Symptoms
Oxygen Toxicity: Symptoms can include coughing, sore throat, substernal chest pain, difficulty breathing, and in severe cases, lung damage.
Skin Breakdown: Redness, irritation, or sores around the mask's contact points (nose, cheeks).
Aspiration: Coughing, choking, wheezing, or difficulty breathing, particularly if the patient vomits.
Claustrophobia/Anxiety: Feelings of panic, breathlessness, or being trapped while wearing the mask.
Improper Fit: Air leaks around the mask, reduced oxygen saturation despite mask use, increased respiratory effort.
Causes
Oxygen Toxicity: Prolonged exposure to high concentrations of oxygen.
Skin Breakdown: Constant pressure and friction from the mask on the skin.
Aspiration: Vomiting while wearing the mask can lead to aspiration of stomach contents into the lungs.
Claustrophobia/Anxiety: The feeling of being enclosed by the mask.
Improper Fit: Mask size is incorrect, straps are not properly adjusted, or the mask is damaged.
Reservoir Bag Issues: Bag not inflating properly, leading to inadequate oxygen delivery.
Medicine Used
Oxygen Toxicity: Reduce the oxygen concentration as tolerated. Corticosteroids may be considered in severe cases to reduce lung inflammation.
Skin Breakdown: Topical creams or dressings to promote healing.
Aspiration: Antibiotics to treat aspiration pneumonia.
Claustrophobia/Anxiety: Anxiolytics (anti-anxiety medications) may be administered. In some situations, a less restrictive oxygen delivery method may be necessary.
Is Communicable
No. Complications related to non-rebreather masks are not communicable (infectious).
Precautions
Oxygen Toxicity: Monitor oxygen saturation levels closely. Use the lowest effective oxygen concentration.
Skin Breakdown: Regularly assess skin under the mask. Use padding or specialized dressings. Ensure proper mask fit without excessive pressure.
Aspiration: Position the patient properly to minimize aspiration risk (e.g., semi-Fowler's position). Be prepared to suction if vomiting occurs.
Claustrophobia/Anxiety: Provide reassurance and explain the mask's purpose. Consider alternative oxygen delivery methods if anxiety is severe.
Improper Fit: Select the correct mask size. Properly adjust the straps. Inspect the mask for damage before use. Ensure the reservoir bag inflates properly. Educate patient on correct application.
How long does an outbreak last?
There is no outbreak associated with Non-Rebreather masks.
How is it diagnosed?
Oxygen Toxicity: Based on symptoms, arterial blood gas analysis (showing high PaO2), and chest X-ray (may show lung changes).
Skin Breakdown: Visual inspection of the skin.
Aspiration: Based on symptoms, chest X-ray (may show infiltrates), and clinical history.
Claustrophobia/Anxiety: Patient report, observation of anxiety signs (e.g., rapid breathing, increased heart rate).
Improper Fit: Observation of air leaks, inadequate oxygen saturation despite mask use.
Timeline of Symptoms
Oxygen Toxicity: Symptoms can develop gradually over 24-48 hours or longer with prolonged high-oxygen exposure.
Skin Breakdown: Can develop within hours of mask application, especially with poor fit or sensitive skin.
Aspiration: Symptoms occur immediately following an aspiration event.
Claustrophobia/Anxiety: Occurs immediately upon mask application or shortly thereafter.
Improper Fit: Evident immediately upon mask application.
Important Considerations
Regular assessment of the patient's respiratory status is crucial.
Careful monitoring of oxygen saturation levels is essential.
Proper mask fit and maintenance are vital.
Patient education and reassurance can help reduce anxiety.
Be prepared to manage potential complications promptly.
Consider alternative oxygen delivery methods when appropriate.