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RsCr 220 - Lab 2 Oxygen Delivery

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					Lab #2 – Oxygen Delivery Devices – High and Low Flow Systems

RsCr 220 - Lab 2 Oxygen Delivery Devices - Low and High Flow Systems EXERCISE A: Use of a nasal cannula. (Low Flow System) 1. Attach an oxygen flowmeter to the appropriate DISS wall outlet. 2. Attach a humidifier to the outlet of the flowmeter. 3. Remove the nasal cannula from your equipment storage area and attach it to the humidifier. 4. Turn the flowmeter to 5 L/m. Crimp the small bore tubing completely. Note the sound. What does it indicate? 5. Turn the flowmeter off. Have your partner place the cannula on your face. Be gentle and practice more than once. 6. Turn the flowmeter on to 1, 3, 5, and 8 L/m. (Why do we limit flow to 6 L/m?) 7. Turn the flowmeter off and repeat steps 4 & 5 for your partner. 8. Add an extension (or 2) of small bore tubing to your nasal cannula for added mobility. 9. As extra practice placing nasal ‘cannula cushions’ on tubing. EXERCISE B: Use of the simple oxygen mask. (Low Flow System) 1. Obtain a Simple Oxygen Mask from your equipment area. Attach the simple mask to the Christmas tree. (Masks generally DO NOT use a bubble humidifier.) 2. Place it on your partners face and set the flowmeter to 4; 6; 8 & 10 L/m. 3. Turn the flowmeter off. Remove the simple mask. (Isn’t that simple?) EXERCISE C: Use of the non-rebreather mask. (Low Flow System) 1. Obtain a Non-rebreather Mask from your equipment area. 2. Attach the small bore tubing to the humidifier. Before putting the mask on your partner's face turn the flowmeter to 6 L/m AND occlude the valve between the bag and the mask with your thumb until the bag is full. 3. Carefully place the mask on your partner. Make sure it is very tightly fitted to their face to minimize leaks. Regulate the flow properly based on normal relaxed breathing (4-6 L/m). If the mask is fitting tightly the bag should be deflating slightly during inspiration. Record the initial 02 flow rate during normal breathing. 4. Have your partner increase their breathing rate to approximately 1 breath every 2 seconds (30 breathes/minute). What happens to the bag? Increase the flow rate to keep the bag from completely deflating. Note the difference in flow required. Record the flow rate needed during rapid breathing _________. Turn the flowmeter off. 5. What happens to the humidifier with high flows (flush)? 6. Remove the valve located between the bag and the mask and on the side of the mask. You have now created a Partial Rebreather Mask. Replace the valves. Why are nonrebreathe masks NEVER be used with on infants?
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Lab #2 – Oxygen Delivery Devices – High and Low Flow Systems

RsCr 220 - Lab 2 continued EXERCISE D: Use of the venti-mask. (High Flow System) 1. Obtain a venturi mask kit from the instructor. 2. Attach the white adaptor to the inlet of the mask and set it to deliver 40%. 3. Attach one end of the small bore tubing to the venturi inlet and the other end to a flowmeter equipped with a nipple adaptor. 4. Set the flow rate to the amount suggested on the face of the venturi adaptor. 5. Remove the hard plastic venturi portion of the mask from the soft plastic mask. Hold the oxygen analyzer a few centimeters from the outlet of the venturi. If you are unsure how to do this ask the instructor for help. Measure the oxygen percentage. 6. Increase the flow rate by 3 to 4 L/m. Measure the percentage again. Did it change? (Disregard any changes of 1 - 3%) 7. Decrease the flow rate to ½ of the original suggested amount. Once again measure the oxygen percentage? Did it change? 8. Turn off the flowmeter. Remove the white adaptor and attach the green adaptor in its place. 9. Remove the nipple adaptor and attach a humidifier in its place. Attach the small bore tubing to the humidifier. 10. Turn the flow rate to highest it will go. Note the flow. Observe the whistling sound. Try and determine where the sound is coming from. TURN THE FLOWMETER OFF. Why is it a good idea not to use a bubble humidifier with a mask? RsCr 220 Lab 2 - Lab Questions - Due at the end of lab. Name _______________________ 1. Can you think of a time when the use of a simple mask would be clinically preferred over a nasal cannula?

2. When is it preferable to use a nasal cannula?

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Lab #2 – Oxygen Delivery Devices – High and Low Flow Systems

3. Why do we generally limit the flow rate when using a nasal cannula to 6 L/m? a. (Hint: There are 2 reasons).

4. What are the two major dangers associated with the use of the Non-rebreather mask?

5. Do increases or decreases in oxygen flow rate significantly affect the delivered Fi02 in a Venturi device? Explain your answer – What does it effect?

6. What does affect the delivered FiO2 in a venturi mask?

Why is the use of humidifier not recommended when using a venturi mask at Fi02's requiring the green adaptor? RsCr 220 - Lab 2 Homework Name __________________________ Due Next Tuesday at the beginning of Lecture. Show your work for all questions. 1. You are assisting in the helicopter transport of a patient from Yosemite National Park to a Modesto hospital. The transport should take a maximum of two hours. You anticipate the patient will be requiring approximately 15 LPM of oxygen during the flight. How many "E" cylinders will you need?

2. The outlet valve of your hospital's bulk liquid 02 system has malfunctioned requiring you to switch over to your 10 "H" cylinder tank bank system. At 2 PM you noticed the
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Lab #2 – Oxygen Delivery Devices – High and Low Flow Systems

pressure of the bank system is 1500 PSI. The total oxygen requirement of your hospital is approximately 300 LPM. AT this rate how long will maintenance have to repair the outlet valve?

3. Calculate the total liter flow delivered by a 35% venturi mask running at 10 LPM.

4. The policy at your hospital is that high flow systems must have a total liter flow of at least 50 LPM. How many liters of air and oxygen are required in order to achieve an Fi02 of 80% with at least this recommended total liter flow?

5. A large volume jet nebulizer set on the 60% entrainment setting is being driven by an oxygen flowmeter at 10 LPM. Oxygen is being bled into the system downstream from the nebulizer at 20 LPM. a. b. What is the total liter flow of this system? What is the final Fi02?

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