The Different Parts of Oxygen Tanks

Oxygen tanks revolutionized home care by allowing people who needed constant oxygen the ability to travel away from the hospital. Improper usage of oxygen tanks, however, can cause injuries or in some cases, even death. Knowing how to properly use an oxygen tank will ensure the utmost safety, no matter what the tank is being used for. The first step to understanding how to use an oxygen tank is to understand all of the parts and what they are used for. Tank This is also referred to as the cylinder. The tank is the largest part of the apparatus. It is made of metal and is what holds the oxygen in this apparatus. The oxygen is highly pressurized within this tank. Depending on the use for the oxygen tank, they can also vary in size. Small tanks are portable which allows them to be used for purposes such as rescue missions and personal medical use. Larger tanks are usually used to fill smaller containers. A portable medical oxygen tank has a wheeled cart so that it can be moved easily. Crush Gasket This is a plastic washer that comes on every new tank of oxygen and on refilled tanks. The plastic is usually of the Nylon brand. This is not a permanent piece to the oxygen tank. It is put on to ensure that no oxygen leaks from the tank during transport. When setting up a new oxygen tank for use, it is removed and discarded. Humidifier The humidifier is composed of a bottle and an adaptor. The adaptor is used to connect the humidifier to the regulator of the tank. It dispenses a mist of water that mixes with the oxygen before you breathe it in. This part is important because breathing the oxygen directly from the tank can dry a person's nose, mouth, throat, and skin. The water mist stops this from occurring. The water must either be distilled or sterile, as it is mixing with the oxygen a person is about to breathe in, and therefore needs to be as clean as possible. Regulator This piece is attached to the top of the oxygen tank cylinder. Both the flow meter and the pressure gauge are contained on the regulator. The regulator has its own purpose as well. It controls the amount of oxygen that is leaving the tank, and ensures it stays at a safe pressure. Flow Meter The flow meter is located on the regulator. It measures the amount of oxygen that is leaving the tank in liters per minute. The meter is either a vertical line with a small silver ball inside of it that rises or drops as the amount of oxygen leaving the tank changes, or a circle that has a small arrow inside of it that moves around the circle as the amount of oxygen leaving the tank changes.

Pressure Gauge The pressure gauge is located on the regulator with the flow meter. This gauge measures the pressure still inside of the tank to display how much oxygen is remaining. A round, glass covered dial displays the amount of oxygen that is still contained in the tank. A full portable oxygen tank used for most medical purposes has 1800-2200 pounds per square inch (PSI). Sealing Washer The sealing washer is located between the oxygen tank and the regulator. It is a washer made of either metal or metal and rubber. It ensures that there is a tight seal between the two components surrounding it so there is no oxygen leakage. Oxygen Delivery Apparatus The oxygen delivery apparatus is any of a number of breathing apparatuses that transfers the oxygen from the actual tank to the person. This device could be a nasal cannula, nonrebreather mask, partial rebreather mask, or just a simple face mask. The device that is used differs based on the needs of the person using the oxygen tank. Oxygen travels through the regulator, flow meter, humidifier, and pressure gauge to get from the oxygen tank to the tube that connects to the breathing apparatus.

Phototherapy
Definition Phototherapy, or light therapy, is the administration of doses of bright light in order to normalize the body's internal clock and/or relieve depression. Purpose Phototherapy is prescribed primarily to treat seasonal affective disorder (SAD), a mood disorder characterized by depression in the winter months, and is occasionally employed to treat insomnia and jet lag. The exact mechanisms by which the treatment works are not known, but the bright light employed in phototherapy may act to readjust the body's circadian (daily) rhythms, or internal clock. Other popular theories are that light triggers the production of serotonin, a neurotransmitter believed to be related to depressive disorders, or that it influences the body's production of melatonin, a hormone derived from serotonin that may be related to circadian rhythms. Precautions Patients with eye problems should see an ophthalmologist regularly, both before and during phototherapy. Because some ultraviolet rays are emitted by the light boxes used in phototherapy, patients taking photosensitizing medications (medications making the skin more sensitive to light) and those who have sunsensitive skin should consult with their physician before beginning treatment. Patients with medical conditions that make them sensitive to ultraviolet rays should also be seen by a physician before starting phototherapy. Patients who have a history of mood swings or mania should be monitored closely, since phototherapy may cause excessive mood elevation in some individuals.

Description Phototherapy is generally administered at home. The most commonly used phototherapy equipment is a portable lighting device known as a light box. The box may be mounted upright to a wall, or slanted downwards towards a table. The patient sits in front of the box for a prescribed period of time (anywhere from 15 minutes to several hours). Some patients with SAD undergo phototherapy sessions two or three times a day, others only once. The time of day and number of times treatment is administered depend on the physical needs and lifestyle of the individual patient. If phototherapy has been prescribed for the treatment of SAD, it typically begins in the fall months as the days begin to shorten, and continues throughout the winter and possibly the early spring. The light from a slanted light box is designed to focus on the table it sits upon, so patients may look down to read or do other sedentary activities during therapy. Patients using an upright light box must face the light source (although they need not look directly into the light). The light sources in these light boxes typically range from 2,500-10,000 lux. (In contrast, average indoor lighting is 300-500 lux; a sunny summer day is about 100,000 lux). Phototherapy prescribed for the treatment of SAD may be covered by insurance. Individuals requiring phototherapy should check with their insurance company to see if the cost of renting or purchasing a light box is covered. Aftercare Patients beginning light therapy for SAD may need to adjust the length, frequency, and timing of their phototherapy sessions to achieve the maximum benefit. These patients should keep their doctor informed of their progress and the status of their depressive symptoms. Occasionally, antidepressants and/or psychotherapy may be recommended as an adjunct to phototherapy. Risks An abnormally elevated or expansive mood (hypomania) may occur, but it is usually temporary. Some patients undergoing phototherapy treatment report side effects of eyestrain, headaches, insomnia, fatigue, sunburn, and dry eyes or nose. Most of these effects can be managed by adjusting the timing and duration of the phototherapy sessions. A strong sun block and eye and nose drops can alleviate the other problems. Long-term studies have shown no negative effects to the eye function of individuals undergoing phototherapy treatments.

APGAR Scoring for Newborns A score is given for each sign at one minute and five minutes after the birth. If there are problems with the baby an additional score is given at 10 minutes. A score of 7-10 is considered normal, while 4-7 might require some resuscitative measures, and a baby with apgars of 3 and below requires immediate resuscitation.

A P G A R

Sign 0 Points 1 Point 2 Points Activity (Muscle Arms and Legs Absent Active Movement Tone) Flexed Pulse Absent Below 100 bpm Above 100 bpm Grimace (Reflex Sneeze, cough, No Response Grimace Irritability) pulls away Appearance (Skin Blue-gray, pale Normal, except for Normal over Color) all over extremities entire body Respiration Absent Slow, irregular Good, crying

Medications Given to a Newborn

lung surfactant types of meds Beractant(survanta) Colfosceril palmitate(exosurf) 1. replenish surfactant to restore surface activity to the lungs 2. Intratracheal route 3. prevent or treat resp. distress syndrome in premature infants 1. include transient bradycardia and oxygen desaturation 2. adm. with caution to those at risk for circulatory overload. 1. surfactant is instilled through a catheter inserted in infants endotracheal tube 2. avoid suctioning for 2 hours after adm. 3. mon for bradycardia, decreased o2 saturation 3. assess lungs for crackles and moist breath sounds prevent anti RHo(D)antibody formation. 2. Most successful is adm. 28 weeks gestation and within 72 hours after delivery 2. to prevent isoimmunization in Rh negative clients who are exposed or potentially to Rh positive RBCs NOT ADM TO NEWBORNS 1. erythromycin(0.5% ilotycin) 2. tetracycline(1%) 3. Silver nitrate (1%) 1. opthalmic ointment or drops 2. Provide prophylaxis against infection Neisseria gonorrhoe and chlamydia trachomatis. 3.

lung surfactant

lung surfactant-adverse reactions and contraindications

lung surfactant-interventions

RHo(D) immune globulin (RHOGAM)

types of eye prophylaxis

erythromycin (0.5% Ilotycin) and Tetracycline(1%)

Silver nitrate(1%)

eye prophylaxis- adverse reactions and interventions

Vitamin K (aquamephyton)

vitamin K (Aquamephyton)

Rubella vaccine

Rubella vaccine- AR and intervention

Hep B vaccine

Hep B Vaccine- AR and interventions

1. use is minimal bc it does not protect against chlamydial infection and can cause chemical conjuctivitis 2. preventitive treatment of gonorrhea is required by law 1. silver nitrate (1%) can cause conjuctivitis. 2. cleanse neonate eyes before installing drops or ointment 3. instill in each of the neonate conjuctival sacs within 1 hour after delivery 4. do not flush eyes after instillation 1. aiding in production of active prothrombin 2. newborns are deficient in vit. k the first 5-8 days bc lack of intestinal flora necessary to absord vit. k. 3. use for prophylaxis and treat hemorrhage in neonate 1. can cause hyperbilirubinemia in newborns 2. protect medication from light 3. adm in vastus lateralis muscle of the thigh 3. mon for bruising at inj. site and bleeding from cord. 4.monitor for jaundice 1. give if rubella titer is less than 1:8 2. given subcutaneously before hospital discharge to nonimmune postpartum clients AR; transient rash and hypersensitivity Interventions; 1. DO NOT give if client or family member are immunocompromised 2. Take contraception- client should avoid pregnancy 1-3 months given IM to mewborns b4 discharge. 2. recommended for all newborns to prevent hep B. AR; rash, fever, erythema, pain at injection site. Interventions 1. parental consent must be obtained 2. adm. 3rd vastus lateralis IM 2. if mother is pos. for Hep B., hep b immune globulin should be given within 12 hours in addition to vaccine.

Submitted by:

Andes, Rhaye Jannie Clynde BSN II 1

Submitted to:

Mrs. Wilma Fernandez, RN

Clinical Instructor

City University of Pasay College of Nursing and School of Midwifery 13th September 2011