A medicine student arrives at the emergency unit due to a burn injury that occurred inside the laboratory and an inhalation injury is suspected. Which of the following is the appropriate oxygen therapy for the client?
A. Oxygen via nasal cannula at 5 L/min.
B. Oxygen via a tight-fitting, non-rebreather face mask at 100% concentration.
C. Oxygen via nasal cannula at 10 L/min.
D. Oxygen via Venturi mask at 30% Fi02.
Correct Answer: B. Oxygen via a tight-fitting, non-rebreather face mask at 100% concentration.
If an inhalation injury is suspected, management includes the administration of oxygen via a tight-fitting, non-rebreather face mask at 100% concentration. This is prescribed until carboxyhemoglobin levels in the blood fall below 15%. Non-rebreathing masks have a bag attached to the mask known as a reservoir bag, which inhalation draws from to fill the mask through a one-way valve and features ports at each side for exhalation, resulting in an ability to provide the patient with 100% oxygen at a higher LPM flow rate.
Options A and C: The nasal cannula is a thin tube, often affixed behind the ears and used to deliver oxygen directly to the nostrils from a source connected with tubing. This is the most common method of delivery for home use and provides flow rates of 2 to 6 liters per minute (LPM) comfortably, allowing the delivery of oxygen while maintaining the patient’s ability to utilize his or her mouth to talk, eat, etc.
Option D: An air-entrainment (also known as venturi) mask can provide a pre-set oxygen to the patient using jet mixing. As the percent of inspired oxygen increases using such a mask, the air-to-oxygen ratio decreases, causing the maximum concentration of oxygen provided by an air-entrainment mask to be around 40%.
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