DEFINITION:OXYGEN Element, gas, and drug.OXYGEN THERAPY Is the administration of oxygen at concentrations greater than that in room air to treat or prevent hypoxemia.
WHAT IS HYPOXIA AND TYPESHYPOXIA A condition of insufficient oxygen anywhere in the body from the inspired gas to the tissue.TYPES OF HYPOXIA Hypoxemic hypoxia Circulatory hypoxia Hematological hypoxia Demand hypoxia Histotoxic hypoxia
SIGNS AND SYMPTOMS Tachypnea, dyspnea, hyperpnoea. Tachycardia, dysrhythmias, pulse change, hypertension. Anemia, polycythemia. Restlessness, disorientation, lethargy. Cyanosis, digital clubbing.
INDICATIONS FOR OXYGENTHERAPY1. Treat hypoxia2. Decrease the work of breathing3. Decrease myocardial work4. Severe trauma5. Short term/long term, post operative
OXYGEN FLOW RATES Determines the amount of oxygen delivered to the patient. Measured in LITERS PER MINUTE (litrs/min). Rate varies according to patient condition and route of O2 administration.
OXYGEN DELIVERY SYSTEMSLOW FLOW Do not provide a constant or known concentration of inspired O2.EXAMPLE- Nasal, face, partial, non-rebreather ..HIGH FLOW Provide the total inspired air. Specific % of O2 is delivered independently. Requires constant & precise amount.EXAMLE- Transtracheal, venturi, T- piece, face tent..
ADVANTAGES Common inexpensive device Easy to apply Does not interfere with eating and talking Relatively comfortable Permits freedom of movement Well tolerated by clients
DISADVANTAGES Delivers relatively low concentration of O2 (24%-45%) at a flow rate of 2Lits-6Lits/Min. Above 6Lits/Min patient tends to swallow air and feels uncomfortable, hence FiO2 cannot be increased
FACE MASKS Oxygen mask is fittedCarefully to avoid leakageOf O2. Shouldn’t be too tight.
COMMONLY USED TYPES OFMASKS ARE- Simple face mask High concentration mask Venturi mask
SIMPLE FACE MASK Has vents on the sides for the room air to leak in and there by diluting the source of O2. Also allows exhaled CO2 to escape. Used when increased O2 delivery is needed for shorter periods.
FACE MASK Simple face mask delivers the oxygen concentrations from 40%-60% at a flow rate of 5L-8L/Min respectively. Due to the risk of retaining CO2 never a simple mask with a delivery rate of less than 5L/Min
HIGH CONCENTRATION MASK Delivers the highest O2 concentration possible(95%-100%) at a flow rate of 10L-15L/Min. There is a 2 liter reservoir bag with 3 one-way valves, which prevents the room air and the client’s exhaled air entering the bag to deliver 100% O2.
VENTURI MASK It delivers O2 concentrations varying from 24%-60% at a flow rates of 4L-10L. It is a medical device to deliver a known oxygen concentration to patients on controlled oxygen therapy.
VENTURI MASK The color of the device reflects the delivered oxygen concentration: BLUE-24%, WHITE-28%, ORANGE-31% YELLOW-35%, RED-40%, GREEN-60%
OXYGEN HOOD -infants A rigid plastic dome that encloses an infant’s head. It provides precise O2 levels and high humidity.
Nurse’s Responsibility The gas should not be allowed to blow directly into infants face. Hood should not rub against infant’s chin, neck or shoulder.
OXYGEN TENT-children Rectangular, clear, plastic canopy with outlets that connects to oxygen which is humidified. O2 flow should be 15L/Min for 5Mins initially and then adjust according to orders (delivers approx. 30% O2)
OXYGEN T-PIECE The Oxygen T-Piece is used for delivering oxygen to patients with a tracheostomy tube in situ.
NURSING RESPONSIBILITIESASSESSMENT Skin and mucus membrane. Breathing patterns. Chest movements. Lung sounds. Presence of clinical signs of hypoxemia. Presence of clinical signs of O2 toxicity.
GOLDEN RULE“YOU SHOULD NEVERSTOP GIVING OXYGEN TOA PATIENT IN NEED”
SOP (CARE HOSPITALS)(Standard Operating Procedure) AIM : To provide guidelines during oxygen therapy. SCOPE : This procedure is applicable for nurses associates to care of the patients who require oxygen administration. RESPONSIBILITY : Assigned Nurse. ACCOUNTABILITY : Nurse manager.
SOP (CARE HOSPITALS)(Standard Operating Procedure)ARTICLES RERUIRED1. Nasal cannula/oxygen mask/reservoir mask/trans tracheal catheter/non rebreather mask/ventilator.2. Humidifier.3. Oxygen source.4. Gauze pads if applicable.5. Pulse oxymeter.PROCEDURE1. Identify the patient2. Check doctors order3. Assess the patient for the signs and symptoms associated
SOP (CARE HOSPITALS)(Standard Operating Procedure) with hypoxia.4. Explain the procedure to the patient.5. Provide comfortable position.6. Record the vital signs and SPO2.7. Perform hand hygiene.8. Check proper functioning of equipment.9. Administer oxygen by appropriate device as per requirement.10. Use a clean flow meter with humidifier.11. Monitor SPO2 during the procedure.
SOP (CARE HOSPITALS)(Standard Operating Procedure)12. Check the O2 supply and connections & patients comfort.13. Record the date, time and flow rate of O2 administration.14. Do not permit smoking near O2 equipment.