Mini-Clini: NPPV/ Pulse oximetry - Essay Example

NPPV/ Pulse Oximetry Introduction: Optimizing the management of oxygen in patients with acute hypoxemic respiratory failure (AHRF) is crucial. Emergency physicians, therefore, provide support to patients with AHRF by using noninvasive positive pressure ventilation (NPPV) (Guion, 2010). The absorption characteristics of oxygenated and deoxygenated hemoglobin form the basics of pulse oximetry. (i) Mini Clini: Initiation of NPPV.Oxygen supplementation in hypoxemic patients becomes necessary when the patient exhibits breathing difficulties; as is in this case.

Since a patient cannot be possibly harmed by additional oxygen, it is necessary to resort to the listed modifications because it can be a matter of life and death. These will decrease myocardial work and the work of breathing. If the patient is not able to tolerate the modifications made, then the following can also be done: administration of the oxygen cage and use of the intra-tracheal method. The oxygen cage is less stressful to the patient in addition to providing known F1O2 in a controlled environment (humidity and temperature).

The trans-tracheal catheter can be placed during emergencies with F1O2 from 40-80% (Guion, 2010).(ii) Mini Clini: Trusting the Pulse Oximeter.Fidelity of pulse oximetry values is always a major issue whenever thie oximeter is used. This is because of interferences and false readings brought about by other factors like blood-borne dyes and methemoglobin levels. A high level of methemoglobin causes false oxygen-saturation readings. Therefore, methylene blue dye which is mentioned in this case as an immediate treatment is used to cause a reduction in oxygen saturation.

This is, however, short-lived and subsequent (probably intravenous) administration of the dye has to be done. Methylene blue reacts with erythrocytes forming leukomethylene blue which is an electron donor of oxidized hemoglobin. In this reaction, the ferric ion is converted back to its ferrous state (oxygen-carrying state) (Bowden & Greenberg, 2011).Conclusion: Noninvasive positive pressure ventilation is a proper alternative to intubation because it reduces serious complications in AHRF patients.

Methods like the use of face masks, oxygen cages and intratracheal procedures are used when patients exhibit difficulties in breathing. These methods are aimed at ensuring that the patient is well oxygenated and hence avoiding the chances of death (Guion, 2010). In cases where the fidelity of the pulse oximeter is in question, methylene blue dye can be used as a solution. This dye causes a short-lived reduction in the level of oxygen saturation which would have been raised by the presence of methemoglobin (Bowden & Greenberg, 2011).

References Bowden, V. R., & Greenberg, C. (2011). Pediatric Nursing Procedures. Philadelphia: Lippincott Williams & Wilkins.Guion, L. (2010). Respiratory management of ALS: amyotrophic lateral sclerosis. Sudbury, Massachusetts: Jones & Bartlett Learning.