oxygen therapy, roles and responsibility of nurse in oxygenation

1. Mrs.DEVINA VICHRAM
NURSING TUTOR
GANGA COLLEGE OF NURSING

3. OXYGEN THERAPY
Oxygen therapy, also known as supplemental oxygen, is the use
of oxygen as medical treatment. Acute indications for therapy
include hypoxemia, carbon monoxide toxicity and cluster
headache. It may also be prophylactically given to maintain blood
oxygen levels during the induction of anesthesia

5. Who needs oxygen therapy?
• COPD (chronic obstructive pulmonary disease)
• Pneumonia
• COVID-19
• A severe asthma attack
• Late-stage heart failure
• Cystic fibrosis
• Sleep apnea

6. Assessment of Oxygen Therapy

7. Nurses play a major role in the following during oxygen
administration:

8.  Health assessment (vital signs) , o2 saturation, rate and depth of breathing & GCS to
be monitored before initiating
 proper functioning of equipments to be confirmed
 confirm no leakage of o2 cylinder or o2 tubings.
 choose appropriate device
 Medical practitioner’s order is required to initiate oxygen therapy, except in an
emergency situation.
 A practitioner’s order should include O2 flow rate or FiO2 & an acceptable range of
SpO2 values.
 In an emergency situation oxygen may be temporarily initiated by a healthcare
provider in the presence of any acute situation in which hypoxemia is suspected

9.  Assess clinical status of client, client history and check the practitioner’s
order
 In clients with a history of COPD and CO2 retention, consult with the
practitioner prior to initiating oxygen therapy to determine the need for
ABGs or ABG results, except in emergency situations
 Complete client /caregiver education
 Safe handling of oxygen/equipment.
 no smoking or vaping to be adviced
 Apply a pulse oximeter and obtain a baseline SpO2 while client is at rest

10. cont............
 Obtain the correct oxygen delivery device and humidifier bottle, if
required.
 fill humidifier with sterile water & ensure all connections are secured
and tight
 Connect the device to the oxygen source
 set the oxygen flow rate appropriate for device, as prescribed
 connect oxygen tubing to an oxygen flow meter sourced from an oxygen
outlet
 Apply the device to the client.
 Continue to monitor SpO2

11. cont............
 If a SpO2 target is ordered, continue to adjust oxygen flow rate
 Use minimum amount of oxygen necessary to achieve target saturation
 Discontinue oxygen therapy when the client’s oxygen saturation can be
maintained on room air
 Donot hyperventilate.

12. cont...........

13. SpO2 will be measured on all clients, in
acute care, requiring oxygen:
• Upon initiation
• When the oxygen flow rate or
concentration is changed
• With a change in respiratory status
• With vital signs
Clients requiring a FiO2 of greater than
50% must have continuous pulse oximetry

14. 4. INFECTION CONTROL
 All oxygen tubing, humidifiers, large volume nebulizers), aerosol masks, and
standard cannulas are for single client use only.
 For clients in long term care, change these items weekly and when visibly soiled
 Document when equipment is due to be changed
 Heated, high flow oxygen system, wire circuit and humidifier chamber are not
required to be changed regularly.
 For clients on airborne and/or droplet precautions, aerosolized liquids and related
equipment present a particular infection control hazard.
 When refilling humidifier bottles, discard remaining water and fill with distilled
water.

15. 5.DISCONTINUATION OF OXYGEN
 A practitioner’s order is required
to discontinue oxygen therapy
 Criteria for discontinuation:
*stable vital signs
*original disease process
has resolved or greatly
improved
*client maintains SpO2
values within or above the target
range on room air for 24 hours.

16. 6.SAFE HANDLING OF OXYGEN OR EQUIPMENT
 Oxygen vigorously supports combustion.
 Oxygen therapy equipment must not be used in the presence of open
flame
 No smoking is allowed in the vicinity of oxygen therapy equipment
 No smoking is allowed in the vicinity of oxygen therapy equipment
 Avoid use of items that create a spark
 Oils and petroleum products are not to be used around the client’s face
 Oxygen cylinders are to be secured in a cylinder cart or bracket
 Do not use humidity on portable oxygen cylinders during patient
transport

17. Cont.......
Oxygen must not be allowed
to flow into the circuit of a
BiPAP or CPAP unit that is
not turned on.
Ensure that the oxygen flow
is turned off prior to turning
off the BiPAP/CPAP unit

18. Cont.......

20.  Date, time of initiation of oxygen
 Client assessment
 O2 flow rate or FiO2 setting and
delivery device(s)
 SpO2 changes
 Client’s response Client/caregiver
education
 Date, time of termination of
oxygen