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LETTER TO EDITOR
Year : 2018  |  Volume : 19  |  Issue : 2  |  Page : 98-99
 

Oxygen therapy of two patients from single oxygen flow meter


1 Department of Trauma and Emergency, All India Institute of Medical Sciences, Patna, Bihar, India
2 Department of Anaesthesia, IGIMS, Patna, Bihar, India

Date of Web Publication15-Nov-2018

Correspondence Address:
Dr. Neeraj Kumar
Department of Trauma and Emergency, All India Institute of Medical Sciences, Patna - 801 507, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/TheIAForum.TheIAForum_35_18

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How to cite this article:
Kumar A, Kumar N, Kumar A, Dubey PK. Oxygen therapy of two patients from single oxygen flow meter. Indian Anaesth Forum 2018;19:98-9

How to cite this URL:
Kumar A, Kumar N, Kumar A, Dubey PK. Oxygen therapy of two patients from single oxygen flow meter. Indian Anaesth Forum [serial online] 2018 [cited 2019 Nov 12];19:98-9. Available from: http://www.theiaforum.org/text.asp?2018/19/2/98/245544




Sir,

The administration of supplemental oxygen is an essential element of appropriate management for wide range clinical conditions crossing different medical and surgical specialties.[1] The supportive oxygen therapy in various clinical conditions at different places is being supplied by oxygen cylinder and central pipeline. Sometimes, it is very difficult to provide oxygen to several patients during mass casualties or certain resource-limited situations.

Here, we are describing a situation in which oxygen therapy was delivered to two patients from single oxygen flow meter by using two three-way stopcock (PolyMedicure Ltd., Haryana, India) assembly as shown in [Figure 1]. A three-way stopcock may tolerate pressure up to 4.5 bar (65 psi), 360 rotation; it consists of one rotating male luer and two female luer connectors.[2] In this assembly, we connected one female luer of three-way with oxygen tubing connected with flow meter, second female luer with another oxygen tubing connected with T-piece and male luer again connected to another three-way stopcock which provides two additional oxygen outlets. We measured oxygen pressure simultaneously in two different oxygen tubing by connecting its distal end to sphygmomanometer.[3] We found the equal rise of 70 mmHg pressure in both oxygen downstream after keeping the oxygen flow rate at 12 L/min through the flow meter. It is the reflection of resistance offered by the assembly and the oxygen therapy device. Aguiar et al.[4] in 2015 concluded that tubing length of 98.42 ft (30 m) might be used by patients for home delivery oxygen with flows up to 5 L/min, as there were no important changes in flows or FIO2. Clinically significant drops in flowrate were defined as >20% reduction in flows which has been discussed as the normal variance for flow meters.[5] Cullen and Koss[6] in 2005 concluded that clinically significant reductions in flow at 2 L/min for tubing lengths >100 ft (30.48 m), but in our case, length of oxygen tubing was <4 m.
Figure 1: Three-way stopcock assembly

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By making above connection of oxygen tubing with three-way stopcock assembly, we provide oxygen outlets to two patients from the single flow meter.

Drawbacks – This assembly will not be useful during high flow oxygen therapy because there may be increased chances of air leak and disconnection at three-way stopcock assembly.


  Conclusion Top


This assembly is lightweight, easy to make and it is cost effective. This method is particularly helpful during mass casualties, in a remote location where oxygen cylinder and oxygen flow meter are limited.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Singh V, Gupta P, Khatana S, Bhagol A. Supplemental oxygen therapy: Important considerations in oral and maxillofacial surgery. Natl J Maxillofac Surg 2011;2:10-4.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Available from: http://www.polymedicure.com/?wpccategories=three-way-stop-cocks. [Last accessed on 2018 Feb 27].  Back to cited text no. 2
    
3.
Kumar A, Kumar L, Sinha C, Kumar N, Bhadani UK. Dual oxygen therapy in patient on bilevel positive airway pressure prevented invasive mechanical ventilation. Indian J Crit Care Med 2017;21:604-6.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Aguiar C, Davidson J, Carvalho AK, Iamonti VC, Cortopassi F, Nascimento OA, et al. Tubing length for long-term oxygen therapy. Respir Care 2015;60:179-82.  Back to cited text no. 4
    
5.
Kacmarek RM. Delivery systems for long-term oxygen therapy. Respir Care 2000;45:84-92.  Back to cited text no. 5
    
6.
Cullen DL, Koss JA. Oxygen tubing lengths and output flows: Implications for patient care. Chron Respir Dis 2005;2:193-7.  Back to cited text no. 6
    


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