The Safe Use and Prescription of Medical Oxygen. Luke Howard
|
|
- Brice Bradley
- 6 years ago
- Views:
Transcription
1 The Safe Use and Prescription of Medical Oxygen Luke Howard Consultant Respiratory Physician Imperial College Healthcare NHS Trust & Co-Chair, British Thoracic Society Emergency Oxygen Guideline Group Workshop 2012 Oxygen Safety 1
2 Oxygen physiology Topics to be covered How is oxygen delivered and utilised How is carbon dioxide cleared How can oxygen delivery be optimised Dangers of oxygen BTS Guidelines Monitoring Delivery Workshop 2012 Oxygen Safety 2
3 The Oxygen Cascade Workshop 2012 Oxygen Safety 3
4 The Oxygen Cascade Workshop 2012 Oxygen Safety 4
5 O 2 O 2 The Oxygen Cascade O 2 O 2 ATP Workshop 2012 Oxygen Safety 5
6 Gas exchange O 2 What can change? FiO 2 O 2 Oxygen utilisation ATP Oxygen carrying & buffering capacity Flow Workshop 2012 Oxygen Safety 6
7 Oxygen Delivery DO 2 = Q x {[SaO 2 /100 x Hb x 1.3] + [PaO 2 x x 10]} Stagnant Hypoxia Hypoxaemic Hypoxia Anaemic Hypoxia Cytopathic Hypoxia Workshop 2012 Oxygen Safety 7
8 Resting oxygen consumption remains constant until PaO 2 falls below 23 mmhg (~3kPa) Anesthesiology 2001;95:A1123 Cardiac output O 2 extraction Workshop 2012 Oxygen Safety 8
9 14 7 Increased metabolic demand VO 2 (ml/kg/min) Impaired cardiac reserve Anaemia Tissue oedema Mitochondrial dysfunction O O PaO 2 (mmhg) 100 Workshop 2012 Oxygen Safety 9
10 The Oxygen Cascade Workshop 2012 Oxygen Safety 10
11 Dangers of Oxygen Therapy Workshop 2012 Oxygen Safety 11
12 Hypoxic Pulmonary Vasoconstriction Reduces the impact of low VQ units Workshop 2012 Oxygen Safety 12
13 Impaired respiratory mechanics, eg, eg, COPD Alveolar hypoventilation Hypercapnia Acidosis Coma Workshop 2012 Oxygen Safety 13
14 Ventilation-perfusion matching and oxygen administration Diverts blood flow away from diseased lung Uses low oxygen levels in diseased lung to signal to divert blood away Administering oxygen masks this signal Diseased lung is less efficient at clearing carbon dioxide When respiratory mechanics are impaired, eg COPD, this inefficiency cannot be compensated for by increasing overall ventilation and carbon dioxide retention occurs Workshop 2012 Oxygen Safety 14
15 Plant et al., Thorax % of 982 patients with exacerbation of COPD were hypercapnic on arrival in hospital 20% had Respiratory Acidosis (ph < 7.35) 5% had ph < 7.25 (and were likely to need ICU care) Workshop 2012 Oxygen Safety 15
16 Risk of Oxygenation in COPD < > 13.3 Increased risk of intubation Plant et al., Thorax 2000, 55: Workshop 2012 Oxygen Safety 16
17 Workshop 2012 Oxygen Safety 17
18 Randomised Controlled Trial of Titrated vs High-Flow Oxygen Pre-hospital setting Tasmania 405 patients with presumed exacerbation of COPD Titrated arm: Nasal prongs to achieve SpO % High-Flow arm: 8-10 l/min non-rebreathing mask Austin et al., BMJ 2010 Workshop 2012 Oxygen Safety 18
19 Results Workshop 2012 Oxygen Safety 19
20 Danger 2: Alveolar Gas Equation and Rebound Hypoxia PAO 2 = PIO 2 PaCO 2 /RER PAO 2 = (100 - PIN 2 ) PaCO 2 /RER Case study: COPD exacerbation at home - on air Seen by ambulance crew given high flow oxygen Brought to ER oxygen removed Workshop 2012 Oxygen Safety 20
21 Rebound Hypoxia PaO kpa PaCO kpa Workshop 2012 Oxygen Safety 21
22 Rebound Hypoxia PaO 2 32 kpa PaCO 2 10 kpa Workshop 2012 Oxygen Safety 22
23 Rebound Hypoxia PaO kpa PaCO 2 10 kpa Workshop 2012 Oxygen Safety 23
24 Oxygen Delivery DO 2 = Q x {[SaO 2 /100 x Hb x 1.3] + [PaO 2 x x 10]} Stagnant Hypoxia Hypoxaemic Hypoxia Anaemic Hypoxia Cytopathic Hypoxia Workshop 2012 Oxygen Safety 24
25 DO 2 = Q x {[SaO 2 /100 x Hb x 1.3] + [PaO 2 x x 10]} High flow oxygen: Decreased cardiac output Decreased coronary flow (~20%) Increased systemic vascular resistance Circulatory effects of of decreasing oxygen?? Workshop 2012 Oxygen Safety 25
26 PaO 2 13 kpa PvO 2 6 kpa Capillary PmtO kpa Workshop 2012 Oxygen Safety 26
27 Dangers 3,4,5...: High-Flow Oxygen? Coronary vasoconstriction ( flow by <23%) Increased Systemic Vascular Resistance Reduced Cardiac Index Possible reperfusion injury post MI and mildmoderate stroke Hypoxic lung injury Harten JM et al J Cardiothoracic Vasc Anaesth 2005; 19: Kaneda T et al. Jpn Circ J 2001; Frobert O et al. Cardiovasc Ultrasound 2004; 2: 22 Haque WA et al. J Am Coll Cardiol 1996; 2: Thomaon aj ET AL. BMJ 2002; Ronning OM et al. Stroke 1999; 30 McNulty, PH et al. JAP 2007; 102; Workshop 2012 Oxygen Safety 27
28 Retrospective analysis of ICU mortality 36,307 patients in 50 Dutch ICUs De Jonge et al., Crit Care 2008 Workshop 2012 Oxygen Safety 28
29 J-shaped Relationship in PaO 2 /FiO 2 vs Standardised Mortality Workshop 2012 Oxygen Safety 29
30 Danger 6: High-Flow Oxygen Delays Diagnosis of Deterioration Trigger FiO SpO 2 FiO Time Workshop 2012 Oxygen Safety 30
31 BTS Guidelines Workshop 2012 Oxygen Safety 31
32 How to Approach the Patient on 100% Oxygen in hypercapnic failure Patient conscious: Change to 35% Venturi Device Patient drowsy: Leave the patient on high-flow oxygen then, Start NIV with Oxygen / call ICU Workshop 2012 Oxygen Safety 32
33 Step up and down through oxygen delivery devices To avoid rebound hypoxia In case of higher respiratory rates/flows Workshop 2012 Oxygen Safety 33
34 Step up and down through oxygen delivery devices Pre-hospital Workshop 2012 Oxygen Safety 34
35 Step up and down through oxygen delivery devices Once stable Workshop 2012 Oxygen Safety 35
36 Oxygen prescription Model for oxygen section in hospital prescription charts cal Workshop 2012 Oxygen Safety 36
37 Workshop 2012 Oxygen Safety 37
OXYGEN THERAPY. Catherine Jones June 2017
OXYGEN THERAPY Catherine Jones June 2017 1 ACKNOWLEDGEMENT 2 LEARNING OUTCOMES To revise why Oxygen is important To identify the indications for Oxygen Therapy To identify problems with administration
More informationRodney Shandukani 14/03/2012
Rodney Shandukani 14/03/2012 OXYGEN THERAPY Aerobic metabolism accounts for 90% of Oxygen consumption by tissues. generates ATP by oxidative phosphorylation. Oxygen cascade: Oxygen exerts a partial pressure,
More informationPICU Resident Self-Study Tutorial The Basic Physics of Oxygen Transport. I was told that there would be no math!
Physiology of Oxygen Transport PICU Resident Self-Study Tutorial I was told that there would be no math! INTRODUCTION Christopher Carroll, MD Although cells rely on oxygen for aerobic metabolism and viability,
More informationThe effect of a hospital oxygen therapy guideline on the prescription of oxygen therapy
The effect of a hospital oxygen therapy guideline on the prescription of oxygen therapy Rachelle Asciak, Caroline Gouder, Maria Ciantar, Julia Tua, Valerie Anne Fenech, Stephen Montefort Abstract Aim:
More informationClinical Skills. Administering Oxygen
Clinical Skills Administering Oxygen Updated July 2017 Clare Cann Original 2012 Carole Loveridge, Lecturer in Women`s Health Aims and Objectives Aims and Objectives The aim of this module is to facilitate
More informationCHAPTER 6. Oxygen Transport. Copyright 2008 Thomson Delmar Learning
CHAPTER 6 Oxygen Transport Normal Blood Gas Value Ranges Table 6-1 OXYGEN TRANSPORT Oxygen Dissolved in the Blood Plasma Dissolve means that the gas maintains its precise molecular structure About.003
More information- How do the carotid bodies sense arterial blood gases? o The carotid bodies weigh 25mg, yet they have their own artery. This means that they have
- How do the carotid bodies sense arterial blood gases? o The carotid bodies weigh 25mg, yet they have their own artery. This means that they have the highest blood flow of all organs, which makes them
More informationRespiratory Signs: Tachypnea (RR>30/min), Desaturation, Shallow breathing, Use of accessory muscles Breathing sound: Wheezing, Rhonchi, Crepitation.
Respiratory Signs: Tachypnea (RR>30/min), Desaturation, Shallow breathing, Use of accessory muscles Breathing sound: Wheezing, Rhonchi, Crepitation. Paradoxical breathing Hyper-resonance on percussion:
More informationOXYGEN FOR ADULTS IN ACUTE CARE
PATIENT GROUP DIRECTION FOR THE ADMINISTRATION OF OXYGEN FOR ADULTS IN ACUTE CARE ALL CLINICAL DIVISIONS ADULT CARE STATEMENT The staff indicated in Staff Group may administer oxygen in the two detailed
More informationEAST CHESHIRE NHS TRUST OXYGEN POLICY. (Adult)
EAST CHESHIRE NHS TRUST OXYGEN POLICY (Adult) Chairman: Lynn McGill Chief Executive: John Wilbraham Policy Title: OXYGEN POLICY Executive Summary: THIS POLICY SETS OUT THE GUIDELINES FOR PRESCRIBING, ADMINISTRATION
More informationUNIQUE CHARACTERISTICS OF THE PULMONARY CIRCULATION THE PULMONARY CIRCULATION MUST, AT ALL TIMES, ACCEPT THE ENTIRE CARDIAC OUTPUT
UNIQUE CHARACTERISTICS OF THE PULMONARY CIRCULATION THE PULMONARY CIRCULATION MUST, AT ALL TIMES, ACCEPT THE ENTIRE CARDIAC OUTPUT UNIQUE CHARACTERISTICS OF THE PULMONARY CIRCULATION THE PULMONARY CIRCULATION
More informationOXYGEN PHYSIOLOGY AND PULSE OXIMETRY
Louis Al-Saleem 5/4/13 OXYGEN PHYSIOLOGY AND PULSE OXIMETRY A very experienced senior resuscitation nurse approached me at work recently, and asked if there was any circulating academic evidence about
More informationOXYGEN THERAPY. (Non-invasive O2 therapy in patient >8yrs)
OXYGEN THERAPY (Non-invasive O2 therapy in patient >8yrs) Learning aims Indications and precautions for O2 therapy Targets of therapy Standard notation O2 delivery devices Taps, tanks and tubing Notation
More informationVENTILATION AND PERFUSION IN HEALTH AND DISEASE. Dr.HARIPRASAD VS
VENTILATION AND PERFUSION IN HEALTH AND DISEASE Dr.HARIPRASAD VS Ventilation Total ventilation - total rate of air flow in and out of the lung during normal tidal breathing. Alveolar ventilation -represents
More informationRESPIRATORY PHYSIOLOGY. Anaesthesiology Block 18 (GNK 586) Prof Pierre Fourie
RESPIRATORY PHYSIOLOGY Anaesthesiology Block 18 (GNK 586) Prof Pierre Fourie Outline Ventilation Diffusion Perfusion Ventilation-Perfusion relationship Work of breathing Control of Ventilation 2 This image
More informationRespiration (revised 2006) Pulmonary Mechanics
Respiration (revised 2006) Pulmonary Mechanics PUL 1. Diagram how pleural pressure, alveolar pressure, airflow, and lung volume change during a normal quiet breathing cycle. Identify on the figure the
More informationCapnography in the Veterinary Technician Toolbox. Katie Pinner BS, LVT Bush Advanced Veterinary Imaging Richmond, VA
Capnography in the Veterinary Technician Toolbox Katie Pinner BS, LVT Bush Advanced Veterinary Imaging Richmond, VA What are Respiration and Ventilation? Respiration includes all those chemical and physical
More informationFysiologie van de ademhaling - gasuitwisseling
What you will learn in this lecture... Lessenreeks co s 014-015 Fysiologie van de ademhaling - gasuitwisseling Professor Dr. Steffen Rex Department of Anesthesiology University Hospitals Leuven Department
More informationChapter 4: Ventilation Test Bank MULTIPLE CHOICE
Instant download and all chapters Test Bank Respiratory Care Anatomy and Physiology Foundations for Clinical Practice 3rd Edition Will Beachey https://testbanklab.com/download/test-bank-respiratory-care-anatomy-physiologyfoundations-clinical-practice-3rd-edition-will-beachey/
More informationBlood gas adventures at various altitudes. Friedrich Luft Experimental and Clinical Research Center, Berlin-Buch
Blood gas adventures at various altitudes Friedrich Luft Experimental and Clinical Research Center, Berlin-Buch Mount Everest 8848 M Any point in bird watching here? Respiration is gas exchange: the process
More informationAccumulation of EEV Barotrauma Affect hemodynamic Hypoxemia Hypercapnia Increase WOB Unable to trigger MV
Complicated cases during mechanical ventilation Pongdhep Theerawit M.D. Pulmonary and Critical Care Division Ramathibodi Hospital Case I Presentation Male COPD 50 YO, respiratory failure, on mechanical
More informationIndications for Mechanical Ventilation. Mechanical Ventilation. Indications for Mechanical Ventilation. Modes. Modes: Volume cycled
Mechanical Ventilation Eric A. Libré, MD VCU School of Medicine Inova Fairfax Hospital and VHC Indications for Mechanical Ventilation Inadequate ventilatory effort Rising pco2 with resp acidosis (7.25)
More informationMechanical Ventilation
PROCEDURE - Page 1 of 5 Purpose Scope Physician's Order Indications Procedure Mechanical Artificial Ventilation refers to any methods to deliver volumes of gas into a patient's lungs over an extended period
More informationPulmonary Circulation Linda Costanzo Ph.D.
Pulmonary Circulation Linda Costanzo Ph.D. OBJECTIVES: After studying this lecture, the student should understand: 1. The differences between pressures in the pulmonary and systemic circulations. 2. How
More informationRespiratory physiology II.
Respiratory physiology II. Learning objectives: 29. Pulmonary gas exchange. 30. Oxygen transport in the blood. 31. Carbon-dioxide transport in the blood. 1 Pulmonary gas exchange The transport mechanism
More informationDeborah Dewaay MD Division of General Internal Medicine and Geriatrics Hospital Medicine Acknowledgment: Antine Stenbit MD
Deborah Dewaay MD Division of General Internal Medicine and Geriatrics Hospital Medicine 2013 Acknowledgment: Antine Stenbit MD Objectives Knowledge: Understand the difference between hypoxia and hypoxemia
More informationVienna, Austria May 2005 MONITORING GAS EXCHANGE: FROM THEORY TO CLINICAL APPLICATION
EUROANESTHESIA 2005 Vienna, Austria 28-31 May 2005 MONITORING GAS EXCHANGE: FROM THEORY TO CLINICAL APPLICATION 5RC2 OLA STENQVIST Department of Anaesthesia and Intensive Care Sahlgrenska University Hospital
More information660 mm Hg (normal, 100 mm Hg, room air) Paco, (arterial Pc02) 36 mm Hg (normal, 40 mm Hg) % saturation 50% (normal, 95%-100%)
148 PHYSIOLOGY CASES AND PROBLEMS Case 26 Carbon Monoxide Poisoning Herman Neiswander is a 65-year-old retired landscape architect in northern Wisconsin. One cold January morning, he decided to warm his
More informationTable of Contents. By Adam Hollingworth
By Adam Hollingworth Table of Contents Oxygen Cascade... 2 Diffusion... 2 Laws of Diffusion... 2 Diffusion & Perfusion Limitations... 3 Oxygen Uptake Along Pulmon Capillary... 4 Measurement of Diffusing
More informationEssential Skills Course Acute Care Module. Respiratory Day 2 (Arterial Blood Gases) Pre course Workbook
Essential Skills Course Acute Care Module Respiratory Day 2 (Arterial Blood Gases) Pre course Workbook Acknowledgements This pre course workbook has been complied and updated with reference to the original
More informationPHTY 300 Wk 1 Lectures
PHTY 300 Wk 1 Lectures Arterial Blood Gas Components The test provides information on - Acid base balance - Oxygenation - Hemoglobin levels - Electrolyte blood glucose, lactate, renal function When initially
More informationRevisiting respiratory failure
Clinical corner Revisiting respiratory failure by Richard D. Pinson, MD, FACP, CCS The diagnosis and documentation of respiratory failure continues to be challenging for coders, documentation specialists,
More informationOXYGEN DELIVERY DEVICES. MD SEMINAR Dr Hemanth C Internal Medicine
OXYGEN DELIVERY DEVICES MD SEMINAR Dr Hemanth C Internal Medicine INTRODUCTION Tissue oxygenation Assessment of tissue hypoxia Indications for oxygen therapy Techniques of oxygen administration - Oxygen
More informationIrish Guidelines on the Administration of Oxygen Therapy in the Acute Clinical Setting in Adults 2017
Irish Guidelines on the Administration of Oxygen Therapy in the Acute Clinical Setting in Adults 2017 The Acute Oxygen Guideline Working Group wishes thanks the following organisations for their submissions
More informationOffice. Hypoxia. Or this. Or even this. Hypoxia E-1. COL Brian W. Smalley DO, MSPH, CPE
Hypoxia Office COL Brian W. Smalley DO, MSPH, CPE Or this Or even this Hypoxia State of oxygen deficiency in the blood cells and tissues sufficient to cause impairment of function 4 Types Hypoxic Hypemic
More informationI Physical Principles of Gas Exchange
Respiratory Gases Exchange Dr Badri Paudel, M.D. 2 I Physical Principles of Gas Exchange 3 Partial pressure The pressure exerted by each type of gas in a mixture Diffusion of gases through liquids Concentration
More informationObjectives. Respiratory Failure : Challenging Cases in Mechanical Ventilation. EM Knows Respiratory Failure!
Respiratory Failure : Challenging Cases in Mechanical Ventilation Peter DeBlieux, MD, FAAEM, FACEP LSUHSC University Hospital Pulmonary and Critical Care Medicine Emergency Medicine pdebli@lsuhsc.edu Objectives
More informationAverage Volume Assured Pressure Support
Ventilation Average Volume Assured Pressure Support How to reach us www.philips.com/healthcare healthcare@philips.com Asia +49 7031 463 2254 Europe, Middle East, Africa +49 7031 463 2254 Latin America
More informationQUESTIONNAIRE FOR MEMBERS OF THE PUBLIC
MAHSC Oxygen Project. Questionnaires for members of the public V1 10-12-2011 QUESTIONNAIRE FOR MEMBERS OF THE PUBLIC We would like to know what you think about oxygen therapy as a member of the public.
More informationHIGH FLOW NASAL THERAPY CLINICAL GUIDELINE GUIDELINE HIGH FLOW OXYGEN THERAPY VIA AIRVO TITLE HIGH FLOW OXYGEN THERAPY VIA AIRVO
GUIDELINE Document No: HIGH FLOW OXYGEN THERAPY VIA AIRVO *All Sites TITLE HIGH FLOW OXYGEN THERAPY VIA AIRVO Version: V.1 Approved by:.sub Group Date: Author/lead responsible for guideline: IG Date issued:
More informationAurora Health Care EMS Continuing Education 3rd Quarter 2014 Packet
Aurora Health Care EMS Continuing Education 3rd Quarter 2014 Packet There remains confusion among healthcare providers about oxygen administration. For many years EMS providers were taught to provide high
More informationROUTINE PREOXYGENATION
EDITORIAL ROUTINE PREOXYGENATION It is a fact of great clinical importance that the body oxygen stores are so small, and if replenishment ceases, they are normally insufficient to sustain life for more
More informationRESPIRATORY REGULATION DURING EXERCISE
RESPIRATORY REGULATION DURING EXERCISE Respiration Respiration delivery of oxygen to and removal of carbon dioxide from the tissue External respiration ventilation and exchange of gases in the lung Internal
More informationAll Programs. CROSS REFERENCE: Initiation, Titration and Discontinuation of Oxygen Therapy for Adult Patients Medical Directive
1 All Programs SUBJECT: Oxygen Standard of Care for the Adult Patient ISSUING BODY: Nursing Practice Council, Respiratory Therapy Services, Physiotherapy Practice Council and Occupational Therapy Practice
More informationRespiratory Medicine. A-A Gradient & Alveolar Gas Equation Laboratory Diagnostics. Alveolar Gas Equation. See online here
Respiratory Medicine A-A Gradient & Alveolar Gas Equation Laboratory Diagnostics See online here Alveolar gas equation helps to calculate the partial pressure of oxygen in alveoli and A-a gradient is the
More informationSome major points on the Effects of Hypoxia
Some major points on the Effects of Hypoxia Source: Kings College London http://www.kcl.ac.uk/teares/gktvc/vc/dental/year1/lectures/rbmsmajorpoints/effectsofhypoxia.htm Cells obtain their energy from oxygen.
More informationBlood Gas Interpretation
Blood Gas Interpretation Pa O2 Saturation (SaO 2 ) Oxygen Therapy Monitoring Oxygen content (O( 2 Ct) Venous Oximetry Mixed venous oxygen saturation SvO 2 Surrogate for Systemic oxygen delivery and
More information4. For external respiration to occur effectively, you need three parameters. They are:
Self Assessment Module D Name: ANSWER KEY 1. Hypoxia should be assumed whenever the PaO 2 is below 45 mm Hg. 2. Name some clinical conditions that will result in hyperventilation (respiratory alkalosis).
More informationPolicy for the Prescription, Administration and Monitoring of Oxygen in Adults. v3.0
Policy for the Prescription, Administration and Monitoring of Oxygen in Adults v3.0 April 2017 Summary ACTION Except in an emergency All patients requiring oxygen therapy will have a prescription for oxygen
More informationMonitoring, Ventilation & Capnography
Why do we need to monitor? Monitoring, Ventilation & Capnography Keith Simpson BVSc MRCVS MIET(Electronics) Torquay, Devon. Under anaesthesia animals no longer have the ability to adequately control their
More informationModule Two. Objectives: Objectives cont. Objectives cont. Objectives cont.
Transition to the New National EMS Education Standards: EMT-B B to EMT Module Two Objectives: Upon completion, each participant will do the following to a degree of accuracy that meets the Ntl EMS Education
More informationPROBLEM SET 9. SOLUTIONS April 23, 2004
Harvard-MIT Division of Health Sciences and Technology HST.542J: Quantitative Physiology: Organ Transport Systems Instructors: Roger Mark and Jose Venegas MASSACHUSETTS INSTITUTE OF TECHNOLOGY Departments
More informationThe Physiologic Basis of DLCO testing. Brian Graham Division of Respirology, Critical Care and Sleep Medicine University of Saskatchewan
The Physiologic Basis of DLCO testing Brian Graham Division of Respirology, Critical Care and Sleep Medicine University of Saskatchewan Objectives Review gas transport from inhaled gas to the rest of the
More informationCOALINGA STATE HOSPITAL NURSING POLICY AND PROCEDURE MANUAL SECTION - Medications POLICY NUMBER: 512. Effective Date: August 31, 2006
SUBJECT: OXYGEN (O 2 ) THERAPY COALINGA STATE HOSPITAL NURSING POLICY AND PROCEDURE MANUAL SECTION - Medications POLICY NUMBER: 512 Effective Date: August 31, 2006 1. GENERAL CONSIDERATIONS A. Individuals
More informationInitiation and Management of Airway Pressure Release Ventilation (APRV)
Initiation and Management of Airway Pressure Release Ventilation (APRV) Eric Kriner RRT Pulmonary Critical Care Clinical Specialist Pulmonary Services Department Medstar Washington Hospital Center Disclosures
More informationOxygen Policy. (Prescribing & Administration of Oxygen to Adults in Hospital Policy)
Document Control Title (Prescribing & Administration of Oxygen to Adults in Hospital Policy) Author Directorate Division of Medicine, A&E and Comm. Hospitals Version Date Issued Status 0.1 June Draft 2010
More informationGENETIC INFLUENCE ON FACTORS OF OXYGEN TRANSPORT
GENETIC INFLUENCE ON FACTORS OF OXYGEN TRANSPORT Claudio Marconi IBFM-Sect. of Muscle Physiology and Proteome National Research Council Milano, Italy 100 90 80 % s.l. VO 2 max. 70 60 50 40 30 20 10 0 2
More informationKey Points. Educational Aims
Credit: Andrew Mason, Flickr; reproduced under the terms of the CC BY 2. Creative Commons license Key Points In clinical practice, the level of arterial oxygenation can be measured either directly by blood
More informationOxygen prescription. Dr Julian Forton. Consultant in paediatric respiratory medicine Noah s Ark Children s Hospital for Wales
Oxygen prescription Dr Julian Forton. Consultant in paediatric respiratory medicine Noah s Ark Children s Hospital for Wales Oxygen prescription chart EXCEPTION: Oxygen may be given without a prescription
More informationRESPIRATORY GAS EXCHANGE
RESPIRATORY GAS EXCHANGE Alveolar PO 2 = 105 mmhg; Pulmonary artery PO 2 = 40 mmhg PO 2 gradient across respiratory membrane 65 mmhg (105 mmhg 40 mmhg) Results in pulmonary vein PO 2 ~100 mmhg Partial
More information2) an acute situation in which hypoxemia is suspected.
I. Subject: Oxygen Therapy II. Policy: Oxygen therapy shall be initiated upon a physician's order by health care professionals trained in the set-up and principles of safe oxygen administration. Oxygen
More informationStandards and guidelines for care and management of patients requiring oxygen therapy.
PURPOSE Standards and guidelines for care and management of patients requiring oxygen therapy. STANDARDS Ongoing management of oxygen therapy requires a prescriber s order. The order must specify oxygen
More informationRESPIRATORY MONITORING AND OXIMETRY
RESPIRATORY MONITORING AND OXIMETRY EE 471 F2016 Prof. Yasser Mostafa Kadah Introduction Respiratory monitoring includes measurement, evaluation, and monitoring of parameters of respiratory system, First
More informationHumidity Therapy. Terms to know:
RC-170 Humidity Therapy Terms to know: Humidity: Water in a vapor state of matter. Absolute Humidity (mg/liter) actual amount of water in a vapor form. Relative Humidity (% up to 100) absolute compared
More informationNROSCI/BIOSC 1070 and MSNBIO 2070 Exam # 2 October 28, 2016 Total POINTS: % of grade in class
NROSCI/BIOSC 1070 and MSNBIO 2070 Exam # 2 October 28, 2016 Total POINTS: 100 20% of grade in class 1) An arterial blood sample for a patient at sea level is obtained, and the following physiological values
More informationEmergency Medicine High Velocity Nasal Insufflation (Hi-VNI) VAPOTHERM POCKET GUIDE
Emergency Medicine High Velocity Nasal Insufflation (Hi-VNI) VAPOTHERM POCKET GUIDE Indications for Vapotherm High Velocity Nasal Insufflation (Hi-VNI ) administration, the patient should be: Spontaneously
More informationPhysiological Basis of Mechanical Ventilation
Physiological Basis of Mechanical Ventilation Wally Carlo, M.D. University of Alabama at Birmingham Department of Pediatrics Division of Neonatology wcarlo@peds.uab.edu Fine Tuning Mechanical Ventilation
More information3100A Competency Exam
NAME DATE (Circle the appropriate answer) 3100A Competency Exam 1. Of the following, which best describes the mechanics of ventilation used by the 3100A? a. Active inspiration with passive exhalation b.
More informationVENTILATION STRATEGIES FOR THE CRITICALLY UNWELL
VENTILATION STRATEGIES FOR THE CRITICALLY UNWELL Dr Nick Taylor Visiting Emergency Specialist Teaching Hospital Karapitiya Senior Specialist and Director ED Training Clinical Lecturer, Australian National
More informationSection Three Gas transport
Section Three Gas transport Lecture 6: Oxygen transport in blood. Carbon dioxide in blood. Objectives: i. To describe the carriage of O2 in blood. ii. iii. iv. To explain the oxyhemoglobin dissociation
More informationexchange of carbon dioxide and of oxygen between the blood and the air in
M. M. HENRY WILLIAMS, JR.*Cardiorespiratory Laboratory, Grasslands WILLIAMS, JR.* Hospital, Valhalla, New York SOME APPLICATIONS OF PULMONARY PHYSIOLOGY TO CLINICAL MEDICINE During the past ten years a
More informationUNDERSTANDING THE BLUE PATIENT Amy Breton Newfield, CVT, VTS (ECC) BluePearl Veterinary Partners, Waltham, MA USA
UNDERSTANDING THE BLUE PATIENT Amy Breton Newfield, CVT, VTS (ECC) BluePearl Veterinary Partners, Waltham, MA USA Amy.Newfield@bluepearlvet.com INTRODUCTION As a veterinary nurse you will likely be the
More informationLUNG CLEARANCE INDEX. COR-MAN IN Issue A, Rev INNOVISION ApS Skovvænget 2 DK-5620 Glamsbjerg Denmark
LUNG CLEARANCE INDEX METHOD COR-MAN-0000-008-IN Issue A, Rev. 3 2013-07-01 INNOVISION ApS Skovvænget 2 DK-5620 Glamsbjerg Denmark Tel.: +45 65 95 91 00 Fax: +45 65 95 78 00 info@innovision.dk www.innovision.dk
More informationFor more information about how to cite these materials visit
Author(s): John G. Younger, M.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike 3.0 License: http://creativecommons.org/licenses/by-sa/3.0/
More informationTESTCHEST RESPIRATORY FLIGHT SIMULATOR SIMULATION CENTER MAINZ
TESTCHEST RESPIRATORY FLIGHT SIMULATOR SIMULATION CENTER MAINZ RESPIRATORY FLIGHT SIMULATOR TestChest the innovation of lung simulation provides a breakthrough in respiratory training. 2 Organis is the
More informationCirculatory And Respiration
Circulatory And Respiration Composition Of Blood Blood Heart 200mmHg 120mmHg Aorta Artery Arteriole 50mmHg Capillary Bed Venule Vein Vena Cava Heart Differences Between Arteries and Veins Veins transport
More informationLung Volumes and Ventilation
Respiratory System ssrisuma@rics.bwh.harvard.edu Lung Volumes and Ventilation Minute ventilation Volume of an inspired or expired air per minute = tidal volume (V T ) x respiratory rate Dead space ventilation
More informationPresentation Overview. Monitoring Strategies for the Mechanically Ventilated Patient. Early Monitoring Strategies. Early Attempts To Monitor WOB
Monitoring Strategies for the Mechanically entilated Patient Presentation Overview A look back into the future What works and what may work What s all the hype about the WOB? Are ventilator graphics really
More informationHCO - 3 H 2 CO 3 CO 2 + H H H + Breathing rate is regulated by blood ph and C02. CO2 and Bicarbonate act as a ph Buffer in the blood
Breathing rate is regulated by blood ph and C02 breathing reduces plasma [CO2]; plasma [CO2] increases breathing. When C02 levels are high, breating rate increases to blow off C02 In low C02 conditions,
More informationClinical Update. Oxygen Therapy
Clinical Update DOI-10.21304/2018.0504.00413 Kundan Mittal*, Amit Jain**, Teena Bansal***, Prashant Kumar****, Anupama Mittal***** *Senior Professor, Incharge PICU & Respiratory Clinic, ***Associate Professor,
More informationProduct description concerning v-tac
Product description concerning v-tac v-tac software calculates arterial blood gas values from venous peripheral blood gas measurement, combined with arterial oxygen saturation v-tac Product description
More informationCollin County Community College. Lung Physiology
Collin County Community College BIOL. 2402 Anatomy & Physiology WEEK 9 Respiratory System 1 Lung Physiology Factors affecting Ventillation 1. Airway resistance Flow = Δ P / R Most resistance is encountered
More informationGas exchange and ventilation perfusion relationships in the lung
ERJ Express. Published on July 28, 214 as doi: 1.1183/931936.3714 REVIEW IN PRESS CORRECTED PROOF Gas exchange and ventilation perfusion relationships in the lung Johan Petersson 1,2 and Robb W. Glenny
More informationPulmonary Circulation
Pulmonary Circulation resin cast of pulmonary arteries resin cast of pulmonary veins Blood Flow to the Lungs Pulmonary Circulation Systemic Circulation Blood supply to the conducting zone provided by the
More informationSouth Staffordshire and Shropshire Healthcare NHS Foundation Trust
South Staffordshire and Shropshire Healthcare NHS Foundation Trust Document Version Control Document Type and Title: Authorised Document Folder: Administration of Oxygen Policy YELLOW - Clinical New or
More informationThe Basics of Ventilator Management. Overview. How we breath 3/23/2019
The Basics of Ventilator Management What are we really trying to do here Peter Lutz, MD Pulmonary and Critical Care Medicine Pulmonary Associates, Mobile, Al Overview Approach to the physiology of the
More informationSIMULATION OF THE HUMAN LUNG. Noah D. Syroid, Volker E. Boehm, and Dwayne R. Westenskow
SMULATON OF THE HUMAN LUNG Noah D. Syroid, Volker E. Boehm, and Dwayne R. Westenskow Abstract A human lung simulator was implemented using a model based on the Fick principle. The simulator is designed
More informationWhat is optimal flow?
Perfusing the microcirculation. Did five decades of cardiopulmonary bypass teach us how to achieve optimal perfusion? Filip De Somer, Ph.D. University Hospital Gent Belgium What is optimal flow? Reference
More informationCASE CONFERENCES. The Clinical Physiologist Section Editors: John Kreit, M.D., and Erik Swenson, M.D.
The Clinical Physiologist Section Editors: John Kreit, M.D., and Erik Swenson, M.D. Treating Hypoxemia with Supplemental Oxygen Same Game, Different Rules Darryl Y. Sue CASE CONFERENCES Division of Respiratory
More informationLondon Respiratory Team
London Respiratory Team By email 28 March 2012 Ambulatory Oxygen for London This guide has been produced to help healthcare maximise the benefit of the new oxygen contract for patients and to reduce waste.
More informationUsing the Lifebox oximeter in the neonatal unit. Tutorial 1 the basics
Using the Lifebox oximeter in the neonatal unit Tutorial 1 the basics Lifebox 2014. 2011. All rights reserved The Lifebox Pulse Oximeter In this tutorial you will learn about: The function of a pulse oximeter
More informationWhy we should care (I)
What the $*!# is Lung Protective Ventilation and Why Should I be Using it in the OR? Disclosures KATHERINE PALMIERI, MD, MBA 64 TH ANNUAL POSTGRADUATE SYMPOSIUM UNIVERSITY OF KANSAS MEDICAL CENTER DEPARTMENT
More informationBunnell LifePulse HFV Quick Reference Guide # Bunnell Incorporated
Bunnell Incorporated n www.bunl.com n 800-800-4358 (HFJV) n info@bunl.com 436 Lawndale Drive n Salt Lake City, Utah 84115 n intl 801-467-0800 n f 801-467-0867 Bunnell LifePulse HFV Quick Reference Guide
More informationSome Clinical Aspects on the Blood Gas Physiology
Special Article* Some Clinical Aspects on the Blood Gas Physiology Hiroshi Sasamoto Professor and Chairman, Department of Medicine, School of Medicine Keio University, Shinjuku, Tokyo Recent trends on
More informationCDI Blood Parameter Monitoring System 500 A New Tool for the Clinical Perfusionist
Original Article Blood Parameter Monitoring System 500 A New Tool for the Clinical Perfusionist David W. Fried, MS Ed, CCP; Joseph J. Leo, BS, CCP; Gabriel J. Mattioni, BS, CCP; Hasratt Mohamed, CCP; Raymond
More informationUnit II Problem 4 Physiology: Diffusion of Gases and Pulmonary Circulation
Unit II Problem 4 Physiology: Diffusion of Gases and Pulmonary Circulation - Physical principles of gases: Pressure of a gas is caused by the movement of its molecules against a surface (more concentration
More informationRespiratory System Physiology. Dr. Vedat Evren
Respiratory System Physiology Dr. Vedat Evren Respiration Processes involved in oxygen transport from the atmosphere to the body tissues and the release and transportation of carbon dioxide produced in
More informationHypoxia Following Rapid Decompression to 18,288 m (60,000 ft) Attributable to Alveolar Hypoventilation
Hypoxia Following Rapid Decompression to 18,288 m (60,000 ft) Attributable to Alveolar Hypoventilation Desmond M Connolly PhD QinetiQ Aircrew Systems Senior Medical Officer Timothy J D Oyly BSc Amanda
More informationRespiratory System. Prepared by: Dorota Marczuk-Krynicka, MD, PhD
Respiratory System Prepared by: Dorota Marczuk-Krynicka, MD, PhD Lungs: Ventilation Perfusion Gas Exchange - Diffusion 1. Airways and Airway Resistance (AWR) 2. Mechanics of Breathing and Lung (Elastic)
More informationCh 16: Respiratory System
Ch 16: Respiratory System SLOs: Explain how intrapulmonary pressures change during breathing Explain surface tension and the role of surfactant in respiratory physiology. Compare and contrast compliance
More information