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NON INVASIVE VENTILATION
LOW AND HIGH FLOW OXYGEN DEVICES
Unnikrishnan.sv90@gmail.com
9995274650
NON INVASSIVE VENTILATION
WHAT IS NON INVASSIVE VENTILATION ?
ADVANTAGES
• Avoids intubation
• Reduces patients work load
• Provides adequate oxygen
• Improves quality of sleep
• Allows patient to communicate
• Allows patient to drink and eat
• Reduces the chance of infection
• Inexpensive
uses
• Weaning trial
• A/C Respiratory failure
• Neuro muscular diseases
• Copd
• Pulomonary edema
• Bronchiectasis
• Poliomyelitis
• Muscular dystrophy etc ..
Contraindications
• Respiratory arrest
• Uncoperative patients
• Inability to protect airways
• Trauma or burns in face
• Facial or GI Surgery
• Apnoea
• Extreme anxiety
• Obesity
Types of non invasive ventilators
• Generally classified into 2
1. Volume pre set ventilators
2. Pressure preset ventilators
Pressure pre set ventilators 2 modes
• CPAP
• BiPAP
NURSING RESPONSIBILITY
• Check patients breath rate and ausculate
• Maintain spo2 100%
• Inform the physician regarding any abnormality in ABG Values
• Always check for air leake
• Give more importance to patients needs like suctioning ,or giving
sputum cups if secretions are present
• Maintain a ABG CHART
Complications of CPAP and BiPAP
• Insufficient ventillatory support
• Mask leake
• Skin trauma
• Sputum retention
• Nutritional deficiencies
• Abdominal discomfort
OXYGEN DELIVERY METHODS /SYSTEMS
• 2 SYSTEMS
• LOW FLOW DELIVERY SYSTEMS
• HIGH FLOW DELIVERY SYSTEMS
LOW FLOW OXYGEN DEVICES
• NASAL CANNULA
• SIMPLE FACE MASK
• PARTIAL REBREATHER MASK
HIGH FLOW DEVICES /SYSTEMS
• TRANS TRACHEAL CATHETRES
• VENTURI MASK
• AEROSOL MASK
• TRACHEOSTOMY COLLARS
• T –PIECE
• NON REBREATHING MASK WITH RESERVOIR AND ONE WAY VALVE
• HIGH HUMIDITY FACE TENTS
Formula for calculating percentage of Fio2%
• Fio2= 20% + (4 X oxygen liter flow)
• 1 liters = 24 %
• 2 liters =28 % etc
• Suppose if we deliver 6 litres of oxygen per min ,what is the Fio2
• ANS- Fio2 = 44% with 6 litres of O2 P/M
NASAL CANNULA
• Flow rate - 2-6 litres per min
• 24-45 percentage
• Advantage – light weight ,comfortable,inexpensive and continuous
use with meals and activity.
• Disadvantage – nasal mucosa drying
Nasal cannula
Oropharyngeal catheter
• Flow rate – 1-6 Litres
• Deliver 22-44 %
• Adv – inexpensive and no need for tracheostomy
• Dis adv – mucosal drying ,catheter should be changed frequently to
both nostrils
Oropharyngeal catheter /air way.
Simple face mask
• Flow rate – 6-8 Litres
• Deliver 40-60%
• Adv – inexpensive and simple to use
• Dis adv – mucosal drying ,poor fitting
Simple Face mask
Partial rebreather mask
• Flow rate – 8-11 Litres
• Deliver 50-75 %
• Adv – moderate oxygen concentration
• Dis adv – mucosal drying ,poorly fitting , must remove to eat.
Partial rebreather mask
Non rebreather mask
• Flow rate – 10-12 Litres
• Deliver 80- 100 %
• Adv – High oxygen concentration
• Dis adv – poorly fitting ,must remove to eat
Non rebreather mask
HIGH FLOW DEVICES
Trans tracheal catheter
• Flow rate – 4 Litres/min
• Deliver 60=100 %
• Adv – more comfortable , concealed by clothings ,less o2 is needed to
achieve 100% saturation
• Dis adv – requires frequent and regular cleaning and needs surgical
intervention
Trans tracheal catheters
Venturi mask
• Flow rate – 4-6 l/min
• Deliver 24-40 %
• Adv – precise fio2 and additional humidity available
• Dis adv – must be removed to eat
Colour Fi O2 O2 flow
Blue 24% 2 l/min
White 28% 4 l/min
Orange 31% 6 l/min
Yellow 35% 8 l/min
Red 40% 10 l/min
Green 60% 15 l/min
Trans tracheal catheter
• Flow rate – 4 Litres/min
• Deliver 60=100 %
• Adv – more comfortable , concealed by clothings ,less o2 is needed to
achieve 100% saturation
• Dis adv – requires frequent and regular cleaning and needs surgical
intervention
Aerosol mask
• Flow rate – 8-10 Litres/min
• Deliver 21- 100% fio2 based on nebulizer setting
• Adv – good humidity and accurate Fio2
• Dis adv – uncomfortable for some
Aerosol mask
Tracheostomy collar
• Flow rate – 8-10 Litres/min
• Deliver 30- 100 %
• Adv – good humidity , comfortable ,fairly accurate Fio2
• Dis adv – requires surgical intervention
Tracheostomy collar
T-piece
• Flow rate – 8-10 Litres/min
• Deliver 60=100 %
• Adv –good humidity , comfortable ,fairly accurate Fio2
• Dis adv – heavy with tubings
T-piece
Face tent
• Flow rate – 8-10 Litres/min
• Deliver 30- 100 %
• Adv –good humidity , comfortable ,fairly accurate Fio2
• Dis adv – bulky and cumbersome
Face tent
Complications Of Oxygen therapy
• Infection
• Combustion
• Oxygen toxicity
• Atlectasis
• Retrolental fibroplasis
• Retinal damage
• Asphyxia
• Thank you
• Count down starts now ……….
• Study well ,future of India is in our hands ……..

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HIGH AND LOW FLOW OXYGEN DEVICES

  • 1. NON INVASIVE VENTILATION LOW AND HIGH FLOW OXYGEN DEVICES Unnikrishnan.sv90@gmail.com 9995274650
  • 2. NON INVASSIVE VENTILATION WHAT IS NON INVASSIVE VENTILATION ?
  • 3. ADVANTAGES • Avoids intubation • Reduces patients work load • Provides adequate oxygen • Improves quality of sleep • Allows patient to communicate • Allows patient to drink and eat • Reduces the chance of infection • Inexpensive
  • 4. uses • Weaning trial • A/C Respiratory failure • Neuro muscular diseases • Copd • Pulomonary edema • Bronchiectasis • Poliomyelitis • Muscular dystrophy etc ..
  • 5. Contraindications • Respiratory arrest • Uncoperative patients • Inability to protect airways • Trauma or burns in face • Facial or GI Surgery • Apnoea • Extreme anxiety • Obesity
  • 6. Types of non invasive ventilators • Generally classified into 2 1. Volume pre set ventilators 2. Pressure preset ventilators Pressure pre set ventilators 2 modes • CPAP • BiPAP
  • 7. NURSING RESPONSIBILITY • Check patients breath rate and ausculate • Maintain spo2 100% • Inform the physician regarding any abnormality in ABG Values • Always check for air leake • Give more importance to patients needs like suctioning ,or giving sputum cups if secretions are present • Maintain a ABG CHART
  • 8. Complications of CPAP and BiPAP • Insufficient ventillatory support • Mask leake • Skin trauma • Sputum retention • Nutritional deficiencies • Abdominal discomfort
  • 9. OXYGEN DELIVERY METHODS /SYSTEMS • 2 SYSTEMS • LOW FLOW DELIVERY SYSTEMS • HIGH FLOW DELIVERY SYSTEMS
  • 10. LOW FLOW OXYGEN DEVICES • NASAL CANNULA • SIMPLE FACE MASK • PARTIAL REBREATHER MASK
  • 11. HIGH FLOW DEVICES /SYSTEMS • TRANS TRACHEAL CATHETRES • VENTURI MASK • AEROSOL MASK • TRACHEOSTOMY COLLARS • T –PIECE • NON REBREATHING MASK WITH RESERVOIR AND ONE WAY VALVE • HIGH HUMIDITY FACE TENTS
  • 12. Formula for calculating percentage of Fio2% • Fio2= 20% + (4 X oxygen liter flow) • 1 liters = 24 % • 2 liters =28 % etc
  • 13. • Suppose if we deliver 6 litres of oxygen per min ,what is the Fio2 • ANS- Fio2 = 44% with 6 litres of O2 P/M
  • 14. NASAL CANNULA • Flow rate - 2-6 litres per min • 24-45 percentage • Advantage – light weight ,comfortable,inexpensive and continuous use with meals and activity. • Disadvantage – nasal mucosa drying
  • 16. Oropharyngeal catheter • Flow rate – 1-6 Litres • Deliver 22-44 % • Adv – inexpensive and no need for tracheostomy • Dis adv – mucosal drying ,catheter should be changed frequently to both nostrils
  • 18. Simple face mask • Flow rate – 6-8 Litres • Deliver 40-60% • Adv – inexpensive and simple to use • Dis adv – mucosal drying ,poor fitting
  • 20. Partial rebreather mask • Flow rate – 8-11 Litres • Deliver 50-75 % • Adv – moderate oxygen concentration • Dis adv – mucosal drying ,poorly fitting , must remove to eat.
  • 22. Non rebreather mask • Flow rate – 10-12 Litres • Deliver 80- 100 % • Adv – High oxygen concentration • Dis adv – poorly fitting ,must remove to eat
  • 25. Trans tracheal catheter • Flow rate – 4 Litres/min • Deliver 60=100 % • Adv – more comfortable , concealed by clothings ,less o2 is needed to achieve 100% saturation • Dis adv – requires frequent and regular cleaning and needs surgical intervention
  • 27. Venturi mask • Flow rate – 4-6 l/min • Deliver 24-40 % • Adv – precise fio2 and additional humidity available • Dis adv – must be removed to eat Colour Fi O2 O2 flow Blue 24% 2 l/min White 28% 4 l/min Orange 31% 6 l/min Yellow 35% 8 l/min Red 40% 10 l/min Green 60% 15 l/min
  • 28.
  • 29. Trans tracheal catheter • Flow rate – 4 Litres/min • Deliver 60=100 % • Adv – more comfortable , concealed by clothings ,less o2 is needed to achieve 100% saturation • Dis adv – requires frequent and regular cleaning and needs surgical intervention
  • 30. Aerosol mask • Flow rate – 8-10 Litres/min • Deliver 21- 100% fio2 based on nebulizer setting • Adv – good humidity and accurate Fio2 • Dis adv – uncomfortable for some
  • 32. Tracheostomy collar • Flow rate – 8-10 Litres/min • Deliver 30- 100 % • Adv – good humidity , comfortable ,fairly accurate Fio2 • Dis adv – requires surgical intervention
  • 34. T-piece • Flow rate – 8-10 Litres/min • Deliver 60=100 % • Adv –good humidity , comfortable ,fairly accurate Fio2 • Dis adv – heavy with tubings
  • 36. Face tent • Flow rate – 8-10 Litres/min • Deliver 30- 100 % • Adv –good humidity , comfortable ,fairly accurate Fio2 • Dis adv – bulky and cumbersome
  • 38. Complications Of Oxygen therapy • Infection • Combustion • Oxygen toxicity • Atlectasis • Retrolental fibroplasis • Retinal damage • Asphyxia
  • 39. • Thank you • Count down starts now ………. • Study well ,future of India is in our hands ……..