NREMT EMT 4: Patient Treatment and Transport - Oxygen Therapy, Nasal Cannula, Non-Rebreather Mask, Bag-Valve-Mask, BVM Ventilation, High-Flow Oxygen

What This Is: Oxygen Therapy

Oxygen therapy is a medical treatment that provides extra oxygen to someone who's struggling to breathe. Imagine you're on a plane, and the air pressure drops – you might feel lightheaded or dizzy. That's similar to what happens when someone's body doesn't get enough oxygen. Oxygen therapy helps get more oxygen to their body, which can be lifesaving.

Key Steps / Core Facts

• Oxygen Concentration: The amount of oxygen in the air (21% in normal air, 60-100% in oxygen therapy). Why it matters: too little oxygen can cause brain damage, too much can cause lung damage. Example: a non-rebreather mask provides 60-100% oxygen.
• Nasal Cannula: A tube that delivers oxygen through the nose (1-6 liters per minute). Why it matters: helps people breathe easier, especially during exercise or in high-altitude areas. Example: a 4-liter nasal cannula is a common setting.
• Non-Rebreather Mask: A mask that delivers 60-100% oxygen (12-15 liters per minute). Why it matters: provides high concentrations of oxygen, often used in emergency situations. Example: a non-rebreather mask is used for severe asthma attacks.
• Bag-Valve-Mask (BVM) Ventilation: A device that helps someone breathe using a bag and mask (1-2 breaths per second). Why it matters: helps people breathe when they're not able to on their own. Example: a BVM is used for cardiac arrest.
• High-Flow Oxygen: A device that delivers high concentrations of oxygen (up to 60 liters per minute). Why it matters: helps people breathe easier, often used in critical care situations. Example: a high-flow oxygen device is used for severe respiratory distress.
• Oxygen Flow Rate: The amount of oxygen delivered per minute (1-60 liters per minute). Why it matters: too high can cause lung damage, too low can cause brain damage. Example: a 6-liter flow rate is a common setting.
• Oxygen Saturation: The percentage of oxygen in the blood (normal range: 95-100%). Why it matters: low oxygen saturation can cause brain damage. Example: an oxygen saturation of 90% is considered low.
• Respiratory Rate: The number of breaths per minute (normal range: 12-20). Why it matters: too high or too low can cause respiratory distress. Example: a respiratory rate of 30 breaths per minute is considered high.
• Mnemonic: "O2" stands for "Oxygen, Oxygen, Oxygen" – remember to check oxygen levels, flow rate, and saturation.
• Red Flag: If someone's oxygen saturation is below 90%, they need immediate oxygen therapy.

What Laypeople Can Do

• If someone is struggling to breathe, call 911 and provide oxygen if available.
• If you're with someone who's having a severe asthma attack, use a non-rebreather mask to provide high concentrations of oxygen.
• If you're with someone who's having a cardiac arrest, use a BVM to help them breathe.

Common Mistakes

• Mistake: Not checking oxygen saturation levels.
• Fix: Use a pulse oximeter to check oxygen saturation levels, and adjust oxygen therapy accordingly.
• Mistake: Not adjusting oxygen flow rate.
• Fix: Adjust the oxygen flow rate based on the person's respiratory rate and oxygen saturation levels.
• Mistake: Not using a non-rebreather mask for severe asthma attacks.
• Fix: Use a non-rebreather mask to provide high concentrations of oxygen for severe asthma attacks.

Quick Practice Scenarios

1. A person is having a severe asthma attack and is struggling to breathe. What should you do first?

Provide oxygen using a non-rebreather mask.

1. A person is having a cardiac arrest and is not breathing. What should you do first?

Use a BVM to help them breathe.

1. A person is having trouble breathing and their oxygen saturation is 80%. What should you do first?

Provide oxygen using a nasal cannula and adjust the flow rate to 4 liters per minute.

Last-Minute Exam Cram

• Oxygen saturation below 90% requires immediate oxygen therapy.
• Normal respiratory rate: 12-20 breaths per minute.
• Normal oxygen concentration: 21% in normal air.
• Agonal breathing is NOT normal breathing – start CPR.
• Pulse oximeter: a device that measures oxygen saturation levels.
• BVM: a device that helps someone breathe using a bag and mask.
• High-flow oxygen: a device that delivers high concentrations of oxygen.
• Non-rebreather mask: a mask that delivers 60-100% oxygen.
• Nasal cannula: a tube that delivers oxygen through the nose.
• Oxygen flow rate: the amount of oxygen delivered per minute.
• Oxygen saturation: the percentage of oxygen in the blood.