1. Oxygen Administration R/C MERT Medic Assistant Lesson V

2. Objectives  Be able to correctly explain: Oxygen tank safety Oxygen tank anatomy The pin system Flow rate on regulator  Be able to perform the following tasks: Regulator removal and placement Turn the oxygen tank On and Off  Check pressure and bleed Apply an NRB to the tank

3. Oxygen Tank Safety  The oxygen tank is a heavy piece of equipment and can cause serious damage to the user or patient if dropped  The cylinder outlet is narrow and weak, if it snaps the oxygen tank will become a torpedo More like the air tank in the movie Gone in 60 Seconds, but you get the idea.

4. Oxygen Tank Safety Cont.  Oxygen is a combustible gas and will explode if exposed to excess heat NASA uses oxygen as a fuel source for their rockets  The oxygen is under high pressure and can damage the regulator of the tank if exposed to this pressure for an extended period of time, without the exit of the oxygen This just means to make sure that when the tank is off, no pressurized oxygen is left in the regulator

5. Oxygen Tank Safety Cont.  Take the proper precautions with the oxygen tank Keep the tank on the ground and on it’s side Do not leave the tank unattended Do not drop the tank Do not keep the tank in excess heart or use near an open flam (cigarette) Bleed the regulator after every use (discussed later)

6. Anatomy of the Oxygen Tank Oxygen Tank Cylinder Outlet Pressure Gauge Flow Meter Oxygen Outlet Main Valve Main Valve Key Regulator

7. The Pin System  Technique implemented to ensure that only medicinal oxygen is used when oxygen is administered to patients  A regulator has a series of protruding pins that are in a configuration only associated with that particular regulator  The cylinder outlet has a series of pin inlets that will only allow the regulator designed for that tank to be fitted properly Like a puzzle  This ensures that a tank for medicinal oxygen receives a regulator for medicinal oxygen, and a that a tank for helium or some other gas can’t be accidentally attached to a medicinal oxygen regulator

8. Medicinal Oxygen Pin System Oxygen Tank Regulator Pins Oxygen Outlet/Inlet

9. Regulator Flow Rate  Component of the regulator that determines the rate that oxygen leaves the tank Determines amount of oxygen going to the patient  The numbers indicate the rate in Liters/Minute NRB: 12-15 Lit/Min Nasal Cannula: 1-6 Lit/Min BVM: 12-15 Lit/Min Flow Meter

10. Regulator Removal  To remove the regulator, ensure that the oxygen is turned off and that there is no residual pressure in the regulator  Twist the regulator attachment screw counter clockwise until loose – not all the way out  Pull the regulator pins out from the cylinder outlet, and lift the regulator up off the tank

11. Regulator Placement  Slide the regulator back onto the cylinder outlet of the tank  Align the pins of the regulator up with the inlets of the cylinder outlet  Push the regulator pins in the outlet  Tighten the regulator screw (clockwise) into the cylinder outet – do not over tighten  Ensure that a good seal has been made by testing the tank – turn it on If no hissing sound can be heard – job well done

12. Turing the Oxygen Tank On  Make sure the regulator is attached well  Turn the main valve counter clockwise  When the tank is turned on the pressure in the tank will appear in the pressure gauge  If the pressure is above 800 psi, the tank is good to go on a call, if not it needs to be refilled  When treating a patient, ensure that the tank value is all the way open!

13. Turing the Oxygen Tank Off  Turn the flow meter to off – 0 Lit/Min  Turn the main value clockwise all of the way  Do not over tighten – just enough to stop the flow of oxygen  There will be residual oxygen under pressure in the regulator  Turn the flow meter back up to any number until all oxygen is out of the regulator  Once all the air is out of the regulator, turn the flow meter back to off This is called bleeding the regulator

14. Applying an NRB to the Tank  The most common administration of oxygen is through the use of the NRB  Insert the end of the NRB tubing into the oxygen outlet on the regulator Make sure it is on securely  Turn the main value all the way on Ensures patient will not suffocate  Turn the regulator to 12-15 Lit/Min, or what ever your 801 or 802 wants – will be different if using a nasal cannula

15. Applying an NRB to the Tank Cont.  Once the NRB is attached and oxygen is flowing through it:  Place a gloved finger over the inlet valve of the NRB mask until the reservoir bag of the NRB inflates  Now the NRB is ready for the 801 or 802 to use for the patient

16. NRB on a patient This is the valve your finger will go on to inflate the reservoir bag Reservoir Bag

17. NRB, The Patient, and Oxygen Clean-Up  If the NRB (or any other oxygen delivery device) is no longer needed, or if the device will be attached to a different oxygen source:  Take the mask off of the patient first  Remove the mask from the tank  Turn the flow meter to off  Turn the main value off  Bleed the tank  Put the tank back into the bag  If the mask is no longer needed it must be discarded in a RED BAG

18. Practical Application  Explain oxygen tank safety, anatomy, the pin system, and the flow rate on regulator  Practice do the following: Regulator removal and placement Turn the oxygen tank On and Off  Check pressure and bleed Apply an NRB to the tank