Why Respiratory Related Complications Are Five Times More Common During NORA Procedures—and Why POM Is the Solution
September 23, 2022
HomeBlogWhy Respiratory Related Complications Are Five Times More Common During NORA Procedures—and Why POM Is the Solution
Nonoperating room anesthesia
Nonoperating room anesthesia (NORA) is used in a wide range of procedures, ranging from gastrointestinal endoscopies to pulmonary and dental procedures. These procedures have varying degrees of complexity and they can present a significant challenge to health professionals. In the last two decades, NORA procedures have become increasingly common. Unfortunately, during these procedures the incidence of respiratory-related complications is five times higher than it is in the operating room.
Why do patients develop respiratory complications during NORA?
Frequently, NORA procedures are performed on people with comorbidities or complex medical needs. They may be frail or elderly, or have underlying problems such as sleep apnea, diabetes or a high body mass index (BMI).
Patients who already have a reduced respiratory reserve can develop hypoxia (a lack of oxygen in the blood) with minimal sedation. Other complications that can occur during NORA procedures include aspiration (the inhalation of liquid or solids into the larynx and respiratory tract), difficult intubation and esophageal intubation (incorrect placement of an endotracheal tube in the esophagus), as well as oversedation leading to respiratory depression (hypoventilation).
Hypoxia events are responsible for 60% of all adverse events during conscious sedation; in severe cases, hypoxia can lead to brain damage or heart failure. For many health professionals, NORA procedures on someone who has underlying conditions may be particularly challenging. The location of the facility can also contribute to how likely patients are to experience complications; professionals working in remote areas might not have access to the same equipment they would have in urban areas.
How can procedural oxygen masks help during NORA procedures?
Procedural oxygen masks (POMs) make NORA procedures safer by reducing the risk of hypoxia. POM is the first mask of its kind to offer self-healing oral and nasal membrane technology, allowing for the entry of scopes, tubes, or probes while keeping the patient oxygenated. POM increases the patient’s blood oxygen content, increasing safe intervention time and apnea detection time for the health professional, and reducing adverse events and patient mortality. POM is also unique as it has a sensitive ETC
o2 (end tidal carbon dioxide) port, allowing for quicker recognition of incidence apnea (suspension of breathing).
The mask is available in medium and high concentration form (depending on whether you insert a medium or high concentration adapter). The medium concentration mask provides an average FiO2 (fraction of inspired oxygen) of 80% with a flow rate of 8–10 liters per minute, whereas the high concentration mask provides an FiO2 of at least 90%, with a suggested flow rate of 10–12 liters per minute. Traditional (and more expensive) positive ventilation masks and nasal cannulas only provide between 25% and 30% FiO2 delivery, which gives clinicians less of a buffer when things go wrong.
POM is helpful for almost all patients undergoing NORA procedures, but it’s most beneficial to high-risk patients with underlying health problems, including stroke patients, people with cardiovascular disease (CAD) or heart disease, and those with a high BMI. POM, manufactured in America, is a Class 2 device, and the only device of its kind that’s FDA approved.
Is POM helpful following NORA procedures?
POM can be reused during the recovery process, not just during the procedure. The self-healing membranes mean the mask closes back up after tubes inserted during the procedure have been removed, providing the patient with the prescribed amount of oxygen they need during recovery. This makes purchasing additional oxygen devices for the recovering patient unnecessary, reducing the cost to the hospital or clinic.
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