In face mask. A simple face mask should be

In EMS we are sometimes
called to a patient that appears in respiratory distress. Once we arrive on
scene we must provide oxygen to our patient to prevent the patient from
declining. Sometimes the 911 call can be for trauma and cardiac, and we provide
oxygen just because of the MOI. The best oxygen therapy for a patient that is
not in respiratory arrest would be a non-invasive airway and breathing device.
Just some of our devices include the use of a partial rebreather, a simple face
mask, and an venturi mask. The decision on which device to use should be based
on protocol for the patients complaint, and at EMS discretion on if its appropriate
for that patient.

             A partial rebreather
mask is a simple face mask with a reservoir bag attached to it. The partial rebreather
should be used with 8-15L of oxygen to assure that the bag is at least 1/2 full
during inspiration. The partial rebreather provides a range of 40% to 70% of
FiO2. The risk of the partial rebreather is the build-up and inhalation of the exhaled
CO2. The indication for the partial rebreather is hypoxia, shock, trauma, and of
course a respiratory illness.  Another
device that can be used is a simple face mask. A simple face mask should be use
with 5-12L of O2, with a FiO2 delivery range of 30-60% O2 depending of the set
flow rate, and depth of breathing. The minimum O2 flow should be 5LPM to prevent
rebreathing of exhaled air. The simple face mask should only be used
temporarily to prevent CO2 intake. The simple face mask should only be used in
mild respiratory cases. The venturi mask provides the most adequate oxygen
without intubation. The mask is a high flow device, and delivers between 24%-50%
of FiO2. The set flow rate also is determined by the FiOS adapter. The mask is used
by using a portion of room air to each liter flow of oxygen. The FiO2 adapters
have different size holes in them, which allows a certain amount of air to mix
in with the oxygen being provided. Each FiO2 adapter uses a different O2 flow. The
only problem with the venturi mask is that when the FiO2 increases the air to
oxygen ratio decreases, especially after 35%. For example, a patient with 60%
of FiO2 on 12L of O2 is only receiving a total flow of 24LPM. This mask does
not require humidification. I would use this mask on a patient that is in respiratory
distress, and at a high risk of going into respiratory failure.

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            These devices are just a few that can be used in the
medical field. All of them provide adequate oxygen to a patient that is needing
oxygen therapy. You can use that patient’s oxygen saturation levels to assure that
the patient is getting the adequate amount of oxygen, and can also use capnography
to assure adequate ventilation, and to also determine if the patient is
exhaling CO2 with expiration. While providing oxygen therapy, you should
encourage the patient to take deep breaths, to ensure intake of oxygen, and
decrease anxiety level. Vital signs should be obtained during and after oxygen therapy
to ensure that the patient is responding well, and that you are providing the
best device for the crisis. You should listen to lung sounds as part of the
vitals signs on a patient that appears in respiratory distress, this will provide
you with a little information on what the patient is experiencing, and if the
oxygen is helping with the issues. A patient that is experiencing a respiratory
crisis is at risk of hypoxia, in which causes multiple other issues once it
occurs. Oxygen should be provided during your medical assessment as soon as you
notice the patient is in distress. Other steps should be taken if you notice
the patient is no longer in respiratory distress, but is now experiencing respiratory
arrest. You should monitor you patient closely while providing oxygen during
transportation.