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Saturday, July 5, 2008

Oxygen therapy: Stripping the threads

I always tell my patients that the hardest part of the job is screwing stuff into the oxygen flowmeters. It's something I never really think of except for when I'm in the process of doing it, so it's my patients I usually mention it to.

And I've had patients, or nurses, laugh at me as I struggle to screw on that nipple adaptor (often referred to as Christmas Trees), or that bubbler, onto the flowmeter. And I grumble and gripe as I try again and again to get it to screw on just right without stripping the plastic threads.

That has got to be the hardest part of this job. It's not so bad when a patient doesn't require a bubbler, but when a patient has a bubbler, and a treatment is indicated, you have to unscrew the bubbler and screw on the nipple adaptor. Those cheap nipple adaptors never seem to go on just right.

Yet, if you aren't patient, and you strip the threads, you have to walk all the way to the supply room to get a new one, that is unless you just so happen to have a spare in your pocket, of which I usually do except for when I need one.

And then, once the treatment is done, you have to thread the bubbler back into place.

Sometimes, as I struggle to do this, I find myself thinking maybe I should just say "screw it," and leave the nipple adaptor in place so I don't have to go through this process again in four hours. But, being the good RTs we are, we have to do the right thing and hook the bubbler back up.

Today, though, as I was doing my last treatment, I thought that when you have a code, you never seem to have a problem hooking up the AMBU bag to the flowmeter. That's because these things are designed to be fool proof, so you can just plug it onto the flowmeter.

My thought was, why can't nipple adaptors and bubblers be that easy? Why do we have to screw the darn things on? Why can't some entrepreneur invent an easy way to hook stuff up to flowmeters.

Thankfully, I never have a problem screwing in the ventilator tubing, but those things aren't made out of plastic either. I think it's the cheap plastic that causes this frustration. I suppose that's the cost we pay for cheaper, disposable equipment.

I searched the Internet to see if maybe some company had made a screwless nipple adaptor, but I have yet to find one. However, I suppose it really doesn't matter, because hospitals usually sign contracts, and get whatever supplies are provided by the one company.

So, I suppose we'll continue to be stuck with these cheap plastic nipple adaptors, and cheap plastic bubblers that never seem to want to thread on easy, or at least not when we are in a hurry.

That, my friends, is the thought of the day.


Heidi said...

I'd have to agree that nipple adapters can be frustrating. We have neb blocks, which have a seperate block for the neb and a port for a bipap if needed. The frustration with that piece of equipment is, the back flow is sometimes enough to pop the neb tubing off the nipple itself, which then, of course, scares the crap out of the patient (and me if I'm not prepared for it).

It's frustrating to stand at the head of the bed holding tubing to the block for 10 minutes.

Jeff Whitnack said...

We carry around these little air adaptors in our pockets. Just plug it into an air outlet and it gives a fixed amount of flow (something like 7-9 I believe). I don't think giving a treatment with oxygen is any big deal, CO2 retainer and hypoxic drive issue is total nonsense. But besides having to monkey around with the flowmeters and nipples...what if you give an O2 tx, put the patient back on 1L/M O2, then 30 seconds later the RN arrives and checks the SpO2--finds it 99%? And puts him on RA. But before you started the tx his SpO2 was 93% on 1L/M.

Anyway here is the information on the product I mentioned.

Ahh 8-9 L/M
Medical Fittings

Frank said...

Searched the Internet to see if maybe some company had made a screw less nipple adapter, but I have yet to find one. However, I suppose it really doesn't matter, because hospitals usually sign contracts.