Oxygen therapy and imaging considerations: Rad Tech

. Oxygen is essential to life, and when patients are unable to maintain adequate oxygen levels on their own, supplemental oxygen therapy is provided.

In radiology settings, oxygen therapy is commonly used for both hospitalized and outpatient patients undergoing imaging procedures.

As a radiologic technologist, understanding how to safely monitor and support oxygen delivery during patient care is essential to providing safe, quality imaging services.

Oxygen therapy is used to treat hypoxemia or low levels of oxygen in the blood, and hypoxia or inadequate oxygen delivery to body tissues.

When the body doesn't receive enough oxygen, cells and organs can't function properly. If left untreated, oxygen deprivation can lead to serious complications, including organ damage, respiratory failure, coma, and death.

Supplemental oxygen increases the amount of oxygen available to the lungs and bloodstream, and helps improve oxygen delivery throughout the body.

Because oxygen is classified as a drug, it requires a prescription and must be administered carefully. Oxygen should always be provided when indicated, but at the lowest concentration needed to achieve adequate oxygenation.

While insufficient oxygen levels are dangerous, excessive oxygen administration can also cause harm. High concentrations of oxygen over time may lead to oxygen toxicity, including damage to lung tissue and collapse of the tiny air sacs in the lungs called alveoli.

Methods of oxygen delivery vary depending on the patient's condition and the care setting. In healthcare facilities, bulk oxygen delivery systems distribute oxygen through a network of pipes and valves connected to wall outlets in patient care areas.

When patients receiving supplemental oxygen are transported to the radiology department, portable oxygen cylinders are typically used.

Throughout imaging procedures, radiologic technologists must ensure patients continue to receive their prescribed oxygen safely and without interruption.

Oxygen delivery systems are commonly classified as either low flow or high flow, based on their ability to meet a patient's inspiratory demands and deliver a predictable concentration of oxygen.

Low flow systems provide oxygen at flow rates lower than the patient's breathing demand, so oxygen mixes with room air during inhalation.

As a result, the exact concentration of oxygen delivered can vary depending on the patient's breathing rate and depth. Common delivery devices used in low systems include nasal cannulas, simple face masks, partial rebreather masks, and non-rebreather masks.

When patients need a small amount of oxygen supplementation, a nasal cannula is often the first choice. Nasal cannulas typically deliver oxygen at flow rates of 1 to 6 L per minute through two small prongs placed in the patient's nostrils.

Tubing wraps around the cheeks and behind the ears to keep the device in place. Humidification is often added when oxygen flows greater than 4 L per minute are used, because oxygen can dry the nasal mucosa and cause patient discomfort.

Simple face masks are used when higher oxygen flow rates are needed, commonly around 5 to 10 L per minute, depending on the device and facility policy.

Partial rebreather masks are usually operated at flow rates of at least 10 L per minute, and use a reservoir bag that increases the amount of oxygen available to the patient while reducing rebreathing of exhaled air.

Non-rebreather masks also use a reservoir bag, along with one-way valves that help minimize room air intake and reduce rebreathing of exhaled air, allowing delivery of higher oxygen concentrations.

In contrast, high flow oxygen systems are designed to deliver a more precise oxygen concentration while better meeting the patient's inspiratory demands.

While low flow oxygen is usually prescribed in liters per minute, high flow oxygen is often prescribed according to FIO2, which is the fraction of inspired oxygen.

A common example is the Venturi or air entrainment mask, which delivers a consistent concentration of oxygen concentration and FO2.

High flow nasal cannulas can deliver heated humidified oxygen at flow rates up to 60 L per minute, and FIO2 concentrations up to 100%.

Some oxygen delivery systems are designed specifically for infants and young children. Oxygen tents and oxy hoods are typically used for infants who can breathe on their own but need supplemental oxygen.

Patients with more severe respiratory compromise may require mechanical ventilatory support. Non-invasive methods of ventilation include BIPAP, or bilevel positive airway pressure, which helps reduce the work of breathing by providing higher pressure during inhalation and lower pressure during exhalation.

More invasive ventilatory support requires an artificial airway inserted into the trachea and connected to a mechanical ventilator.

The ventilator helps maintain breathing by delivering a preset respiratory rate, controlled inspiratory volume, and consistent oxygen concentration.

As a radiologic technologist, there are several safety considerations you should keep in mind when caring for patients receiving oxygen therapy.

During transport from the patient care unit to the radiology department, patients are often switched from a wall oxygen outlet to a portable oxygen cylinder to maintain continuous oxygen delivery.

Before transport, verify that the portable oxygen tank contains enough oxygen to support the patient throughout transport and the imaging procedure.

Next, confirm the type of oxygen delivery device being used and verify the prescribed oxygen flow rate or settings. After checking the equipment, open the main valve on the oxygen cylinder and adjust the flow rate to the prescribed setting.

Then disconnect the patient from the wall oxygen source, connect the oxygen tubing securely to the portable tank, and confirm that oxygen is flowing properly.

Lastly, ensure the tank is properly secured to prevent them from falling or tipping over. Although these oxygen cylinders are very durable, they contain highly pressurized gas and can become dangerous if damaged.

Finally, keep in mind that although oxygen is not flammable, it supports combustion and can greatly increase fire risk. As a radiologic technologist, it's your responsibility to keep oxygen equipment away from heat sources, sparks, and open flames, while ensuring oxygen cylinders are handled safely during transport and imaging procedures.

All right, as a quick recap, Oxygen is essential to life, and when patients are unable to maintain adequate oxygen levels on their own, supplemental oxygen therapy is provided.

In radiology settings, oxygen therapy is commonly used for both inpatients and outpatients undergoing imaging procedures.

As a radiologic technologist, understanding how to safely monitor and support oxygen delivery during patient care is essential to providing safe quality imaging