Fundamentals - Practice & Skills, part 27: Oxygen Delivery Devices, Oxygenation Interventions, and Suctioning

Hi, I'm Meris. And in this video, I'm going to be talking to you about oxygen delivery devices, therapeutic interventions for oxygenation, like chest physiotherapy and positive airway pressure, and best practices for suctioning. I'm going to be following along using our Fundamentals of Nursing flash cards. These are available on our website, leveluprn.com, and if you already have a set of your own, I would invite you to follow along with me, starting on card number 133. Let's get started.

So first up, we're talking about the different types of delivery devices. This is how we get oxygen from the tank to the patient. So you'll see here that on this card we have a table. This table is awesome. I think it is so great and helpful at helping you to understand the information. So it goes over the devices, the flow rates that are required, and then different considerations. Some that I want to pull your attention to, just because I'm not going to go over all of these, nasal cannulas. Nasal cannulas, you can use water-based lubricant in the nares, water-based lubricant, not oil based, not petroleum, water based, to prevent drying because it is very drying to have oxygen being pumped into the nose. A nonrebreather bag. A nonrebreather bag needs to be fully inflated. The reservoir bag needs to be fully inflated prior to applying. But a partial rebreather bag only needs to be kept to two-thirds full. So just an important distinction there. And then your aerosol mask or face tent. That's really great for someone who has facial trauma or claustrophobia, maybe burns. And then lastly, the venturi device. It's actually not a mask, in and of itself, it's a device that is attached to a delivery device, but the thing to know about venturi, when you hear venturi, you need to think precision. The venturi device allows a precise FiO2, fraction of inspired oxygen, to be delivered to the patient, up to 40%, without intubation. That's huge. That's a big deal. So that's what's important to know about venturi devices.

Now, moving on to the next card, we talk about therapeutic interventions for oxygenation. A couple of big ones on here, we have chest physiotherapy, positive airway pressure, and suctioning. So chest physiotherapy is going to be for patients typically with cystic fibrosis or other respiratory conditions like that. It's going to involve postural drainage, percussion, and vibration to help to break up thick secretions and get them out of the patient, but imagine somebody banging on your back or shaking you up with a vibrating vest. It could make you nauseated. So for that reason, be sure to schedule treatments one to two hours after meals or to do it before meals, to avoid vomiting. You'll see that that is in bold red here, on the card. So very important to know. Positive airway pressure. CPAP is continuous positive airway pressure. And then there's BiPAP, bilevel positive airway pressure. All of these are going to apply pressure to keep airway structures open.

Now, suctioning. Suctioning is going to be the use of suction to remove secretions or fluid or blood or anything like that, but let's talk about best practices for suctioning, which is on card number 135. Okay. So look at this. A lot of text here, and some pretty important bold red stuff here that I want to call your attention to as well. I'm not going to go into every single one of these, you can do that in your own time, but I do want to point out a few things. Before you suction your patient, preoxygenate, or hyperoxygenate, you might hear it called, your patient. So give them 100% oxygen because when you suction, you're not just removing fluids. You might also be removing gases, such as oxygen. So we want to make sure that they are fully oxygenated before we suction. Never, ever, ever apply suction while inserting the catheter. You apply suction intermittently as you withdraw the catheter. So it would be like psh, psh, psh, psh. You're very welcome for that excellent example. That's why I'm not an actress. But that's what you want to do. Don't insert the catheter with suction, and don't use constant suction while you're withdrawing the catheter. Make sure you limit suctioning to 10 to 15 seconds per pass and three total passes. Think about it. First of all, it's disruptive to have something in the mouth, right? That's going to be very upsetting for your patient, in most cases. But also, like I said, it could cause their oxygen saturation levels to drop. So we want to make sure that we are not doing that too much. We give the patient a chance to recover and breathe in between suctioning passes and breathe in between suctioning attempts so that we limit that amount of time that we are removing the gas from them. That would not be very good.

Okay. So that is it for oxygen delivery devices, interventions for oxygenation, and suctioning. I hope that review was helpful. If it was, please like this video so that I know. If you have a great way to remember something, I want to hear it. Please put it in the comments below so that I can see it. And be sure you subscribe to the channel so that you can be the first to know when new videos drop. The next one that's coming out in the series is a biggie. It's going to be chest tubes, artificial airways, tracheostomy care, and home oxygen safety. You know if it has to do with oxygenation, it's important. So definitely be sure to join me over there. Thanks so much, and happy studying.