Assessment of Air-Oxygen Blender and Flow Meter Setup in Neonatal Intensive Care Units.

Abstract

Oxygen therapy is provided in neonatal intensive care units to prevent and treat neonatal hypoxia. This treatment is essential for the physiological development and survival of neonates with respiratory dysfunctions. One method of providing oxygen therapy involves the use of a simple face mask to deliver oxygen-enriched medical air. In these systems, a flow meter is used to adjust the volumetric flow rate of the gas between 5 to 15 L/min. If the flow rate falls below 5 L/min, there is a risk for exhaled carbon dioxide to accumulate in the mask and cause hypercapnia. Several potential hazards have been identified in the configuration of these oxygen therapy systems in neonatal intensive care units that can result in a decrease of flow rate measurement accuracy: the use of an oxygen flow meter to deliver a mixed gas, the orientation of how the flow meter is installed, and a decrease in pressure due to the use of junctions and medical gas hoses. With reduced measurement accuracy at low flow rate settings, clinical users may not be aware that flow rate may drop below 5 L/min. Furthermore, inconsistencies in physical set-up and labelling may result in the wrong gas being delivered to a neonatal patient. To ensure that patient safety is maintained in neonatal intensive care units, a best practice recommendation is provided to address these potential hazards.