Oxygen therapy involves administering oxygen at concentrations higher than 21% found in room air. It is done through various devices to treat low blood oxygen levels. Nasal cannulas and masks are commonly used to deliver oxygen to patients. Proper precautions must be taken when using oxygen, such as no smoking signs, checking for leaks, and changing cannulas regularly. The document provides details on different oxygen delivery methods and safety procedures for oxygen therapy.

1. P R E P A R E D B Y
M S S H I W A N I S A H
L E C T U R E R
OXYGEN
THERAPY

2. INTRODUCTION
• Oxygen therapy is the administration of oxygen at a
concentration greater than that found in the
environmental atmosphere through the different
devices.
• Concentration of oxygen in room is 21% .
Normal oxygen level in blood:- an oxygen level of
95-100% is considered to be normal. When the level
of oxygen is within this range, it is considered to be
optimum for smooth functioning of the cell.

3. DEFINITION
• Method by which oxygen is supplemented at
higher percentages than what is available in
atmospheric air.
• It is also called supplemental oxygen. It is only
available through a prescription from health
care provider.

4. INHALATION
• Inhalation is the act of drawing in air, vapour or gas into the
lungs. It may be for local effect eg. Steam inhalation
i. Dry inhalation
ii. Moist inhalation
Dry inhalation: It is the inhalation of gases, fumes from volatile
drugs or burning drugs. Eg. Oxygen inhalation
Moist inhalation : Breathing warm and moist air produced by a
vaporizer is called steam moist inhalation.

10. SOURCES OF OXYGEN:
Therapeutic oxygen is available from two sources
1. Wall Outlets (Central supply)
2. Oxygen cylinders

13. OXYGEN CYLINDER DESCRIPTION
• It is never kept near inflammable material
• Avoid using oil (or) grease around oxygen connections
• Post ‘No smoking’ sign on the patients door and in view of
the patients visitors
• Avoid electric pads
• Turn off flow valve when cylinder valve is being opened and
always check for leakage

14. • EMPTY mark should be placed when the cylinder is empty
• The ordinary nasal catheter should have 3 or 4 holes in the
sides of the tip
• Humidifies should be half fill

15. EQUIPMENT
• Oxygen cylinder after testing it is working efficiently
• A tray with cover
• Nasal catheter (or) cannula (or) a mask
• Bowl with water
• Plaster & scissors
• Half filled humidifier with sterile distilled water
• Flow meter
• Rubber tubing

16. PROCEDURE
• Assemble the equipment
• Explain the procedure
• Post ‘No smoking’ sign on the patient door (or) at the
patients head end
• Hold the catheter and measure the distance between
the nostrils and ear lobe
• Test the apparatus before hand by opening the valve
• Immense the end of the catheter into a bowl of water.

17. • Lubricate the catheter before passing into nose, with
water soluble lubricant.
• Make sure that the humidifier is filled to the
appropriate mark.
• Attach the connecting tube
• Set the flow rate at prescribed litres/minute
• Feel to determine if oxygen is flowing through the tips
of the cannula
• Open the cylinder and adjust the flow before
introducing the catheter into the nose. Never open the
cylinder after introducing into the nose.
• Place the tip of the cylinder (or) nasal catheter in the
patients nose.

18. • Observe the position of the catheter through the
patients mouth.
• Fix the catheter in position on the or the forehead with
adhesive tap
• Before leaving the patient ,make sure that the patient
is comfortable
• Patient should be checked at frequent intervals
• Catheter should be changed every 12 hours or every
24 hours, if it is continued for a long time
• Always record in the patients record time. No. of lit/mt
given to the patient
• Always check the amount of oxygen in the cylinder
when you come on duty and at intervals throughout
your duty time

19. OXYGENINHALATION
Oxygen administration treats the effects of oxygen
deficiency but it does not correct the underlying causes
Indication :
1. Cyanosis
2. Dyspnea or labored breathing
3. An environment low in oxygen content eg. High altitude
4. Anaemia : Definiency of quality or quantity of red
corpuscle in the blood giving rise to anoxaemia
5. Disease of condition in the alveoli of lungs that
interfere with the exchange of oxygen

20. 6. Patient whose respiratory capacity is diminished by
some disease (or) condition eg. Atelectasis, pneumonia,
CCF etc.
7. Poison with chemicals that alter tissue ability to utilize
oxygen eg. Cyanide poisoning
8. Shock and circulatory failure
9. Haemorrhage and air hunger
10. Patient under anaesthesia
11. Patients who are critically ill, CVA, Cardiac
thrombosis
12. Patients with psychologically induced dyspnea
13. Asphysia by foreign body obstruction of the air
passage-drowning etc.

28. PROCEDURE

29. NASAL PRONGS
• It is a disposable plastic device with two protruding
prongs for insertion into the nostrils connecting to an
oxygen source.
• Used for low medium concentration of oxygen (24 to 44
%)

30. NASAL PRONG

31. NASAL PRONG
Advantages
• Client can able to talk and
eat with oxygen in place
• Easily used in home
setting
• Safe and simple
• Easily tolerated
• Delivers low
concentration
Disadvantages
• Unable to use with nasal
obstruction
• Can dislodge from nasal
easily
• Not good for mouth
breathers
• Drying to mucous
membrane, so flow
greater than 4L/min
needs to be humidified.

32. FACE MASK
• The simple oxygen mask
• The partial re breather mask
• The non re-breather mask
• The venture mask

33. THE SIMPLE OXYGEN MASK
• Simple mask is made of clear ,flexible, plastic or rubber
that can be molded to fit the face.
• It is held to the head with elastic bands
• Some have a metal clip that can be bent over the bridge
of the nose for a comfortable fit.

34. THE SIMPLE OXYGEN MASK
Advantages
• Can provide increased
delivery of oxygen for
short period of time
Disadvantages
• Tight seal require to
deliver high concentration
• Difficult to keep mask in
position over nose and
mouth
• Potential for skin
breakdown
• Uncomfortable for patient
while talking or eating

35. PARTIAL RE-BREATHER MASK
• The mask is with a reservoir bag that must remain
inflated during both inspiration and expiration
• It collects of part of the patients exhaled air
• It is used to deliver oxygen
• It is used to deliver oxygen concentration upto 80%
• The oxygen flow rate must be maintained at a minimum
of 6L/min to ensure that the patient does not re breath
large amount of exhaled air.

36. PARTIAL RE-BREATH MASK
Advantages
• Client can inhale room
air through opening in
mask if oxygen supply is
briefly interrupted
Disadvantages
• Requires tight seal
(eating and talking
difficult, uncomfortable)

37. NON RE-BREATHER MASK
• This mask provides the highest concentration of oxygen
(95 to 100%) at flow rate 6 to 15 L/min
• It is similar to the partial re-breather mask except two
one way valves prevent conservation of exhaled air
• The bag has an oxygen reservoir
• When the patient exhales air the one way valve closes
and all of the expired air is deposited into the
atmosphere not the reservoir bag
• In this way the patient is not re-breathing any of the
expired gas.

38. NON RE-BREATHER MASK

39. NON RE-BREATHER MASK
Advantages
• Delivers the highest
possible oxygen
concentration
• Suitable for patient
breathing
spontaneously with severe
hypoxemia.
Disadvantages
• Impractical for long term
therapy
• Malfunction can cause
CO2 build up
• Suffocation
• Expensive
• Uncomfortable

40. VENTURI MASK
• It is high flow oxygen delivery device
• Oxygen from 40 to 50 %At liters flow of 4 to 15 L/min
• The mask is constructed so that there is a constant flow
of room air blended with a fixed concentration of oxygen

41. VENTURI MASK
Advantages
• Delivers most precise
oxygen concentration
• Does not dry mucous
membrane
Disadvantages
• Uncomfortable
• Risk for skin irritation
• Produces respiratory
depression in COPD
patients with high oxygen
concentration 50%

42. OXYGEN HOOD
• The oxygen hood is used for babies who can breath on
their own but still need extra oxygen
• The hood is a plastic dome or box with warm, moist
oxygen inside
• The hood is placed over babies head

43. OXYGEN TENT
• An oxygen tent consist of a canopy placed over the
head and shoulder or over the entire body of a patient to
provide oxygen at a high level than normal
• Typically tent is made of see- through plastic materials
• It can envelop patient bed with the end section held in
place by a mattress to ensure that the tent is air tight
• The enclosure often has a side opening with a zipper

44. OXYGEN TENT

45. AMBU BAG
• AMBU- Artificial manual breathing unit (or) Bag valve
mask ventilation is a hand held device commonly used to
provide positive pressure ventilations to patients who not
breathing or not breathing adequately

46. TRACHEOSTOMY COLLAR/
MASK
• Inserted directed into trachea
• Is indicated for chronic oxygen therapy need
• oxygen flow rate 8 to 10 L
• Provides good humidity
• Comfortable, more efficient

47. T - PIECE
• Used on end of ET tube when weaning from ventilator
• Provides accurate FIO2
• Provides good humidity

48. PREPARATION OF ARTICLES
• Oxygen cylinder with stand and accessories, humidifier
regulator, flow meter, connecting tube etc.
• A tray containing
 Nasal catheter
 Water soluable lubricating jelly
 Adhesive tapes
 Bowl of water
 Flash light & tongue depressor
 Cotton applicators and normal saline in a container

49.  Kidney tray and paper bag
 Mackintosh and towel
 Rag piece or gauze piece

50. PREPARATION OF
PATIENT
• Explain the procedure to the patient to win his
confidence.
• Instruct the patients family members about the safety
precautions required during the oxygen therapy
• Put up the instruction regarding the fire precautions in
the unit
• Remove cigars, matches etc.
• Assemble the equipment and arrange them conveniently
in the unit
• Clean the nostrils
• Protect the bed and garments

51. APPLYING A NASAL CATHETER
• Wash hands
• Measure the length of nasal catheter from the tip of the
nose to the ear lobe and mark the length with ink
• Check the apparatus for the working condition. Open
the flow meter on regulator and adjust the flow as
required. When it is opened the oxygen will start
bubbling through the water/ in the wolfs bottle. Attach the
catheter to the connecting tube and check the flow of
oxygen through the catheter by submerging it under the
water in the bowl

52. • Lubricate the tip of the catheter with water soluable
jelly and then check the flow by immersing it in the
water.
• Introduce catheter slowly into one of the nostrils to
the previous marked distance.
• Check the position of the catheter in the or
oropharynx at the level of the uvula.
• Fix the catheter either over the forehead (or) at the
cheek with adhesive tape. Secure the connecting tube
to the bed clothes or patients gown using an elastic
band and a safety pin.

53. APPLYING A NASAL CANNULA
• Inspect the patient for signs and symptoms of hypoxia
and presence of airway obstruction
• Explain to client and family , the procedure details and
purpose of oxygen therapy
• Assemble needed supplies and equipments
• Check the cylinder for working condition. Wash hands
• Attach nasal cannula to oxygen tubing and attach to
humidified oxygen source adjusted to prescribed flow,
check the flow by introducing it in the water.

54. • Place tips of nasal cannula into clients nares
• Adjust elastic head band or plastic slide until cannula
fits snugly and comfortably
• Maintain sufficient slack of oxygen tubing and secure
to client clothes
• Check the cannula every 8 hours
• Keep humidification jar filled at all time
• Observe clients nares and superior surface of both
ear for skin breakdown
• Wash hands
• Record in nurses record , method of oxygen delivery,
flow rate, patency of oxygen cannula.

55. APPLYING A FACE MASK
After the litre flow is turned on the mask is applied to the
patients face. Oxygen mask selected should rest
comfortably on the patients face.
After care :
• Stay with the patient till he is at ease
• Keep the patient warm and comfortable
• Evaluate the patients progress by observing the vital
signs
• Record the procedure with date and time.
• Check the apparatus for its working condition

56. • Arrange for blood gas analysis at specified interval to
make sure the status of anoxemia is treated
• When the oxygen is to be stopped, do it gradually.
Reduce the volume of oxygen supply then give it
intermittently
• To discontinue the oxygen inhalation loosen the
adhesives take out the catheter from the nostrils close
the main valve, disconnect catheter and put it in
kidney tray
• Replace all the articles
• Watch the patient for any deteriorating symptoms
after the removal of oxygen inhalation.

57. COMPLICATION OF OXYGEN
THERAPY
• Oxygen toxicity: It is a condition which occur due to
inspiration of high concentration of oxygen for a
prolonged period of time. Oxygen concentration more
than 50% over 24 to 48 hours can cause pathological
changes in the lungs
• Retrolental fibroplasia :
Blindness due to vasoconstriction & ischemia
• Absorption atelectasis : During 100% oxygen delivery
nitrogen in alveoli is washed out and replaced by
oxygen. In contrast to nitrogen oxygen is extremely
soluble in blood and diffuses very quickly into the
pulmonary vasculature, the alveolus collapses.

58. MOIST INHALATION
The inhalation of plane steam or with a drug is
known as steam inhalation
Method :
1. Jug method (Nelsons inhaler is used)
2. Steam tent
3. Electric steam inhaler
Drugs used:
• Plain water
• Tr.Benzoin, Eucalyptus, Methyl salicylate,
Menthol, Camphor.

59. GENERAL USES
• The spout of the inhaler must be placed in such a way
that the patient cannot touch it or put his face too near
• Fill the jug only 2/3 with boiling water. Water should
remain below the spout level
• Have the water in the jug at a moderate temperature
(120-160 f) (or) 54.4 to 76.7 c)
• Keep the patient warm and prevent drought before ,
during and after the inhalation
• When voltage group like menthols are used keep his
eyes closed to prevent the drug irritating the conjunctiva

60. • Watch the patient closely through out the procedure
• Place sputum cup within the reach of the patient
• Explain the procedure to the patient
Preliminary assessment:
• Check patients name, bed no, and other identification
• Check the diagnosis and general condition of the
patient
• Check the physicians order
• Assess the patients ability for self care
• Assess the level of consciousness
• Check the articles available

61. ARTICLES
• Nelsons inhaler with a mouth piece fitted to the neck of
the inhaler
• Bowl or basin large enough to hold the inhaler
• A towel
• Tr, Benzoin or any other inhalant ordered
• Kettle with boiling water, Gauze piece
• Cotton swab, kidney tray
• Acetone or milk of magnesia in a container

62. PREPARATION OF THE PATIENT
• Explain the procedure to the patient
• Ask the patient to empty bowel and bladder if needed so that
he will not be disturbed during the procedure and he will
remain on the bed for several hours after the inhalation
• Place the patient in a fowlers position with a cardiac table
• Close the door and window and put off the fan to prevent
draft
• Place the sputum cup in a convenient place within the easy
reach of the patient
• Mouth piece should be boiled and cooled before use.

63. PROCEDURE
• Explain the procedure to the patient
• Measure the capacity of the inhaler with cold water
• Warm the inhaler by pouring a little hot water into the jug
and emptying it.
• Pour the required amount of inhalant into the inhaler
and fill the jug 2/3 with hot water. The water should
remain just below the spout
• Cover the mouth piece and close the jug tightly see that
the mouth piece is in the opposite direction to the spout

64. • Cover the jug with towel
• Cover the mouth piece with a gauze piece and plug
the spout with a cotton ball
• Place the inhaler in the basin and take it to the
bedside quickly
• Place the apparatus conveniently in front of the
patient with the spout opposite to the patient . Remove
the cotton plug and discard it into the paper bag.
• Instruct the patient to place the lips on the mouth
piece and breath in the vapour. After removing the lips
from the mouth piece, breath out the air.

65. AFTER CARE
• Continue the treatment for 15-20 min as long as the
patients gets vapour
• Remove the inhaler from the patient after the stated
time
• Remove the backrest and cardiac table. Adjust the
position of the patient in bed
• Instruct hi to remain in bed for 1-2 hours to avoid drafts
• Replace the articles and record the procedure with date
and time
• Return to the patient to assess his comfort . Offer hot
drinks if needed

66. STEAM INHALATIONS (OR) AEROSOL
THERAPY
It is the procedure to prevent (or) treat condition of the
respiratory tract by adding airborne water particles and
possibly by medications
Types of medication used for the inhalation
a. Mucolytes
b. Decongestant
c. Bronchodilators
d. Antimicrobial agents
i. moist – Intermittent and continuous
ii. Dry – Smelling salts

67. PROCEDURE
• Check doctor’s prescription including date, time,
flow liter/minute and methods.
• Perform hand hygiene and wear gloves if
available.
• Explain the purpose and procedures to the
patient.
• Assemble equipments.

68. PROCEDURE
• Prepare the oxygen equipment:
1)Attach the flow meter into the wall outlet or
oxygen cylinder
2)Fill humidifier about 1/3 with sterile water
or boiled water
3)Blow out dusts from the oxygen cylinder
4)Attach the cannula with the connecting
tubing to the adapter on the humidifier

69. PROCEDURE
• Test flow by setting flow meter at 2-3L/ minute
and check the flow on the hand.
• Adjust the flow meter’s setting to the ordered flow
rate.
• Insert the nasal cannula into client’s nostrils,
adjust the tubing behinds the client’s ears and
slide the plastic adapter under the client’s chin
until he or she is comfortable.
• Maintain sufficient slack in oxygen tubing

70. PROCEDURE
• Encourage the client to breathe through the nose
rather than the mouth and expire from the
mouth
• Initiate oxygen flow ’s response to oxygen and
comfort level.
• Dispose of gloves if you wore and perform hand
hygiene
• Place “No Smoking” signboard at entry into the
room.
• Document the following:
Date, time, method, flow rate, respiratory
condition and response to oxygen
• Sign the chart

71. NURSING ALERT
After used the nasal cannula, you should cleanse it as follows:
1. Soak the cannula in salvon water for an hour
2. Dry it properly
3. Cleanse the tip of cannula by spirit swab before applying to
client

72. NEBULIZER THERAPY
• Nebulizer Therapy is to liquefy and remove retained secretions
from the respiratory tract. A nebulizer is a device that a stable
aerosol of fluid and /or drug particles.
• Most aerosol medication have broncho dilating effects and are
administered by respiratory therapy
personnel.

73. NEBULIZER THERAPY
• Purpose:
1. To relieve respiratory insufficiency due to bronchospasm
2. To correct the underlying respiratory disorders responsible
for bronchospasm

74. ❖NURSING ALERT
 Teach the client how to use personnel device.
(Rationale: To ensure appropriate self-care after discharge)
 Avoid treatment immediately before and after meals.
(Rationale: To decrease the chance of vomiting or
appetite suppression, especially with medication that cause
the client to cough or expectorate or those that are done in
conjunction with percussion/ bronchial drainage).

75. NEBULIZER THERAPY

76. OXYGEN TOXICITY
•Oxygen toxicity is lung damage that
happens from breathing in too much
extra (supplemental) oxygen.
•It's also called oxygen poisoning. It can
cause coughing and trouble breathing. In
severe cases it can even cause death.

80. THANK
YOU