Paramedics Course – Oxygen Masks

Oxygen Masks

Micro-lecture by the Australian Paramedical College

In today’s micro-lecture, Australian Paramedical College Hon. Snr. Lecturer Sam Willis talks about oxygen administration and the different types of masks that you have available to you.

Oxygen Masks

In today’s micro-lecture, we’re going to talk about oxygen administration and the different types of masks that you have available to you. Now as a paramedic, one of the things that you’ll be doing quite often, is assessing a patient’s primary survey. In particular, looking to see how oxygenated they are.

Now when you place an oxygen mask on someone’s face, you are oxygenating them. You are enriching their atmospheric air with oxygen. This must not be mistaken with ventilation. So the process of ventilation involves taking the air in, then using the lungs ripping upwards and outwards, the movement is upwards and outwards, the air goes in, then the body uses the oxygen and excretes CO2. That’s ventilation. So let’s not mix the two.

Now when you need to give patient oxygen, you really are using one of two methods. You’re either looking to see if they are showing signs of hypoxia such as blue lips, pale skin, sweaty, clammy skin, other signs of hypoxia and compensation. Then they’re indicated for oxygen. The other method is to use oxygen saturation. So place the oxygen, the SPO2 meter on their fingers and if it’s below 92%, then they are indicated for oxygen.

Then you need to choose which mask to use. Now this mask here is the high flow mask, all the Hudson and trauma mask. Basically, this mask, in a conscious, well-ventilated patient is the mask to use if the patient is looking really unwell. If they have really low saturation. I’m not gonna give you a number because that is a clinical choice. But basically, here we have a reservoir bag, you have the mask itself, and you have oxygen tubing that leads directly to the oxygen canister. And of course, you have the elastic that keeps it around the patient’s face.

So when you have a situation where the patient looks really, acutely unwell and you’re wanting to give the most amount of oxygen that you possibly can as a paramedic, with the exception of ventilating and doing it for the patient, this is the mask to use.

The next one down from this is the medium concentration Hudson mask. You can use five to six liters, six to seven or seven to eight liters, and that will give you 40%, 50%, and 60% oxygen. Whereas, with the trauma mask here, you really do need to put this under 15 liters of oxygen right away.

So again, in my clinical experience, if my patient’s got oxygen saturation around about 90%, I might put them on this one. I could even put them on a nasal cannula because I’m only trying to raise the oxygenation up by 2%. So the nasal cannula goes around, these two prongs here go into the nose. The cannula goes around the ears, and you can bring it back forwards and tie it here. Or come out, go around the back of the patient’s head.

Let’s take a very quick look at the flow rates. As you can see the nasal cannula, we’re using between one and six liters per minute. So that’s what we’re turning the oxygen canister to at the top. We’re turning it between one and six and you’re able to give between 24% and 44% oxygen. So again, if the patients only need a couple of percent of oxygen, then you can use that.

The simple mask or the medium concentration Hudson mask 6 to 10 liters per minute, and you’re giving 35% to 55%.

A non-rebreather mask is between 50% and 90%. Now, I attempt to only ever use 15 liters per minute because you need that reservoir bag filling up. Notice how you’re never ever giving 100% oxygen with any of these masks because you’ll find that with these masks you’ve got these CO2 ports here, and the CO2 just leaks out of the side, and it also leaks out of here as well.

And of course, you’ve got this thing called a Venturi mask, which is something we haven’t talked about here today. Venturi mask is used for patients with COPD, hence the low numbers here.

Okay, guys. That’s the summary of oxygen masks. You will get a chance to play around with these in the workshops. I hope you’ve enjoyed my session. My name’s Sam Willis and I look forward to speaking to you again shortly. Take care.

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