Oxygen Delivery and Positive Pressure

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Supplemental O2 Devices

https://infonet.nyp.org/Nursing/Standards/OxygenTherapyProcedure.pdf

https://infonet.nyp.org/Nursing/Standards/RespiratoryTreatment.pdf

Positive Pressure Indications and Contraindications

NIPPV can be used on patients that are hemodynamically stable, cooperative and able to maintain a patent airway and clear his or her own secretions

Contraindications:

apnea

hemodynamic instability

somnolence

high risk for aspiration and inability to clear secretions

dec mental status and confusion

severe claustrophobia

Comparing CPAP and BiPAP

CPAP:

Delivers the same pressure throughout the resp cycle

Decreases alveolar dead space and improves intrapulmonary shunt by opening the alveoli

Decreases atelactasis, reduces work of breathing, and reduces hypoxia

BiPAP

Provides two pressure levels: IPAP (insp positive airway pressure) and EPAP (exp positive airway pressure). Pressure delivered during IPAP > than pressure delivered during EPAP

Helps maintain open airways and increase tidal volume and alveolar ventilation, improves hypercarbia and decreases the work of breathing using IPAP

EPAP increases functional residual capacity and improves hypoxemia by keeping alveoli inflated during expiration