Titrate Oxygen – COPD Nursing Care in ER

00:00 Now I wanna go back to that word 'titrate'.

00:03 What does it mean to titrate oxygen? We see on the screen, we have an oxygen flow meter.

00:11 See that little green knob on it? That's what we turn up and down and that little ball will float.

00:17 Wherever the middle of that ball is, that's gonna tell us how many liters of oxygen the patient is receiving.

00:23 So you're gonna titrate it by turning that knob so that you can make sure you changed the amount or the liters that the patient is receiving.

00:32 We'll look at our orders.

00:35 Every 15 minutes, we're gonna go up a little bit on that if we can't keep a sat at 93.

00:41 Now we're gonna go all the way up to 4 liters and if that still can't maintain the sat, then we're gonna switch to a Venturi mask.

00:49 So those are the orders the health care provider has written for us for titrating the oxygen.

00:54 You're gonna monitor the pulse ox, make small changes in the oxygen as ordered until the target pulse ox reading is reached.

01:02 So that's what it means when you get a titrating an oxygen order.

01:07 Think of it as kinda like a sliding scale that we use with insulin.

01:09 If you have this number as a blood sugar, the physician has written orders for how much insulin you give.

01:15 Same thing with titrating oxygen.

01:18 If you have this pulse ox, these are the changes -- the small changes you make in the O2 amount of liters the patient gets per minute.

01:26 Okay, so let's practice.

01:27 Got the order, titrate oxygen on nasal cannula 1 liter every 15 minutes.

01:34 So I know I'm only gonna go up what amount? Right, 1 liter and I'm gonna check every 15 minutes trying to get that pulse ox between 90 and 93.

01:44 Now if you can't keep the pulse ox after 15 minutes and we've gone up to 4 liters, then we're gonna change to a Venturi mask.

01:52 So let's take another patient. I'm just gonna give you a patient that's not Mrs. Taylor, okay? So the example, it's 8 o'clock in the morning. The patient's pulse ox is 88%.

02:02 We have this order for the patient. They're on 2 liters of oxygen per nasal cannula.

02:06 What do you do? Okay, well, 88% is not in the range of 90-93 so I need to do something.

02:16 I need to change it. The order tells me to increase by how much? Right, 1 liter. So what I should do is increase the oxygen from 2 liters to 3 liters by changing that knob on the oxygen flow meter.

02:32 When should I recheck the pulse ox? The order tells me in 15 minutes.

02:37 So you wanna give it some time for the oxygen to settle in and see if it's gonna be enough for it.

02:42 So we wait every 15 minutes, we'll keep going up on the oxygen.

02:46 Now if the patient's status drastically changes, we would do something different.

02:51 We're talking about the patient stays relatively the same or better, we're gonna do this slowly 1 liter of oxygen at a time.

02:59 So that's an example of another patient, not Mrs. Taylor.

03:03 Now we're gonna apply this order to what we would actually do for Mrs. Taylor.