Pulsed-Dose System Electronic Demand Pulsed-Dose oxygen
delivery systems deliver oxygen to the patient by detecting the
patient's inspiratory effort and providing gas flow during the
initial portion of inspiration. This method reduces the amount of
oxygen needed by 50 to 85% (compared to continuous flow) and
significantly reduces the cost, the supplies needed, and the
limitations on mobility caused by a limited oxygen supply.
As the patient initiates a
breath, the cannula tip senses the flow, a solenoid valve opens, and
a burst of oxygen is rapidly delivered to the patient. The size of
the burst or flow varies among different manufacturers. The
pulsed-dose system takes the place of a flowmeter during oxygen
therapy and is attached to a 50 psig gas source. In most devices the
operator can select the gas flow and the mode of operation (either
pulse or continuous flow). A battery-powered fluidic valve is
attached to a gaseous or liquid oxygen supply to operate the system.
Other methods used to
further reduce oxygen usage when using the pulse-demand system is to
reduce the dose of oxygen delivered to the patient during each
pulsation and/or to deliver a burst only on the second or third
breath instead of every breath. In addition, the size of the oxygen
pulse dose will change with the flow setting with increases in flow
delivering larger doses of oxygen and vice versa. All of the above
variations will differ among the various manufacturers.
Potential problems
encountered when using the pulse-demand system will include either
no oxygen flow from the device or decreased oxygen saturations in
the patient. If no oxygen flow is detected, then possible causes may
include a depletion of the gas supply, an obstruction or
disconnection of the connecting tubing, or an inability of the
device to detect the patient's effort to breath. If the device
cannot detect the patient's inspiratory effort, the sensitivity will
need to be increased or the nasal cannula will need to be
repositioned in the nares.
A decrease in the patient's
oxgyen saturation should always be a cause for alarm and may
indicate a change in the patient's medical status, tachypnea, or a
failure in the device. In any case, a backup system should be
available in order to verify whether the problem is with the device
or with the patient.
Limitations of the
Pulsed-Dose System:
- The high cost of the
system.
- Technical problems may
be associated with such a complicated device. This may include
disconnections, improper placement of the device, and a possible
device failure.
- The lack of accomodation
for an increased need during exercise, stress, illness,
ect.
- The operation of the
device can vary if not properly setup.
- The size of the burst or
flow varies among different manufacturers and should be taken into
consideration when purchasing.
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