Oxygen Administration and Ventilotherapy: Methods and Care
Oxygen Administration Methods
Resources are those materials that are used when the patient can breathe by himself, such as a mask (facial and tracheotomy), nasal cannula, nasal catheter, and oxygen tent.
Mask
Oxygen is used to manage quickly and for a short period of time. With this method, oxygen concentrations between 24 and 100% can be given, with more frequent concentrations of 24 to 28%. When you use it, apply Vaseline to the patient’s lips, nose, and ears with gauze.
Nasal Cannula
Used when the patient breathes through the nose. It is a plastic tube that unfolds at the end, with two holes to suit the nose. It is placed on the cheek and behind the ears. If the patient breathes through the mouth, the treatment is not effective; they should try to breathe through their nose. Oxygen is used to manage in a concentration less than 40%.
Nasal Probe
Used to administer oxygen through a nasopharyngeal tube. It is a flexible tube, with a rounded tip and with several holes at the end that is inserted into the patient (10 to 14 French units for adults). It is valid for oxygen concentrations less than 40%. It has the disadvantage of producing irritation problems and may cause lesions in the nasopharynx, and gastric distention.
Oxygen Tent
The use of an oxygen tent is common in hospitals. It is used in patients who are very anxious, in children, or those uncooperative with the other methods of administering oxygen.
Oxygen Administration Procedure
These are a set of techniques that allow the transfer of oxygen from the source where it is stored to the patient’s respiratory system.
Precautions
- Do not use electrical appliances in disrepair.
- No smoking.
- Do not use flammable cleaning products.
- Moisten the patient’s mouth and monitor the condition of the nostrils.
- Always follow the doctor’s orders.
The nurse and nursing assistant are involved in these procedures, following the medical prescription, which specifies the flow (liters/min), the concentration of oxygen (%), and the method to be employed.
Ventilotherapy
Artificial respiration is the embodiment of the patient’s ventilation by artificial or mechanical means, to achieve sufficient alveolar ventilation which ensures the exchange of gases in the pulmonary alveoli.
It is used in patients with specific diseases (pulmonary emphysema, severe respiratory failure) and when respiratory function is compromised, as in a cardiac arrest, and during general anesthesia.
Types of Artificial Respiration
- Manual-bag: Performed using the mask-bag on the patient’s nose and blowing air to squeeze the ball with both hands. It is used for short periods of time, usually in emergency situations.
- Automatic: Done with a vacuum.
Types of Respirators or Ventilators
These are devices that supply or assist respiratory function and also incorporate other features such as variables reflecting respiratory pressure curves, flow, oxygen consumption, and anhydrous.
Pressure-Cycled Respirators
The only parameter that can be regulated is the inflation pressure, which is pre-set in the apparatus and corresponds to the volume of air insufflated. After reaching the required pressure, the inspiration time is interrupted, allowing spontaneous exhalation due to the lung’s elasticity.
Volume-Cycled Respirators
They can regulate breathing rate per minute, volume, percentage of oxygen, the inspiration-expiration ratio, and expiratory controls.
Time-Cycled Respirators
They work by regulating all times of the respiratory cycle: inspiration, pause, expiration.
Care of the Patient on a Respirator
The connection of the patient to the medical respirator is aided by a nursing team. This procedure requires endotracheal intubation and then special care.
General Care
- Hygiene: It is important to perform daily hygiene of the patient, paying special attention to cleaning the mouth and eyes, washing with saline, and protecting with an eyewash.
- Ulcer prevention: Aspiration of secretions, respiratory exercises, etc.
Special Care
- Cannula and tracheobronchial aspiration.
- Keep the patient relaxed; sedatives or muscle relaxants may be given.
- Continued emotional support.
Monitoring of Breathing
If some kind of abnormality occurs, the ventilator will automatically activate its alarm system.
- Avoid sudden maneuvers when moving the patient.
- Change all tubing, humidifier filters, and respirator daily to avoid failure in their optimal performance.
Care of Patients with Tracheotomy
To ensure adequate ventilation in a patient with severe respiratory problems, sometimes artificial methods or instruments are used, making adequate alveolar ventilation possible.
The methods used are the channeling of the trachea through:
- Intubation: Introduction of a tube through the mouth or nose.
- Tracheotomy: Inserting a tube into the trachea after opening up to the anterior cervical region.
When a patient has been tracheotomized, it is important to moisten the air that they inspire, maintain aseptic conditions to prevent possible infections, remove secretions by suction, and clean the inner cannula of the tracheotomy tube. The most used cannulas are made of single-use plastic, silicone, and silver. Do not forget the patient’s psychological state.