Medical Gas and Oxygen Therapy

OXYGEN AND MEDICAL
GAS THERAPY
• Medical Gas and Cylinder Characteristics
• Cylinders are constructed of molybdenum steel.
• Gas cylinders are stored at high pressures; a full O2 cylinder contains 2200
psig pressure (H) and 1900 (E).
• The most common sizes for O2 storage are the “H” cylinder and the “E”
cylinder.
• Cylinder factor as follows: H = 3.14L/psig and E = .28L/psig

CONVERSION
• How to calculate Minutes Remaining in Cylinder:
= Cylinder pressure x cylinder factor

flow rate
• How to convert LPM to FiO2:
= LPM x 4 + 20 = %
• How to convert FiO2 to LPM:
𝑓𝑖𝑂2
= + 20 = 𝑙𝑝𝑚
4
DIFFERENCE BETWEEN PRIMARY
SYSTEM AND SECONDARY SYSTEM
• PRIMARY SYSTEM – oxygen tanks, reservoir found on the hospitals
(emergency rooms, ICU, etc.)
• SECONDARY SYSTEM – oxygen deliver devices (low flow system and

high flow system)
OXYGEN DELIVERY DEVICES
• LOW FLOW SYSTEM – are O2 delivery devices that does not meet the
patients inspiratory flow demands; therefore room air must make the
remainder of the patients VT.
• HIGH FLOW SYSTEM – O2 delivery device provides all of the

inspiratory flow required by the patient at relatively accurate and
consistent O2 percentage.
LOW FLOW SYSTEM
• Nasal Cannula – 24% to 40% at 1-5 LPM. A nasal cannula is generally
used wherever small amounts of supplemental oxygen are required,
without rigid control of respiration, such as in oxygen therapy.
• Simple Mask – 35% to 50% at 5-10 LPM. This mask is only meant for
patients who are able to breathe on their own, but who may require a
higher oxygen concentration than the 21% concentration found in
ambient air. And also patient who are experiencing conditions such as
chest pain (possible heart attack), dizziness, and hemorrhage.
• Partial Rebreathing Mask – 40% to 70% at 8-15 Lpm. The partial re-
breather mask looks very similar to the non-rebreather mask except
that it has a two-way valve that permits the patient to rebreathe
about one-third of his or her exhaled air. And is used if patient has
respiratory disease, cardiac disease, shock, trauma, and severe blood
loss.
• Non-Rebreathing Mask – 60% to 80% at 10-15 Lpm. The non-
rebreather mask is utilized for patients with physical trauma, chronic
airway limitation, cluster headache, smoke inhalation, and carbon
monoxide poisoning, or any other patients who require high-
concentration oxygen, but do not require breathing assistance.
HIGH FLOW SYSTEM
• Venturi Mask (Air Entrainment Mask) – 24% to 60% also known as an
air-entrainment mask, is a medical device to deliver a known oxygen
concentration to patients on controlled oxygen therapy.
• Aerosol Mask – 21% to 100% at flow rates of 8 to 15Lpm is
a mask used for the therapeutic administration of a nebulized
solution, humidity, or high airflow with oxygen enrichment. It has a
large-bore inlet and an exhalation port.
• Face Tent – 21% to 40% at flow rates of 8 to 15 L/min. Face tents are
used to provide a controlled concentration of oxygen and increase
moisture for patients who have facial burn or a broken nose, or who
are claustrophobic.
• Tracheostomy Mask (Collar) – 35% to 60% at 10 to 15 L/min.
Tracheal Masks. Tracheostomy is an opening in the neck, into
the trachea to deliver oxygen or remove secretion build up in the
airway. Tracheostomy can be necessary after a disease, trauma or
surgery. The tracheostomy tube is placed on the stoma and is secured
with a harness.
• Oxygen Tent – 21% to 50% of O2 at flow rates 10 to 15 L/min, used
primarily on children with croup or pneumonia.
OXYGEN THERAPY
INDICATIONS:
• Hypoxemia – low levels of oxygen in the body
• Labored breathing or Dyspnea – Difficulty in

breathing
• Increased Myocardial Work – overworked heart muscles

SIGNS AND SYMPTOMS OF
HYPOXEMIA
• TACHYCARDIA
• DYSPNEA
• CYANOSIS
• IMPAIRMENT OF SPECIAL SENSES
• HEADACHE
• MENTAL DISTURBANCE
• SLIGHT HYPERVENTILATION
COMPLICATIONS OF O2 THERAPY
• RESPIRATORY DEPRESSION – common among patient “hypoxic drive”
mechanism. Maintain oxygen between 50 to 65 mmHg oxygen.
• Atelectasis – too much oxygen in take can wash out nitrogen
• Oxygen Toxicity
• Reduced Mucociliary activity.

FOUR TYPES OF HYPOXEMIA
• HYPOXEMIC HYPOXIA – caused by lacked of oxygen in the blood.
• ANEMIC HYPOXIA – blood’s capacity to carry O2 is reduced
• STAGNANT HYPOXIA – O2 capacity and carrying is normal but

perfusion is diminished.
• HYSTOTOXIC HYPOXIA – oxidative enzyme of the cell is impaired.

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OXYGEN AND MEDICAL

• Cylinder factor as follows: H = 3.14L/psig and E = .28L/psig

= Cylinder pressure x cylinder factor

• How to convert FiO2 to LPM:

• SECONDARY SYSTEM – oxygen deliver devices (low flow system and

• HIGH FLOW SYSTEM – O2 delivery device provides all of the

• Hypoxemia – low levels of oxygen in the body

• Labored breathing or Dyspnea – Difficulty in

• Increased Myocardial Work – overworked heart muscles

• Atelectasis – too much oxygen in take can wash out nitrogen

• Reduced Mucociliary activity.

• ANEMIC HYPOXIA – blood’s capacity to carry O2 is reduced

• STAGNANT HYPOXIA – O2 capacity and carrying is normal but

• HYSTOTOXIC HYPOXIA – oxidative enzyme of the cell is impaired.

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