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Optiflow TM via Airvo TM High/Low Flow Oxygen Delivery System Devika Cook Charge Nurse Adult and Emergency PACU Auckland City Hospital.

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Presentation on theme: "Optiflow TM via Airvo TM High/Low Flow Oxygen Delivery System Devika Cook Charge Nurse Adult and Emergency PACU Auckland City Hospital."— Presentation transcript:

1 Optiflow TM via Airvo TM High/Low Flow Oxygen Delivery System Devika Cook Charge Nurse Adult and Emergency PACU Auckland City Hospital

2 What is the definition of a double blind study?

3 Two Orthopaedic Surgeons trying to read an ECG!

4 Objectives

5 Optiflow TM Nasal High/Low Flow Oxygen Therapy Designed to meet inspiratory demand Provides natural balance of temperature and humidity Low level positive airway pressure Used in conjunction with the Airvo TM

6 AIRVO TM High-performance humidifier and integrated flow generator Consistent temperature & humidity level Accurate FiO 2 with a constant flow rate Ability to alter flow rate (15-45 lpm and oxygen percentage 21-60%)

7 Indications for Use Increased respiratory demand Intolerance of conventional face mask Hypoxia/Emergence Agitation Major surgery – abdominal, head and neck High BMI Obesity Smoker

8 Benefits Easy to implement Comfort patient compliance Not affected by NGT Can prevent less invasive ventilation Direct Delivery to Naso/Oro-Pharynx Less dilution effect

9 Benefits - cont Warm humidified oxygen Less damage to mucosa Improved gas exchange and O 2 saturation Decreased LOS in PACU Transferable system for ward use Reduced care costs Disadvantage No battery pack, dependent on AC power

10 Case Study 34 year old male caucasian Post-Op Lap Appendicectomy ASA 1 – training for Auckland Marathon ? Aspirated on induction CXR – slight Pulmonary Oedema Decreased saturations in PACU

11 Clinical Presentation Patient not distressed Breathing not laboured Hudson Mask on 15 litres Persistent low sats 88-90% Nil complaints of Pain or PONV Circulation stable Medical request for CPAP circuit

12 CPAP Circuit Dolly Parton

13 Optiflow TM /Airvo TM Circuit

14 Treatment Optiflow TM via Airvo TM commenced Initially set for high oxygenation 15 lpm of oxygen (piped via flow meter) 15 lpm flow rate (generated by Airvo TM ) Approximate oxygen concentration 63% Arterial line inserted ABGs at 30 minute intervals

15 Treatment - cont 1500 – sats slight improvement to 92% 1600 – sats up to 94% 1630 – commenced weaning of O 2 Oxygen flow 7 lpm(50%) Flow rate to 30 lpm Saturations constant in mid 90s Constant monitoring of ABGs & pulse ox Optiflow TM /Airvo TM titrated for effect

16 AIRVO TM Table

17 Outcome Referred to HDU wait & see Oxygen flow decreased incrementally Steady improvement in saturations Re-routing of ward Six hours later stable Oxygen flow 5 lpm Flow rate maintained at 35 lpm approx 32% Maintaining saturations at 97-98% 2000-transferred to Gen Surg ward with Optiflow TM /Airvo TM

18 Resolution 24 hours later CXR Pulmonary Oedema resolved completely Maintaining adequate saturations on air 48 hours – discharged home Unable to complete the Marathon

19 Conclusion Early intervention with Optiflow TM /Airvo TM O 2 delivery and humidification does have an impact on patient outcomes Works relatively quickly – sustained effect Suitable for patients when conventional masks are not feasible Can decrease LOS in PACU Simply Better Oxygen Therapy

20 Acknowledgements Product Specialist F & P Annelise La Roche Materials Management ACH Nurse Educators PACU Liz Boucher & Penny Jones Level 8 PACU RNs For embracing the technique and ongoing support of the system

21 The A, B, C of Anaesthesia Airway Bagel Coffee


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