Supplemental Oxygen: Flow Meter (Nursing)

by Rhonda Lawes, PhD, RN

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      Slides Nursing Supplemental Oxygen FiO2 and Controlling the Flow.pdf
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    00:00 Okay, now is the chance to test your memory. What's the average percentage of oxygen in room air? What do you got? Right. It's 21%. So hopefully you're in breathable room air right now and you're breathing in about 21%. Now, how do you know how many liters of oxygen your patient is receiving? I will never forget the first time they told me to put a patient on 4 liters of oxygen. I wasn't even exactly clear on how to do that. They did a research study and they found out that several healthcare professionals were also unclear about exactly how to do that. Now we're going to talk about the flow meter and the black ball. So see the flow meter there, that's the entire piece of equipment you see in that graphic, but look down there toward the bottom. There's a little black ball in there. Now when you turn on the oxygen, there's a little knob usually on the front and you turn that knob and that little ball will start to float higher and higher. So that will indicate to you how many liters of oxygen you're giving the patient. So in there, a little black ball will float and on those lines are numbers. That indicates the number of liters that's being delivered to the patient. Now the problem came with the healthcare professionals. Some looked at the top of the ball, some looked at the bottom of the ball, but actually the correct way to do this is at the middle of the ball. So use that knob to adjust the number of liter flow so that the middle of the ball lines up with the appropriate number ordered liters. Okay? So don't make the same mistakes other healthcare professionals have made. Be clear, it's the middle of the floating black ball that indicates how many liters your patient is on. Now let's talk about the ways we control the flow with these flow meters. See, they can either be inserted directly into wall outlets or the meter might be attached to a portable oxygen cylinder. Now what you see in the picture is actually a wall outlet. We'll show you in a minute what a portable cylinder would look like. I want to point out what a Christmas tree is. Yes, that is the actual name most of us call it. A Christmas tree is usually green, but I guess it could be any color like the one you see in the picture, but usually they're green. It's a tree-shaped connector. Now it goes at the bottom of the flow meter and that's where the oxygen tubing is connected. So, at the top the widest part, that's the part that we'll screw on to the oxygen meter. As the tree goes down to the point where we would put the star or the angel that was a real Christmas tree, that's where you connect the oxygen tubing. Now, a nasal cannula or a mask, all of these apparati will have tubing. So that's where you would connect it. If I have the flow meter and no Christmas tree, I'm not going to be able to connect them. So that's what a Christmas tree is used for. Again, I remember when they asked me to go get a Christmas tree and I just looked at them like "whoaaahhh." I didn't know what it was. You quickly don't forget that one once you see it. So when you're making those connections, make sure that connections are tight. I want the Christmas tree on their snug, don’t try it super clamp it down but make sure it's snug and when you connect the oxygen tubing same thing. You don't want any leaking because we want to make sure that we're delivering an accurate amount of liter flow to that patient. Now wall supply oxygen, you can see the flow meter right there is plugged directly into a special outlet that supplies oxygen.

    03:39 I want to kind of talk about those outlets. Make sure you read the labels carefully. A lot of hospitals have them color coated, they're the same in every room, but you want to make sure that you don't confuse the oxygen flow meter with a medical air outlet. Okay, that's not going to be oxygen. Medical air is a clean supply of compressed air. We use it for some other purposes, but we don't use it to oxygenate the patient. We use it in hospitals and healthcare facilities to distribute other medical gases, but we don't want you to plug and think that you've got an oxygen meter in a medical air. So just read the labels, you'll be fine. I promise that will be very clearly labeled in the patient's room. Now, this is a graphic that represents a portable oxygen tank. Hey this is serious stuff. This is a really scary thing because that oxygen cylinder can be potentially explosive if it's not handled correctly. So don't ever get in a hurry and set an oxygen tank down and just leave it there. If that gets knocked over, it could be a really big problem for everyone. So, oxygen tanks should always be stored in a stand because you don't want it to tip or to fall. If that happens, that's under extreme pressure. If that tank is damaged, it becomes like a missile and it could shoot off at a high rate of speed. I mean like going through a wall high rate of speed. So, you'll actually have to take safety training if you're employed by a hospital and how to handle oxygen. Because I've never seen it happen, but the potential is always there. Everyone knows. Never leave the tank free standing, always have it in a cart, and handle with care. If you're trying to __ a patient and a tank and an IV, don't do it, get help. Don't do things, you need more equipment than you have hands, then you need someone to help you move that patient. Now humidifier is optional. You can connect it to any flow meter and it will help provide some moisturizer to the oxygen. Even low flow if the patient's wearing it long enough or if they had a high liter, sometimes it can really dry out their nasal passages. Now, long-term oxygen, we use it if they have a high amount, those are good recommendations. There are some kind of debate as if it really helps or not but if it makes your patient feel better consider it. So use it on patients who get high-flow oxygen or who are going to be on it for longer than 24 hours if they say they are going to feel some discomfort up here because they're drying out. So small thing, it's not the difference between life or death but it might make your patient feel much more comfortable.

    About the Lecture

    The lecture Supplemental Oxygen: Flow Meter (Nursing) by Rhonda Lawes, PhD, RN is from the course Supplemental Oxygen (Nursing).

    Included Quiz Questions

    1. 21%
    2. 100%
    3. 90–100%
    4. 10%
    1. Liters per minute
    2. FiO2 percentage
    3. End-tidal capnography
    4. SpO2 percentage
    1. Portable oxygen tanks should never be left freestanding.
    2. Oxygen tanks should always be stored in a stand or cart.
    3. Oxygen in a cylinder is stored under pressure, and if damaged, it can become a missile and shoot off at a high speed.
    4. Smoking is allowed near oxygen tanks when oxygen is being delivered at a low flow rate.
    5. Only respiratory therapy staff should manage and store portable oxygen tanks.

    Author of lecture Supplemental Oxygen: Flow Meter (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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