Hospital Oxygen Delivery Devices

So, you're having a flare-up. You require the services of an emergency room. A nurse or respiratory therapist will assess your oxygen levels. If they are low, you may need one of our oxygen delivery devices. Here's what we have available.

If you haven't done so already, you may want to read "Home Oxygen Delivery Devices." In that post, I define some terms used in this post.

Low flow delivery devices

These are oxygen devices that supply you with supplemental oxygen. But, the flow is not high enough to prevent you from inhaling room air. So, low flow basically means you will be inhaling a mixture of supplemental oxygen plus room air.

Nasal Cannula

I defined this in the above linked to post. This is the simplest of all oxygen delivery devices. Our goal is to get you to only need one of these. Some of you may probably already use one at home. This is because these are the most comfortable and easiest to use oxygen delivery device.

What can they do?
These are low flow oxygen devices. Depending on the flow, they deliver anywhere from 22-44% FiO2. Most people with COPD only need 2-3 LPM. This delivers FiO2s of 28-32% respectively. This is usually all that's needed to maintain oxygen levels with stable COPD.

What are limitations?
During flare-ups, your respiratory pattern may change. This may cause the FiO2 you are inhaling to decrease. Also, 6LPM is the maximum effective liter flow. So, if this is not enough to maintain an adequate SpO2, some other oxygen delivery device may be indicated.

Non-rebreather masks (NRB)

These are funny looking masks. They have a huge bag attached to them. They also have ports or openings on either side of the mask. You may look like an alien from Mars while wearing one. But, fortunately, they are usually only used short-term.

One of these holes is covered by a rubber flap. This flap acts as a one-way valve. This makes it so you can exhale through it, but you cannot inhale room air. Supplemental oxygen comes up the tubing. While you are exhaling, this oxygen is stored in the bag. So, this bag is called a reservoir bag. It's a reservoir for oxygen. When you exhale, oxygen is stored in it.

What they can do?
Tubing from the mask is hooked to a flowmeter and oxygen source on the wall. The flow is set at 12-15 LPM. This allows you to inhale about 75% FiO2.

Limitations 
The FiO2 may vary depending on leaks in the system, Liter flow set, and your respiratory pattern. If they do not deliver enough oxygen to maintain adequate oxygen levels, a high flow oxygen device (see below) may be indicated.

Partial rebreather

These are basically NRBs. But, the flap is removed. This allows you to inhale more room air. This allows you to inhale about 60% FiO2.

High flow delivery devices

These are oxygen delivery devices that supply you with supplemental oxygen. But, the flow is high enough that we can prevent you from breathing any air from the room. So, this allows us to supply you with specific FiO2s.

Venturi mask

These are masks. Attacked to the bottom is a weird looking gadget. This gadget allows us to adjust the mask. This allows us to deliver a specified Fio2. They allow us to give you anywhere from 28%-50% FiO2.

These masks were actually invented specifically for COPD. This was back in the 1950s. Back then, it was learned how important oxygen is to COPD patients. It was also learned that too much oxygen can be harmful. So, we wanted to deliver you lower FiO2s to maintain adequate oxygenation.

High flow nasal cannula

These are fancy, and often weird looking, nasal cannulas. They allow us to deliver flows higher than 6LPM. They can deliver very high flows to you. What we set it at depends on what you can tolerate. It also depends on what your oxygen demands are. With these, we can deliver all the way up to 100% Fio2.

These are nice because you don't need a mask.

Oxygen machines

Some people with COPD benefit from CPAP and BiPAP. In fact, many even have these at home. In the hospital, our machines are a lot fancier than your home units. They have more bells and whistles. They also allow us to deliver 21-100% Fio2 if you need it. So, they may also be considered high flow oxygen devices. We also have machines called Ventilators. Leon wrote about them in his post, "Intubation And Ventilators." These are rarely used for COPD these days. But, they do allow us to deliver high flow oxygen, anywhere from 21%-100%.

What to make of this? So, these are the most common oxygen delivery devices used in hospitals. In my next post, I will describe how we decide which oxygen delivery device to use. So, stay tuned!