Certified Respiratory Therapist Practice Exam

When providing supplemental oxygen to a patient receiving nasal BIPAP, how should it be delivered?

1. Directly from the wall oxygen source

2. By using a high-flow oxygen mask

3. Through a humidifier

4. By bleeding supplemental O2 from a flowmeter into the circuit

The correct answer is: By bleeding supplemental O2 from a flowmeter into the circuit

Delivering supplemental oxygen through a method that allows it to blend effectively with the positive pressure being applied by the BIPAP system is crucial for maintaining the prescribed oxygen concentration while ensuring patient comfort and safety. Bleeding supplemental oxygen from a flowmeter into the BIPAP circuit is the most effective way to achieve this. This method allows for a continuous flow of oxygen directly into the BIPAP system, which can then mix with the air being delivered during each breath. It also helps in preventing any significant increase in pressure that might occur if oxygen were to be delivered through other methods, such as directly from a wall source or through a high-flow oxygen mask. Additionally, this approach allows for precise titration of oxygen levels according to the patient’s needs, which is particularly important in a BIPAP setup where the patient's ventilatory requirements can change. While using a humidifier is beneficial in many respiratory treatments, it does not facilitate the effective blending of oxygen with the air from the BIPAP system in the same way as bleeding oxygen into the circuit does. Therefore, bleeding oxygen directly from a flowmeter into the circuit is preferred for ensuring optimal oxygen delivery alongside positive airway pressure therapy.