Page 417 - WSAVA2018
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presentation, disease and availability within the clinic. Methods include:
· · Oxygen supply
· · Tubing
· · The anaesthetic machine is often used when providing oxygen via a mask, as the mask fits snugly on the end of the appropriate anaesthetic circuit.
· · Again, remember to ensure that the gaseous agent is turned off and the circuit has been thoroughly flushed prior to use.
· · Masks can also be used with a humidified oxygen source with the correct adaptor.
Head Tent / Box Oxygen
This is a simple and effective technique for providing supplemental oxygen, although may not be tolerated by some patients.
Equipment required Elizabethan collar (or similar)
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‘Flow-by’ / ‘Fly-by’ Face mask
Head Tent Oxygen Box
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immediate stabilisation as too stressful to patient and time consuming
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as possible
Nasal Oxygen – not recommended for
Fly By / Flow By Oxygen
This is an excellent way to provide oxygen for a distressed patient on presentation.
Equipment Required:
· · Oxygen supply
· If this is not available the anaesthetic machine can be used, however ensure that the gaseous anaesthetic is turned off and the system has been flushed, so no anaesthetic residue is in the line.
· · A humidifier is preferred for any prolonged administration time
· Specific oxygen tubing is available that can be attached to the regulator / humidifier. This tubing can also be attached to the oxygen port on the anaesthetic machine with a small adaptor.
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Glad wrap Oxygen tubing Oxygen supply Tie for collar
Hold tubing as close to the patients airway
· · Cover the collar front with glad wrap / cling film, leaving a small gap at the top for expired carbon dioxide to be excreted
· · If the patient has reduced consciousness you may be able to place the tubing just inside the mouth without distressing it
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· · tie
Secure glad wrap / cling film with tape
· · Face Mask
Have the oxygen on the highest flow rate
Position end of oxygen tubing on the bottom of the e-collar (away from gap) and secure in place with adhesive tape
Although a face mask will provide a greater amount of inspired oxygen than ‘fly by’, it can be very stressful for the patient and often make the situation worse. Imagine if you could not breathe and someone tried to place something over your airway!
The mask, if used, does not have to be an airtight fit as expired carbon dioxide needs to be released.
High oxygen flow rates should be used and if full coverage of the mouth / nose is not possible, hold as close to airway as tolerated.
Provide oxygen at a flow rate of 8-10L/min
Equipment · ·
Mask of appropriate size
· Facial trauma Although this is an excellent way to provide oxygen support when nasal oxygen cannot be placed due to facial trauma, the patient must be closely monitored for pooling of fluids (e.g. blood, saliva) within the head tent.
· Heat The head tent can become quite hot if
a suitable area has not been left unwrapped. Careful monitoring should be provided to ensure panting from excessive heat or discomfort from heat within the box does not occur.
· Patient observation As the head of the patient
Your Singapore, the Tropical Garden City
Collect appropriately sized Elizabethan
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collar and assemble
Place e-collar on patient and secure with
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Considerations to be aware of include:

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