oxygen(吸氧).ppt

OxygenTherapy 氧气疗法 Contents ClassificationofHypoxia 缺氧 LevelofHypoxiaIndicationofOxygenTherapySourcesofOxygenMethodsofOxygenDeliveryImplementationofOxygenTherapyComplicationsofOxygenTherapy Objectives StateindicationsofoxygentherapyExpatiateonprecautionsofoxygentherapyStatedifferentsourcesofoxygenandmethodsofoxygendeliveryDemonstratetheprocedureofadministeringoxygentherapybynasaltubecorrectlyStatecomplicationsofoxygentherapyandexpatiatehowtoprevent OxygenTherapy Purpose RaisePaO2 SaO2 andCaO2PreventorrelievehypoxiaPromotemetabolism 新陈代谢 氧气疗法是指通过给氧 提高动脉血氧分压 Pa02 和动脉血氧饱和度 Sa02 增加动脉血氧含量 Ca02 纠正各种原因造成的缺氧状态 促进组织的新陈代谢 维持机体生命活动的一种治疗方法 O2 CO2 O2 CO2 Lung Circulatorysystem Cells FunctionofRespiration Hypoxiacanberelatedtoanypartofrespiration ventilation diffusionofrespiratorygases transportofrespiratorygases andutilizationofoxygenatcellularlevel ClassificationofHypoxia IndicationofOxygenTherapy Hypotonichypoxia thebestOxygentherapymayhaveeffectonclientswithheartfailure shock severeanemia orcarbonmonoxidepoisoning LevelofHypoxia 50 80 30 60 60 80 30 50 IndexofOxygenTherapy Mildhypoxia notindicatedforclientModeratehypoxia needoxygentherapySeverehypoxia absoluteindication SourcesofOxygen OxygenCylinderSystem 氧气筒装置 WallOutletSupply 中心供氧装置 OxygenBag 氧气枕 HighPressureCabin 高压氧舱 OxygenCylinderSystem Oxygencylinder 氧气筒 Content 6000LPressure 150kg cm2Oxygenregulator 氧气表 Pressuregauge 压力表 Reductor 减压器 Flowmeter 流量表 Humidifier 湿化瓶 Safevalve 安全阀 OxygenCylinderSystem Pressuregauge humidifier Flowmeter regulator cylinder Safevalve Reductor 吸氧浓度 21 4 氧流量 L min Inspiredoxygenconcentration 21 4 oxygenflowrate L min Smallercylindersareavailableforemergency ambulatory andhomeuse WallOutletSupply Theoxygenissuppliedfromacentralsourcethroughapipeline Thewalloutletsourcecanbepreparedforusequicklyandsimply OxygenBag Theoxygenbagcanreplaceotheroxygensourcetemporarilyinhomeoxygentherapyandrescuingortransportingcrisiscase SourcesofOxygen OxygenCylinderSystem 氧气筒装置 WallOutletSupply 中心供氧装置 OxygenBag 氧气枕 HighPressureCabin 高压氧舱 MethodsofOxygenDelivery NasalCatheter 鼻导管 NasalCannula 鼻塞 OxygenMask 氧气面罩 OxygenHood 氧气头罩 OxygenTent 氧气帐 NasalCatheter Toinsertingannasalcatheterfromnosetonasopharynx 鼻咽部 Shortcomings Itcancausepressureonthenostrilandmaybeobstructedbysecretions Itmustbechangedatleastevery8hoursandinsertedintotheothernostril Theclienthavepainwhenthecatheterispassedintothenasopharynxandtraumacanoccurtonasalmucosa NasalCannula MostcommonlyuseddevicetooxygentherapyItiseasytoapplyandiswelltoleratedbytheclient OxygenMask OxygenHood OxygenTent Implementoxygentherapy UsinganoxygencylinderInsertinganasalcatheterRemovinganasaltube Usinganoxygencylinder Procedure PlacecylinderinsecurepositionChecktagtodetermineamountofoxygeninthecylinderClearopeningofcylinderAttachoxygenmetertovalveoutletAttachtopofhumidifiertoflowmeterAttachrubbertubingtoflowmeter Checkiftheequipmentisworkingwellorder turnoffhandwheelturnongeneralswitchopenhandwheelclose Usinganoxygencylinder Procedure Bringtoroom Usinganoxygencylinder Procedure PayattentiontousecylindersecurelyOxygenincylindershouldn tbeusedupcompletelyThepressureincylindershouldbemorethan5kg 2Usetagtoindicateamountofoxygen precaution Implementoxygentherapy UsinganoxygencylinderInsertinganasalcatheter Implementoxygentherapy AssessmentLevelofHypoxia nailbed lips NasaldiseaseExplanationPurposeandmethodsCheckoxygensupplydevices Insertinganasaltube Preparation Oxygensupplysource cylinderEquipment KidneybasinNasaltubeTherapeuticbowlwithdistilledwaterSwab 棉签 Adhesivetape 胶带 Recordcard 记录单 Equipment Usinganasaltube Procedure Checkphysician sordersforoxygenprescriptionGatherequipment bringtoroomIdentifycorrectclientExaminenostrils selectthemorepatentnostrilforinsertion cleanit TurnonoxygenflowtolitersprescribedConnectnasaltubetorubbertubingCheckifnasaltubeispatency andlubricateitDisconnectnasaltubefromrubbertubing Usinganasaltube Procedure MeasurelengthforinsertionInserttubegentlythroughnostriltonasopharynxTapetubesecurelytonoseandcheekConnectnasaltubetorubbertubingSecurerubbertubingtobedlinenWritedowntimeandflowonrecordcardAssistclienttoacomfortableposition lengthforinsertion Measurefromtipofnosetoearlobe 耳垂 twothirdsofthelengthisappropriatefortubeinsertion Oxygenflowrate Mildhypoxia 1 2L minModeratehypoxia 2 4L minSeverehypoxia 4 6L minChild 1 2L min Implementofoxygentherapy UsinganoxygencylinderUsinganasaltube Removinganasaltube Removingnasaltube Equipment Kidneybasinwithtwopiecesofgauzeinit Procedure DisconnectnasaltubefromrubbertubingTurnoffgeneralswitchLoosentapeonthenoseandcheekPullthetubeCleanclient snaresUnpintubefromsheetTurnoffhandwheelandrecordthefinishedtime precaution DisconnectnasaltubefromrubbertubingbeforeadjustingflowmeterChangenasaltubetwotimesaday usenaresbyturnsCleannasalcavityintimeCheckequipmentfrequently ifhumidifierisattached checkwaterleverintimeObserveclient sconditionfrequently assessifsignsandsymptomsofhypoxiaarerelievedDisinfectequipmentintime summary 给氧注意事项 严格遵守操作规程 注意用氧安全 做好 四防 防震 防火 防热 防油氧气筒内O2不可用尽 压力表上指针降至5Kg c 时不可再用未用或已用尽的氧气筒应分别悬挂 空 或 满 的标志 1 使用氧气筒应注意 2 使用鼻导管时应注意 注意分离鼻导管 不在病人插管情况下调节流量表 持续使用时应注意 每日更换鼻导管2次以上 双侧鼻孔交替使用及时清洁鼻腔 防止导管阻塞定时做雾化吸入 口腔护理 湿化瓶水面保持在1 3 1 2处 定时清洗 给氧注意事项 1 使用氧气筒应注意2 使用鼻导管时应注意3 观察缺氧症状是否改善4 用物定期消毒 防止交叉感染 六 氧疗的副作用 1 CO2滞留和呼吸抑制 常见于低氧血症伴二氧化碳潴留患者预防措施 低流量 低浓度给氧 维持PaO2在60mmHg 2 吸入性肺不张 3 晶体后纤维组织形成 4 呼吸道分泌物干燥 氧浓度高于60 持续时间超过24小时 5 氧中毒 1 类型 肺型 脑型 2 预防氧中毒 控制氧的吸入浓度和时间 60 以下 安全60 80 不超过24h100 不超过4h高压氧 严格控制氧分压和氧疗时间 下列哪种类型的缺氧最适宜氧疗 A 低张性缺氧B 血液性缺氧C 循环性缺氧D 组织性缺氧 A 关于中度缺氧症状的描述 下列哪项不妥 A 明显紫绀B 三凹症C 烦躁不安D 氧分压在30mmHg 50mmHgE SaO2在60 80 B 某肺心