Some patients need supplemental oxygen via their trach. This will add a few more pieces to the setup. In order for oxygen to be added to a patient’s trach, it will first need to be indicated and ordered by a physician. Once the doctor or healthcare provider orders the oxygen, it may be added in a couple of ways. The two most common ways it is added are via nipple adaptor or via a venturi (aka as a venti).
The nipple adaptor is very simplistic. It is a plastic adaptor with a nipple to attach the oxygen. It will be added to the trach mask or somewhere in line and run at whatever liter flow has been ordered by the healthcare provider. There are HME’s that can be purchased that also have a nipple for patients who are using a heat/moisture exchanger and oxygen.
The other common way to add oxygen to a tracheostomy is via a venturi device.
A venturi is an oxygen device that gives the patient exactly the amount of oxygen needed and is expressed as a percentage. This device is normally ordered from a hospital or rehab facility where it has been trialed and titrated to the patient’s needs. It is usually added to the trach mask, up close to the patient’s trach. There are two types of venturis that are commonly seen in the hospital and home care settings.
High flow venti devices use different colored adaptors that tell what percentage of oxygen the patient will get and how many liters per minute the oxygen has to flow at in order to achieve the exact amount needed. These can have liter flows as high as 12 liters per minute for patients who need higher oxygen percentages. This is difficult to use in the homecare setting as it may require several oxygen systems (concentrators) put together to achieve these higher liter flows. The low-flow venturi devices can achieve higher oxygen requirements with lower liter flows of oxygen. On these devices, it is imperative that you make sure it is set properly. The highest liter flow on this device is 6 liter per minute, which makes it more practical for home use.
Author Profile: Laura Castricone, Respiratory Therapist
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