Level 2 Award in Oxygen Therapy

1. 1
Oxygen Therapy
Level 2 Award
Advantage Accreditation / Version No V.2.2.F

2. AIM
To provide learners with the
knowledge and skills in the
use of oxygen in first aid
and medical situations

3. 01 Explain the role of oxygen
Identify and manage those who
require supplementary oxygen
Describe the respiratory system
Explain how to administer oxygen
via a variety of delivery methods
Understand normal and
abnormal breathing Explain the safe storage, use and
practices in oxygen administration
Learning
Objectives
02
03
05
06
07
Understand the role
of pulse oximetry
04

4. Oxygen
Oxygen is required for the function and survival of all body
tissues and deprivation for more than a few minutes is
potentially fatal

5. c
The air we breath in is held in our lungs and absorbed into our blood stream
Oxygen
Oxygen is transported throughout our body by Red blood cells
Red blood cells deliver oxygen to all the tissues within the body
If the airway becomes obstructed, oxygen uptake is reduced or becomes absent (Asphyxia)
Without adequate oxygen, irreversible brain damage can begin within 3-4 minutes
During cardiac arrest, there is no blood flow to transport oxygen around the body
Without oxygen, death can occur within 4-6 minutes

6. The Air Around Us
VS
Inspired
79% Nitrogen
Expired
20% Oxygen
0.04% Carbon dioxide
<1% Other gases
Water vapour
79% Nitrogen
16% Oxygen
4% Carbon dioxide
<1% Other gases
Water vapour increased

7. Respiratory System

8. External respiration exchanges gases between the lungs and the bloodstream
Internal respiration exchanges gases between the bloodstream and body tissues
Air vibrating the vocal cords creates sound
Olfaction, or smelling, is a chemical sensation to help detect hazards
Functions of the Respiratory System
Respiration is made up of two processes – inhalation and exhalation.
The nose warms, humidifies and filters air, prior to entering the lungs

9. Breathing
Rates
Adults
(over 12 years old)
12-20 breaths per minute
Infants & young children
(under 12 years old)
25+ breaths per minute
“Normal” breathing rates are
variable according to the situation,
patient and reference book. For
example new-borns may have rates
of 30-40 breaths per minute

10. Severe bleeding
Severe breathing difficulties
i.e. COPD, Pneumonia
Airway obstruction (Asphyxia)
Low oxygen levels in the blood can
occur in the following patients:
Low Blood Oxygen Levels
(Hypoxia)
Chest Injury (crush injury/
punctured lung)
Asthma
COPD
Head injury
Poisoning

11. Difficulty in breathing
Unable to talk in full sentences, without pausing for breath
Raised respiratory rate
Recognising Low Blood Oxygen Levels
(Hypoxia)
Cyanosis (blue tinge) of lips, face or extremities i.e. fingers
Abnormal oxygen saturations on pulse oximeter

12. Displays pulse rate
Oxygen saturation levels displayed as a % (SPo2%)
Calculates oxygen saturation levels in red blood cells
Pulse Oximeter (SPo2)
Can be inaccurate with cold fingertips and nail varnish
Normal ranges 94-98%, 88-92% in chronic respiratory dise

13. Nasal
Cannula
2-6 litres per minute

14. Venturi
Mask
28%
4 litres per minute

15. Simple
Face Mask
5-10 litres per minute

16. Non
Re-breath
Mask
15 litres per minute

17. Bag Value
Mask
(BVM)

18. 01
Critically ill adults requiring high
levels of supplementary oxygen
(Cardiac arrest, major trauma)
Seriously ill adults requiring moderate
levels of supplementary oxygen
(oxygen level below 94%)
Oxygen Therapy
02 Adults not requiring supplementary
oxygen
04
Adults with chronic lung disease
(COPD) requiring low levels of
supplementary oxygen
(Hypoxia is normal for those with
chronic lung disease)
03
There are four groups of people
that may require oxygen
British Thoracic Society
guidelines 2017 / O’Driscoll BR,
et al. Thorax 2017;72:i1-i90

19. Oxygen Therapy - Children
In all cases involving children with significant illness and/or injury
oxygen therapy should commence as soon as possible
In most cases this will involve HIGH levels of supplementary oxygen

20. c
Critically Ill Patients
Group 1
Cardiac Arrest / Resuscitation
Major trauma
Sepsis
In critically ill patients, provide high flow
oxygen therapy 15 litres per minute via
reservoir mask or bag valve mask (BMV) if
delivering resuscitation
Aim for oxygen saturations 94-98%,
if pulse oximeter is available
British Thoracic Society
guidelines 2017 / O’Driscoll BR,
et al. Thorax 2017;72:i1-i90

21. c
Serious Illness – Group 2
Acute Hypoxia
Acute asthma
Acute heart failure
Use simple face mask 5-10 litres per
minute or nasal specs 2-6 litres per
minute to provide supplementary
oxygen, if required to maintain oxygen
saturations 94-98%.
If saturations are less than 85%,
provide high flow oxygen 15 litres per
minute by reservoir mask
British Thoracic Society guidelines 2017 / O’Driscoll BR, et al.
Thorax 2017;72:i1-i90
Pneumonia
Lung cancer
Post operative breathlessness
Pulmonary embolism
Pneumothorax
Severe anaemia

22. c
Chronic Lung Disease
Group 3
Chronic Obstructive Pulmonary Disease
Exacerbation of Cystic Fibrosis
Chronic asthmatic (not acute)
Target saturation 88-92%.
Oxygen delivery should be via 28%
venturi mask 4 litres per minute or
nasal specs 1-2 litres per minute.
British Thoracic Society guidelines 2017 / O’Driscoll BR, et al.
Thorax 2017;72:i1-i90
Chest wall disorders
Morbid obesity (BMI>40)
If an individual with a chronic respiratory condition develops a
critical illness/injury then they should be treated the same as
critical illness (high flow oxygen)

23. Childbirth
Chest pain
Stroke
Supplementary oxygen is not required unless the person has
oxygen saturation (SPo2) of less than 94%
If oxygen levels are 94% or higher for the following,
supplementary oxygen is not required routinely.
Not Requiring
Supplemental Oxygen
Group 4
Drug overdose
Diabetic emergencies
Abdominal pain

24. If a person is believed to be suffering from carbon monoxide poisoning,
provide high flow oxygen via a non-rebreathe reservoir mask:
Carbon Monoxide Poisoning
Warning: Pulse oximeters are unable to differentiate between carbon monoxide
and oxygen levels within blood and may provide a false reading.
If in doubt and you suspect carbon monoxide poisoning provide high flow oxygen
British Thoracic Society guidelines 2017 / O’Driscoll BR, et al.
Thorax 2017;72:i1-i90

25. Oxygen
delivery
Patient Group Method
SPo2 94-98% or 88-92% in
Chronic Respiratory Disease
No supplementary oxygen
SPo2 below 88-92% in Chronic
Respiratory Disease
28% Venturi mask 4 litres per minute
or nasal specs 1-2 litres per minute
Serious illness SPo2 less than
85%
High flow non-rebreathe mask, 15
litres per minute
Serious illness SPo2 85-94% Simple face mask 4 litres per minute
Critical illness High flow non-rebreathe mask, 15
litres per minute
Critical illness – Cardiac Arrest High flow 15 litres per minute via BVM
Aim f o r normalisation of SPo2, that is appropriate
to the ind ivid ual’ s tar g et o xyg en as ap p r o p r iate

26. 01 02
Oxygen cylinders come in a range of sizes.
Most common are HX and CD sizes.
Oxygen Cylinders

27. CD Oxygen Cylinders

28. Oxygen cylinders are compressed gas and therefore highly volatile:
- Not to be used near hazardous fire situations/high temperatures
- Do not smoke near oxygen
- Keep away from oil and grease
- Caution near electrical equipment
Remove oxygen and turn off when defibrillating
Safety of Oxygen Equipment
Always adhere to the manufacturer’s recommendations
in relation to safe use and storage

29. Oxygen is a ‘Prescription Only Medication’ and in order for you to
administer you need to adhere to your local policy and
competencies within your place of work
All oxygen administration within the non-urgent must be prescribed in advance.
In emergency situations, administration of oxygen should be followed up by
thorough documentation and health care professional review

30. 01 Explain the role of oxygen
Identify and manage those who
require supplementary oxygen
Describe the respiratory system
Explain how to administer oxygen
via a variety of delivery methods
Understand normal and
abnormal breathing Explain the safe storage, use and
practices in oxygen administration
Learning
Outcomes
02
03
05
06
07
Understand the role
of pulse oximetry
04