Purchasing an Oxygen kit and where to get O2

[divingmedic]

How can go about circumventing the laws on O2 with a rx? A far as demand valves we quit using those in EMS about 15 years ago, they over inflate the lungs and cause a pneumothorax. There are two types of non-rebreather face masks. One is a partial non-rebreather which lets some room air in and gives you about 85-95 percent end tidal O2 concentration. The other is a total non-rebreather which gives you 100 percent oxygen. The only true way to deliver 100 pecent oxygen is through a endotracheal tube via intubation, which requires expensive equipement, training and the direction of a MD.

 

[Thalassamania]

How can go about circumventing the laws on O2 with a rx? A far as demand valves we quit using those in EMS about 15 years ago, they over inflate the lungs and cause a pneumothorax. There are two types of non-rebreather face masks. One is a partial non-rebreather which lets some room air in and gives you about 85-95 percent end tidal O2 concentration. The other is a total non-rebreather which gives you 100 percent oxygen. The only true way to deliver 100 pecent oxygen is through a endotracheal tube via intubation, which requires expensive equipement, training and the direction of a MD.

With all due respect both your statement concerning pneumothorax (may well be true for some class of patients other than divers) and partial non-rebreather masks (about 70%) flies in the face of what I was taught, I do find staments on the that non-rebreathers CAN deliver up to 90%, we need some referenced data here.

 

[knotical]

As far as demand valves we quit using those in EMS about 15 years ago, they over inflate the lungs and cause a pneumothorax.

Terminology often bites us when this discussion comes up.

Some of us use the term “demand” when referring to regulators that react to the demand of a breathing patient, much as a scuba regulator, which is a demand-activated regulator. Some, especially emergency medical personnel, use the term “demand” when referring to positive-pressure regulators that are used to inflate a non-breathing patient’s lungs. The concern divingmedic raises relates to the latter.

Fortunately, there are now positive-pressure ventilators that reduce this concern by limiting the pressure delivered.

See also this thread: http://scubaboard.com/showthread.php?t=146108
and/or this article: http://www.otwo.com/article_2.htm

Anyone using a positive-pressure regulator to administer oxygen should be trained in its use.
DAN provides such training in its Advanced Oxygen First Aid course.

 

[Thalassamania]

Terminology often bites us when this discussion comes up.

Some of us use the term “demand” when referring to regulators that react to the demand of a breathing patient, much as a scuba regulator, which is a demand-activated regulator. Some, especially emergency medical personnel, use the term “demand” when referring to positive-pressure regulators that are used to inflate a non-breathing patient’s lungs. The concern divingmedic raises relates to the latter.

Fortunately, there are now positive-pressure ventilators that reduce this concern by limiting the pressure delivered.

See also this thread: http://scubaboard.com/showthread.php?t=146108
and/or this article: http://www.otwo.com/article_2.htm

Anyone using a positive-pressure regulator to administer oxygen should be trained in its use.
DAN provides such training in its Advanced Oxygen First Aid course.

That's what I thought. Now can we resolve the oxygen percentage question?

 

[Trever]

I purchased a bottle, reg and mask on e-bay for under $100 bucks, as for fills my local gas distributor will fill it for $18. If I want to get it filled for free my EMT buddy will get it filled for free, but I have to wait several days on it. 12-15 liters per minute with a nonrebreather mask will deliver 80-100% O2 depending on fit of the mask. This is according to Brady Emergency Care 8th edition page 128 table 6-3.

 

[Trever]

That's what I thought. Now can we resolve the oxygen percentage question?

Thalassamania,

According to Brady Emergency Care 8th edition page 128 table 6-3, With a flow rate of 12-15 liters per minute a nonrebreather mask will deliver 80-100% O2 depending on the fit of the mask.

 

[knotical]

can we resolve the oxygen percentage question?

Here’s my attempt.

Mostly extracted from:
http://www.diversalertnetwork.org/medical/articles/download/The4Rs.pdf

Resuscitating without supplemental oxygen 16%.
Bag valve mask without supplemental oxygen 21%.
Normal breathing 21%.
Resuscitating with supplemental oxygen can exceed 50%.
Non-rebreather mask varies, but can exceed 90%. <Trever&#8217;s answer of 80-100% seems better here.>
Demand valve with tight fitting mask approaches 100%.

I did not find anything on the bag valve mask with supplemental oxygen, or the manually triggered ventilator, but logic tells me they also approach 100%.

 

[Thalassamania]

My spinal column has been very, very good to me ... I'll stick with a demand regulator and get a guaranteed 100%, 80% to 100% can mean the difference between bladder, bowel and sexual function and NOT.

 

[JEScholz]

My spinal column has been very, very good to me ... I'll stick with a demand regulator and get a guaranteed 100%, 80% to 100% can mean the difference between bladder, bowel and sexual function and NOT.

The assumption here is that with the demand (negative pressure induced flow) regulator, you have a perfect seal on the mask so that there is no air leakage when you inhale. Otherwise, you will not receive 100% on inhalation.

 

[DaFireMedic]

My spinal column has been very, very good to me ... I'll stick with a demand regulator and get a guaranteed 100%, 80% to 100% can mean the difference between bladder, bowel and sexual function and NOT.

Nothing is guaranteed 100% O2, only rated at 100% 02. Your seal has a lot to do with it, especially if trying to administer oxygen to an unconscious person. I've been administering O2 on a daily basis for 16 years, and some faces are just difficult to get a good seal on.

I have a demand valve on my O2 kit, and I also carry a bag valve mask. BVM is much safer for resuscitation, for reasons mentioned earlier regarding lung overpressurization. The demand valve was been removed as a resuscitation device in California years ago for this reason. It is still good for delivering O2 to a conscious person capable of maintaining their airway and holding the mask themselves. The BVM will provide 100% oxygen with a good seal and the reservoir bag filled and as I said, is far better for resuscitation. But they also require practice to use correctly, especially as a 1 person skill.

The non-rebreather mask is the best constant flow delivery device commonly available, but as mentioned before, uses O2 faster than a demand valve. The positive side to them is that it does not require someone to hold it to their face, which in the case of a person with decreased mental status may make it the device of choice if an adequate O2 supply is at hand.

Oh, also I put my kit together myself. I bought a regulator and demand valve used, and bought the cylinder and adjuncts from local suppliers. Total cost of less than $200 including BVM, NRB masks, OP airways, etc.