserving devices (pulse dose) Pulse demand O 2 Delivers O 2 on inspirabon 1-5 L/min Off on exhalabon HumidificaBon not required Ba\ery required on some models Double cannula required without ba\ery Can be pulse dosed or conbnuous flow Electrically powered Provides approx. 97% 1-2 L/min FIO 2 falls at higher flowrates Must change filters Photo courtesy of Merck Medicus Flowmeters calibrated <10 psi 7

$Filling from LOX reservoir May be difficult to fill O 2 is vented out when not used 10 20 lbs with ba\ery$ Can be carried over the shoulder or wheeled Max. 3.8 hours @ 2 L/min pulse dosed 2 2.

Can be carried over the shoulder or wheeled Max. 3.8 hours @ 2 L/min pulse dosed 2 2.

8 Lightweight Capable of delivering 8 hrs O 2 at 2 L/min 1 lb LOX = 344 L of O 2 gas ConBnuous O 2 source Filling from LOX reservoir May be difficult to fill O 2 is vented out when not used lbs with ba\ery Can be carried over the shoulder or wheeled Max L/min pulse dosed hours conbnuous 2 L/min Recharge Bme: 4.5 hours AC or DC power source 90 96% purity Photo courtesy of Invacare Corp. 8

50 psi large units Portable Mobility Used when pabent room lacks 50 psi air source Must clean air

turnaround Bme Improves care Decreases costs Hand- held or pole mounted 3 calibrabon solubons Will

9 50 psi large units Portable Mobility Used when pabent room lacks 50 psi air source Must clean air filter regularly Contained in some mechanical venblators Small portable compressors Mainly for powering nebulizers Produces approx. 8 L/min Small air filter changed regularly Point- of- care tesbng (POCT) Lab to pabent Decreases turnaround Bme Improves care Decreases costs Hand- held or pole mounted 3 calibrabon solubons Will not release results if calibrabon is bad Measures ph, PaCO 2, PaO 2, HCO 3, SaO 2, most forms of Hb, Hct, Na+, Cl -, Ca++, K+, lactate, and glucose Photo courtesy of Radiometer Corp. 9

Isolates from infecbon Humidified environment Regulates O 2 concentrabon (Photo

10 Provides a neutral thermal environment (NTE) Isolates from drads Maintains normal core temp No increase in O 2 consumpbon Servo control for skin temp. Isolates from infecbon Humidified environment Regulates O 2 concentrabon (Photo courtesy of DRE, Inc.) Temperature fluctuabons FIO 2 fluctuabons Some limitabon to pabent access Noise concerns 10

Welcome to the Specialized Medical Services Respiratory training webinar series!

Welcome to the Specialized Medical Services Respiratory training webinar series! SMS is your Long Term Care (LTC) facility single source for oxygen, medical equipment, respiratory care services and supplies