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1

Define supplemental oxygen.

A supply of 100% oxygen for use with ill or injured patients.

2

Define oxygen concentration.

The amount of oxygen being delivered to a patient.

3

Define humidifier.

A device used to increase the moisture content of supplemental oxygen.

4

Name some common reasons a patient may need oxygen.

Respiratory compromise
Cardiac compromise
Cardiac arrest
Shock
Major blood boss
Injury to the lungs or chest
Airway obstruction
Stroke

5

What are the three (3) most common indications that a patient may be in need of supplemental oxygen?

Abnormal signs and symptoms - includes abnormal vital signs, significant pain, or any other complaint that is out of the ordinary.

Significant mechanism of injury - any person who has suffered a significant injury, regardless if there is an open wound or not, may have sustained damage to the circulatory system resulting in a disruption in normal blood flow to all the vital organs.

Increased level of distress - anyone who appears to be in significant distress as indicated by difficulty breathing or significant pain.

6

What are the three (3) hazards of oxygen.

1. Oxygen used in emergency care is stored under pressure (2,000 psi or greater). If the tank is punctured or if a valve breaks off, the supply tank and the valve can become projectiles, injuring anyone nearby.

2. Oxygen supports combustion and causes fire to burn more rapidly.

3. Oxygen and oil do not mix. When they come into contact with one another, there can be a severe reaction, which may cause an explosion.

7

What does a typical oxygen delivery system include?

Oxygen source (oxygen cylinder)
Regulator
Delivery device (cannula, mask)
Humidifier ( occasionally when more than 30 minutes of oxygen are provided)

8

Oxygen is considered a medication, true or false?

True

9

Describe hypoxic drive.

When a patient has become used to the lower levels of oxygen in their lungs and blood. Prolonged use of a high concentration of oxygen can lower their drive to breathe, causing respiratory arrest in some patients.

This is not common in the prehospital setting and is rarely a concern for the EMR. Never withhold supplemental oxygen from someone in respiratory distress.

10

What is a pressure gauge?

The device on a regulator that displays the pressure inside a cylinder.

11

What is a pressure regulator?

The device used to lower the delivery pressure of oxygen from a cylinder.

12

What are the common cylinder sizes and contents used in EMR?

Jumbo D cylinder, which contains about 640 L of oxygen.
D cylinder, which contains about 425 L of oxygen.
E cylinder, which contains about 680 L of oxygen

13

When should you check an oxygen cylinder?

The beginning of your shift
Before each use
While in use
At the end of each use

14

What should you use to determine the pressure remaining in your oxygen tank?

Pressure gauge

15

Where is the pressure gauge located?

Directly on the pressure regulator.

16

What does a pressure gauge show you?

Actual pressure inside the tank.

17

What is the PSI of a full oxygen tank?

2,000

18

What is the PSI of a half-full oxygen tank?

1,000

19

What is the PSI of a quarter-full oxygen tank?

500

20

You should never allow the pressure of an oxygen cylinder to fall below what PSI?

200

21

What can happen if an oxygen cylinder is completely empty?

Moisture can accumulate inside the tank and cause oxidation or rust to develop.

22

What does a five point star stamped on the crown of a cylinder indicate?

It is allowed to go up to 10 years between test dates.

23

What are the twelve (12) general guidelines to keep in mind when working with high-pressure cylinders?

1. never allow smoking around oxygen equipment
2. never use oxygen equipment around open flames or Sparks
3. never use grease or oil on devices that will be attached to an oxygen cylinder. Do not handle those devices when your hands are greasy.
4. never put tape on the cylinder outlet or used tape to mark or label any oxygen cylinder or oxygen delivery equipment. The oxygen can react with the adhesive left behind and produce a fire.
5. never store a cylinder near high heat or in a closed vehicle that is parked in the sun.
6. always keep portable oxygen cylinders lying flat. If you must stand a tank up right, keep your hand on the tank to prevent it from falling over.
7. always use the pressure gauges and regulators that are intended for use with oxygen and the equipment you are using.
8. always ensure that the O-ring is in good condition and free of cracks or divits. This will help prevent dangerous leaks.
9. tighten all valve connections hand tight only.
10. open and close all valves slowly
11. always store reserve oxygen cylinders in a cool, ventilated room as approved by your EMS system.
12. always have oxygen cylinders hydrostatically tested. This should be done every five years for steel tanks (three for aluminum cylinders). The date for retesting should be stamped on the top of the cylinder near the valve.

24

What grade of oxygen is used in EMS?

Medical grade oxygen

25

How often must medical grade oxygen cylinders be tested?

Every 5 years

26

Define hydrostatic test.

The process of testing high-pressure cylinders.

27

What are the three (3) functions of an oxygen or pressure regulator?

1. Reduce tank pressure
2. Display tank pressure
3. Control the delivery of oxygen

28

And oxygen regulator can reduce the pressure in the tank to what PSI?

Between 30 and 70 psi

29

Define liter flow.

The measure of the flow of oxygen being delivered through a mask or cannula.

30

Define LPM.

liters per minute