oxygen therapy and resuscitation

1. OXYGENTHERAPY

2. GOALS
The purpose is to increase oxygen saturation
in tissues where the saturation levels are too
low due to illness or injury

3. OXYGEN THERAPY
•Oxygen therapy is the administration of
oxygen at concentrations greater than that
in room air to treat or prevent hypoxia.
•Oxygen delivery systems are classified as
stationary, portable, or ambulatory, and
oxygen can be administered by mask,
nasal cannula ,or teint.

4. INDICATIONS
Conditions requiring oxygen therapy:
documented hypoxemia
severe respiratory distress (e.g., acute asthma or
pneumonia, pulmonary oedema, pulmonary embolism)
severe trauma
acute myocardial infarction
short-term therapy, such as post-anesthesia recovery
insufficient hemoglobin ( bleeding, anemia, carbon
monoxide intoxication )
heart failure, schock,

5. Hyperbaric oxygen therapy
It is providing the body with extra oxygen
• It is used in the following conditions:
gas gangrene
decompression sickness
air embolism
smoke inhalation
carbon monoxide poisoning
cerebral hypoxic event

6. • CONTRA-INDICATIONS
The oxygen should never be used in an explosive environment
Smoking during oxygen therapy is a fire hazard
Untreated pneumothorax
• OXYGEN SOURCES
Environment
Oxygen is processed and stored in oxygen cylinders
Liquid storage: liquid oxygen is stored in chilled tanks
Compressed gas storage: the oxygen gas is compressed in a gas cylinder
which provides convenient storage

7. METHOD OF OXYGEN ADMINISTRATION
Nasal cannula: offers the gas flow of 4-6L/min
Oxygen mask: the oxygen flow is maintained at
the rate of 6-10L/min when using this method of
administration.
Oxygen tent: the oxygen flow is maintained at
the rate of 6-10L/min.

8. GENERAL CARE OF THE CLIENT UNDER
OXYGENOTHERAPY
Care of the mouth and nose frequently and regularly.
Verify proper connection of oxygen tube to the oxygen
apparatus
Verify if the prescribed amount of oxygen is the amount
given
The client must be advised not to change the flow of
oxygen
Maintain all adequate measures to protect explosion.
Keep free air ways to permit the passage of air.
If the client is unconscious, place him/her in the lateral
position
If the client is conscious, install him in fowler's position to
facilitate the thoracic expansion

9. GENERAL CARE OF THE CLIENT UNDER
OXYGENOTHERAPY
Change the client position at least every two hours to avoid
bed sores.
Provide daily hygiene in particular mouth care.
Verify the oxygen flow and insure that it remains stationary
Verify the content of the oxygen cylinder in order to change
it immediately when it will be empty
Assess the clients general condition noting skin color and
vital signs client
Record all observations on the client's file or medical record.

10. MONITORING OF THE CLIENT UNDER OXYGEN THERAPY
Skin appearance: Is the client cyanotic or pale? Is the client
sweating?
General signs: check blood pressure (usually high blood
pressure), check respiratory rate and check physical condition
of client.
Neuropsychiatric signs: the client may present signs of
agitation, anxiety, confusion, or unconsciousness. Agitation
may persist in case of excessive oxygen administration.

11. PRECAUTIONS
•Oxygen supports combustion, therefore no
open flame or products that are
combustible should be permitted when
oxygen is in use.
•Special care must be given when
administering oxygen to premature
infants, because of the danger of high
oxygen levels causing retinopathy

12. DESCRIPTION
• In the hospital, O2 is supplied to each client room and is available
via an outlet in the wall.
• A flow meter attaches to the wall outlet to access the oxygen.
• Oxygen is most commonly delivered to the client via a nasal
cannula or mask attached to the tubing.
• Another delivery option is transtracheal oxygen therapy, which
involves a small flexible catheter inserted in the trachea or
windpipe through a tracheostomy tube.
• In this method, the oxygen bypasses the mouth, nose, and throat,
and a humidifier is required at flow rates of 2Lpt (1 l) per
minute and above.

13. OXYGEN BY MASK

14. • PREPARATION
• A physician's order is required for oxygen therapy except in emergency use.
• The need for supplemental oxygen is determined by inadequate oxygen
saturation, as determined by blood gas measurements, pulse oximetry, or
clinical indications.
• No special preparation of the client is required to administer oxygen therapy.
• AFTER CARE
• Once oxygen therapy is initiated, periodic assessment and documentation of
oxygen saturation levels is required.
• If the client is using a mask or a cannula, gauze can be tucked under the tubing
to prevent irritation of the cheeks or the skin behind the ears.
• Water-based lubricants can be used to relieve dryness of the lips and nostrils.

15. • COMPLICATIONS
In normal conditions, complications from oxygen therapy are
infrequent.
Respiratory depression, oxygen toxicity, and absorption
atelectasis are the most serious complications with overuse of
oxygen.
High pressure of oxygen can alter the bronchia and lungs
irritating the alveoli membrane leading to acute edema of the
lungs
Non humidified oxygen causes irritation of the respiratory tract
Blindnes

16. •Delivery equipment may present other problems.
Perforation of the nasal septum as a result of using a
nasal cannula and non–humidified oxygen has been
reported.
In addition, bacterial contamination of the nebulizer and
humidification systems can occur, potentially leading to
the spread of pneumonia.

17. RESULTS
• The client demonstrates adequate oxygenation through pulse oximetry,
blood gases, and clinical observation.
• Signs and symptoms of inadequate oxygenation include cyanosis,
drowsiness, confusion, restlessness, anxiety, or slow, difficult, or
irregular breathing.
• Clients with obstructive airway disease may exhibit "aerophagia" or "air
hunger," as they work to pull air into the lungs.
• In cases of carbon monoxide inhalation, the oxygen saturation can be
falsely elevated.
 aerophagia is the medical term used to describe excessive and
repetitive air swallowing

18. HEALTH CARE TEAM ROLE
• Health care team members may check and document that
oxygen therapy is being used appropriately and the oxygen
flow is as ordered.
• Physicians are responsible for ordering oxygen therapy ( flow
rate and when the client will need to use the oxygen).
• Nurses are responsible for assessing clients, ensuring that
oxygen therapy is initiated as prescribed, monitoring oxygen
delivery systems, and recommending changes in therapy.
• Respiratory therapists may assess clients, initiate and monitor
oxygen delivery systems, and recommend changes in therapy.

19. Specific Care of the Client Receiving Oxygen
by Nasal Cannula
clean the cannula at least every 8 hours to avoid
mucus obstructing the cannula
decrease the irritation of the mucous membrane,
alternate nostril
Provide mouth care to avoid dryness
Check if the catheter is attached well (fixed)

20. REFERENCES
• Hess, D. (Ed.). (2014). Nebulizers and inhalers: Advances in delivery
science and technology. CRC Press.
• Dolovich, M., & Newman, S. (Eds.). (2015). Aerosols in medicine:
Principles, diagnosis and therapy (3rd ed.). CRC Press
• Dexter, J.R., Wilkins, R.L., & Gold, P.M. (2019). Respiratory Disease: A
Case Study Approach to Patient Care. F.A. Davis Company.
• Kacmarek, R.M., Dimas, S., & Mack, C.W. (2019). Essentials of
Respiratory Care. Elsevier.