SlideShare a Scribd company logo
OXYGEN INHALATION 
Dr. JayeshPatidar 
www.drjayeshpatidar.blogspot.com 
1
DEFINITION 
9/17/2014 
2 
www.drjayeshpatidar.blogspot.com
Administration of oxygen is a process of providing the 02 supply to child for the treatment of low concentration of 02 in the blood. Children with respiratory dysfunctions are treated with oxygen inhalation to relieve anoxaemiaor hypoxaemia(deficiency of oxygen in the blood). The normal amount of oxygen in the arterial blood should be in the range of 80 to 100 mm of Hg. If it falls below 60 mm of Hg; irreversible physiologic effects may occur. The oxygen administration treats the effects of oxygen deficiency but it does not correct the underlying causes 
9/17/2014 
3 
www.drjayeshpatidar.blogspot.com
9/17/2014 
4 
www.drjayeshpatidar.blogspot.com
PURPOSES 
OF 
OXYGEN 
INHALATION 
9/17/2014 
5 
www.drjayeshpatidar.blogspot.com
•To manage the condition of hypoxia 
•To -maintain the oxygen tension in blood plasma 
•To increase the oxy hemoglobin in red blood cells 
•To maintain the ability of cells to carry out the normal metabolic function 
•To reduce the risk of complications 
9/17/2014 
6 
www.drjayeshpatidar.blogspot.com
COMMON 
INDICATIONS 
FOR 
OXYGEN 
ADMINISTRATION 
9/17/2014 
7 
www.drjayeshpatidar.blogspot.com
Cyanosis: Bluish discoloration of skin, nail buds, mucus membranes, resulting from a decreased amount of oxygen in the hemoglobin of the blood. 
9/17/2014 
8 
www.drjayeshpatidar.blogspot.com
Breathlessness or labored breathing: By some diseases such as -emphysema, pulmonary embolism, coronary thrombosis etc. 
9/17/2014 
9www.drjayeshpatidar.blogspot.com
Anemia 
Diseases such as -pulmonary edema, pneumonia, chest trauma etc 
Environment with low oxygen content e.g. high attitudes 
Poisoning with chemicals that alter the tissues ability to utilize oxygen e.g. cyanide poisoning 
Hemorrhage 
9/17/2014 
10 
www.drjayeshpatidar.blogspot.com
ARTICLES 
NEEDED 
FOR 
OXYGEN 
ADMINISTRATION 
9/17/2014 
11 
www.drjayeshpatidar.blogspot.com
Oxygen source -02 cylinder, central supply 
9/17/2014 
12 
www.drjayeshpatidar.blogspot.com
Oxygen instrument according to methods like –oxygen mask, oxygen hood, nasal prongs, nasal catheter, oxygen tent or canopy9/17/2014 
13 
www.drjayeshpatidar.blogspot.com
Humidifier 
9/17/2014 
14 
www.drjayeshpatidar.blogspot.com
Flow meter 
9/17/2014 
15 
www.drjayeshpatidar.blogspot.com
Gauze pieces 
Adhesive tape 
9/17/2014 
16 
www.drjayeshpatidar.blogspot.com
‘No smoking' signs 
9/17/2014 
17 
www.drjayeshpatidar.blogspot.com
Spinner to open the main valve of oxygen cylinder 
9/17/2014 
18 
www.drjayeshpatidar.blogspot.com
Bowel with water to check the patency of the tube 
9/17/2014 
19 
www.drjayeshpatidar.blogspot.com
METHODS 
OF 
OXYGEN 
ADMINISTRATION 
9/17/2014 
20www.drjayeshpatidar.blogspot.com
Oxygen administration depends upon the condition of child, age, concentration desired, facilities available and the preference of the doctor. Oxygen administration can be given continuously or intermittently. It depends on the requirement of the child. It is given in 40 to 60 percent concentration. There are following methods of oxygen administration 
9/17/2014 
21 
www.drjayeshpatidar.blogspot.com
ADMINISTRATION OF 02 BY NASAL CATHETER 
This is very common method of 02 administrations in hospital settings. A catheter is inserted into the nostril reaching up to the uvula and is held in place by adhesive tapes 
This catheter does not interfere with the Childs freedom to eat, to talk and to move on the bed. Catheter no. 4 to 6 is used and it should be 7.5 to 10 cm inserted in the nasopharynx. The catheter should be removed every 8 hourly, and new catheter should be inserted by using other nostril alternatively. Catheter method is used for the older children. The amount of oxygen should be 4 liter per minute 
9/17/2014 
22 
www.drjayeshpatidar.blogspot.com
9/17/2014 
23 
www.drjayeshpatidar.blogspot.com
ADMINISTRATION OF OXYGEN BY THE MASK 
Today, there are various face masks available that cover the Childs mouth and nose for 02 administration. The mask size should be according to the child's size. It should be properly fitted and if it does not fit properly, 02 will be lost from the mask. It should be removed after every four hours and-wine the face. The masks are advantageous for those patients who are unable to breathe through nose. The flow of oxygen should be about 2-3 litrefor young children and 1-2 litre/minute for the infants. 
9/17/2014 
24www.drjayeshpatidar.blogspot.com
9/17/2014 
25 
www.drjayeshpatidar.blogspot.com
ADMINISTRATION OF OXYGEN BY THE TENT METHOD 
The oxygen tent method consists of a canopy over the patients bed, that cover the patient fully or partially. Oxygen tent is made up of plastic material, transparent and prevent absorption of oxygen. The lower part of the canopy is tucked under the bed to prevent the escape of oxygen. There are certain advantages and disadvantages for using a oxygen tent method. 
Oxygen tent provides the environment for the patient with controlled oxygen concentration, temperature regulation and humidity control. 
9/17/2014 
26 
www.drjayeshpatidar.blogspot.com
9/17/2014 
27 
www.drjayeshpatidar.blogspot.com
PROCEDURES 
9/17/2014 
28 
www.drjayeshpatidar.blogspot.com
Assemble the 02 headboxPlace the headboxproperly covering head, face and neck. Seal the opening of headboxaround neck to minimize 02 leakingAttach thermometer probe to head box via aperture or use disposable thermometer 
9/17/2014 
29 
www.drjayeshpatidar.blogspot.com
Adjust 02 and air flow rates to achieve prescribed oxygen concentration the total flow should be between 6 and 8 liters per minute to prevent accumulation of carbon dioxide in the head box. 
Place sensor of oxygen analyzer into headboxalongside infant's nose (within 8 cm) to check oxygen concentration in headbox 
9/17/2014 
30 
www.drjayeshpatidar.blogspot.com
NURSING PRINCIPLES 
9/17/2014 
31 
www.drjayeshpatidar.blogspot.com
Monitor oxygen concentration hourly 
Check frequently for loose connections in the circut 
Ensure position of oxygen analyzer sensor is close to infant's nose and not in mainstream of the oxygen hose 
Maintain the infant's head inside the headbox 
Fill humidifier to appropriate level with distilled water PRN 
9/17/2014 
32www.drjayeshpatidar.blogspot.com
G. Maintain inspired gas temperature as indicated below 
Weight in kg 0.5 1 2 3 4 
Temperature=C 35-37 34-36 33-35 31-34 30-33 
All procedures through open incubator doors or with infant partially out of the incubator should be carried out with the infant in headboxor with a mask connected to gas supply, and close to the infant's nose. 
9/17/2014 
33 
www.drjayeshpatidar.blogspot.com
DISADVANTAGES 
•It creates a feeling of isolation. 
•It requires high volume of oxygen which is not easily available. 
•When tent is opened, there is loss of 02 concentrations 
•It has more chances of fire. 
•It requires more time and cleanliness to maintain a tent. 
9/17/2014 
34 
www.drjayeshpatidar.blogspot.com
COMPLICATIONS 
OF 
0XYGEN 
ADMINISTRATIONS 
9/17/2014 
35 
www.drjayeshpatidar.blogspot.com
Infection: By using the contaminated equipments, the causative organisms can be present in such places as tracheotomy or endotrachealtubes, catheters, humidifying water and masks etc. 
Drying of mucus membrane of the respiratory tract: It can occur when oxygen is administered without sufficient humidity. It can cause irritation and drying of the mucus membrane. 
Combustion (fire) : 02 itself does not burn, but it supports combustion. 
9/17/201436 
www.drjayeshpatidar.blogspot.com
Oxygen toxicity: Symptoms of toxicity includes tracheal irritation and cough. 
Atelectasis: Collapse of alveoli develops as a result of increased oxygen concentration in the inspired air. This is due to elimination of nitrogen. 
Oxygen induced apnoea: The carbon dioxide is washed off completely from the blood by a high concentration of oxygen. The respiratory center is not stimulated sufficiently. 
9/17/2014 
37 
www.drjayeshpatidar.blogspot.com
Asphyxia: Patient who receives 02 by masks and close tents must be protected from asphyxia. 
Retrolentalfibroplasia: The hazards of oxygen may affect the eyes. It is noted in premature infants who have a high concentration of oxygen inhalation. 
Some others are -Bronchopulmonary, dysplasia, respiratory depression, seizure disorders and epilepsy. 
9/17/2014 
38 
www.drjayeshpatidar.blogspot.com
IMPORTANT 
INSTRUCTIONS 
FOR 
OXYGEN 
INHALATION 
9/17/2014 
39 
www.drjayeshpatidar.blogspot.com
Oxygen should be prescribed in specific dose. It acts as a drug and cause oxygen toxicity. Always use humidifier and regulator. All the articles should 'be cleaned and use the disposable nasal catheter and change the nasal catheter every 8 hourly. Lubricate the nasal catheter before inserting. 9/17/2014 
40 
www.drjayeshpatidar.blogspot.com
Control valve of cylinder should be adjusted only when catheter is out of nose. or during oxygenation, do not alter the valve. Discontinue of oxygen should be gradually. Leave a calling signal or bell near the patient while going away from the patient. Keep in close observation conditions, which can interfere with the flow of oxygen from the source to the patient. Keep ready one cylinder to prevent the deprivation of oxygen. 
9/17/2014 
41 
www.drjayeshpatidar.blogspot.com
Give oxygen in low concentration to the premature babies to prevent the. retrolentalfibroplasia. 
Continuously monitoring of patient to find out the oxygen toxicity symptoms. 
Empty cylinder should mark "empty" and keep separately from full cylinders. 
9/17/2014 
42 
www.drjayeshpatidar.blogspot.com
While oxygen administration, paste the "No Smoking" signs, near the patient bed or on the door. 
Proper recording and reporting should be followed 
9/17/2014 
43 
www.drjayeshpatidar.blogspot.com
9/17/2014 
www.drjayeshpatidar.blogspot.com 
44Thank You

More Related Content

What's hot

oxygen administration procedure
oxygen administration procedureoxygen administration procedure
oxygen administration procedure
Sachin Chauhan
 
Sitz bath converted
Sitz bath convertedSitz bath converted
Sitz bath converted
saheli chakraborty
 
Ng tube feeding
Ng tube feedingNg tube feeding
Ng tube feeding
KHyati CHaudhari
 
Hot application.pptx
Hot application.pptxHot application.pptx
Hot application.pptx
Koyel Thander
 
Bowel Wash
Bowel WashBowel Wash
Enema
EnemaEnema
Nebulization procedure
Nebulization procedureNebulization procedure
Nebulization procedure
Vikram Singh Rajawat
 
Oral medications Procedures of Administering Oral Medicines
Oral medications  Procedures of Administering Oral Medicines Oral medications  Procedures of Administering Oral Medicines
Oral medications Procedures of Administering Oral Medicines
Ganga Tiwari
 
Eye care & perineal care
Eye care & perineal careEye care & perineal care
Eye care & perineal care
Nikita Sharma
 
Nail care, Fundamentals of Nursing
Nail care, Fundamentals of Nursing Nail care, Fundamentals of Nursing
Nail care, Fundamentals of Nursing
Pooja Koirala
 
Care of linens, rubber goods,glasswares
Care of linens, rubber goods,glasswaresCare of linens, rubber goods,glasswares
Care of linens, rubber goods,glasswares
baladinesh .K
 
Back care of patient , Fundamentals of Nursing
Back care of patient , Fundamentals of Nursing Back care of patient , Fundamentals of Nursing
Back care of patient , Fundamentals of Nursing
Pooja Koirala
 
Death & Care of dead body
Death & Care of dead  bodyDeath & Care of dead  body
Death & Care of dead body
Renil Robert
 
Bed Bath Procedure
Bed Bath ProcedureBed Bath Procedure
Bed Bath Procedure
Prof Vijayraddi
 
Hospital house keeping & care of rubber goods
Hospital house keeping & care of rubber goodsHospital house keeping & care of rubber goods
Hospital house keeping & care of rubber goods
Siva Nanda Reddy
 
Oral drug administration
Oral drug administrationOral drug administration
Oral drug administration
Manikandan T
 
Back care in nursing
Back care in nursing Back care in nursing
Back care in nursing
anjalatchi
 
Mouth care
Mouth careMouth care
Mouth care
SusmitaBarman2
 

What's hot (20)

oxygen administration procedure
oxygen administration procedureoxygen administration procedure
oxygen administration procedure
 
Sitz bath converted
Sitz bath convertedSitz bath converted
Sitz bath converted
 
Ng tube feeding
Ng tube feedingNg tube feeding
Ng tube feeding
 
Restraints
RestraintsRestraints
Restraints
 
Hot application.pptx
Hot application.pptxHot application.pptx
Hot application.pptx
 
Bowel Wash
Bowel WashBowel Wash
Bowel Wash
 
Enema
EnemaEnema
Enema
 
Nebulization procedure
Nebulization procedureNebulization procedure
Nebulization procedure
 
Oral medications Procedures of Administering Oral Medicines
Oral medications  Procedures of Administering Oral Medicines Oral medications  Procedures of Administering Oral Medicines
Oral medications Procedures of Administering Oral Medicines
 
Eye care & perineal care
Eye care & perineal careEye care & perineal care
Eye care & perineal care
 
Nail care, Fundamentals of Nursing
Nail care, Fundamentals of Nursing Nail care, Fundamentals of Nursing
Nail care, Fundamentals of Nursing
 
Care of linens, rubber goods,glasswares
Care of linens, rubber goods,glasswaresCare of linens, rubber goods,glasswares
Care of linens, rubber goods,glasswares
 
Back care of patient , Fundamentals of Nursing
Back care of patient , Fundamentals of Nursing Back care of patient , Fundamentals of Nursing
Back care of patient , Fundamentals of Nursing
 
Positions
PositionsPositions
Positions
 
Death & Care of dead body
Death & Care of dead  bodyDeath & Care of dead  body
Death & Care of dead body
 
Bed Bath Procedure
Bed Bath ProcedureBed Bath Procedure
Bed Bath Procedure
 
Hospital house keeping & care of rubber goods
Hospital house keeping & care of rubber goodsHospital house keeping & care of rubber goods
Hospital house keeping & care of rubber goods
 
Oral drug administration
Oral drug administrationOral drug administration
Oral drug administration
 
Back care in nursing
Back care in nursing Back care in nursing
Back care in nursing
 
Mouth care
Mouth careMouth care
Mouth care
 

Viewers also liked

Basics of Oxygen Therapy
Basics of Oxygen TherapyBasics of Oxygen Therapy
Basics of Oxygen Therapy
Claire Constantino
 
Oxygen therapy
Oxygen therapyOxygen therapy
Oxygen therapy
MEEQAT HOSPITAL
 
Oxygen administration
Oxygen administrationOxygen administration
Oxygen administration
Francis K. Antwi
 
Oxygen administration procedure
Oxygen administration procedureOxygen administration procedure
Oxygen administration procedure
Sachin Chauhan
 
Asepsis and infection control
Asepsis and infection controlAsepsis and infection control
Asepsis and infection control
Nursing Path
 
OxyFit Oxygen Inhalation Product Presentation
OxyFit Oxygen Inhalation Product PresentationOxyFit Oxygen Inhalation Product Presentation
OxyFit Oxygen Inhalation Product Presentation
Ernest John Fleckenstein
 
O2 therapy presentation
O2 therapy presentationO2 therapy presentation
O2 therapy presentation
LonlOoN
 
sterization and asepsis in maxillofacial surgery
sterization and asepsis in maxillofacial surgerysterization and asepsis in maxillofacial surgery
sterization and asepsis in maxillofacial surgery
Joel D'silva
 
Motivation
MotivationMotivation
Motivation
Nursing Path
 
Asepsis
AsepsisAsepsis
Spinal coard injury
Spinal coard injurySpinal coard injury
Spinal coard injuryNursing Path
 
Asepsis
AsepsisAsepsis
Body composition and analysis
Body composition and analysisBody composition and analysis
Body composition and analysis
Vidhi Thakar
 
FW190 Body Composition
FW190 Body CompositionFW190 Body Composition
FW190 Body Composition
Matt Sanders
 
Peripheral nerves &roots lession localisation
Peripheral nerves &roots lession localisationPeripheral nerves &roots lession localisation
Peripheral nerves &roots lession localisation
Abino David
 
Aseptic Technique
Aseptic TechniqueAseptic Technique
Aseptic Technique
St Mark's Academic Institute
 

Viewers also liked (20)

Basics of Oxygen Therapy
Basics of Oxygen TherapyBasics of Oxygen Therapy
Basics of Oxygen Therapy
 
Oxygen therapy
Oxygen therapyOxygen therapy
Oxygen therapy
 
Oxygen therapy
Oxygen therapyOxygen therapy
Oxygen therapy
 
Oxygen administration
Oxygen administrationOxygen administration
Oxygen administration
 
Oxygen administration procedure
Oxygen administration procedureOxygen administration procedure
Oxygen administration procedure
 
Asepsis and infection control
Asepsis and infection controlAsepsis and infection control
Asepsis and infection control
 
Physical therapy
Physical therapyPhysical therapy
Physical therapy
 
OxyFit Oxygen Inhalation Product Presentation
OxyFit Oxygen Inhalation Product PresentationOxyFit Oxygen Inhalation Product Presentation
OxyFit Oxygen Inhalation Product Presentation
 
O2 therapy presentation
O2 therapy presentationO2 therapy presentation
O2 therapy presentation
 
sterization and asepsis in maxillofacial surgery
sterization and asepsis in maxillofacial surgerysterization and asepsis in maxillofacial surgery
sterization and asepsis in maxillofacial surgery
 
Motivation
MotivationMotivation
Motivation
 
Asepsis
AsepsisAsepsis
Asepsis
 
Spinal coard injury
Spinal coard injurySpinal coard injury
Spinal coard injury
 
Asepsis
AsepsisAsepsis
Asepsis
 
Body composition and analysis
Body composition and analysisBody composition and analysis
Body composition and analysis
 
FW190 Body Composition
FW190 Body CompositionFW190 Body Composition
FW190 Body Composition
 
Rt insertion
Rt insertionRt insertion
Rt insertion
 
Peripheral nerves &roots lession localisation
Peripheral nerves &roots lession localisationPeripheral nerves &roots lession localisation
Peripheral nerves &roots lession localisation
 
Aseptic Technique
Aseptic TechniqueAseptic Technique
Aseptic Technique
 
Nasogastrik tube
Nasogastrik tubeNasogastrik tube
Nasogastrik tube
 

Similar to Oxygen inhalation

Oxygen therapy
Oxygen therapyOxygen therapy
Oxygen therapy
Gianne Gregorio
 
Oxygen Inhalation.pptx
Oxygen Inhalation.pptxOxygen Inhalation.pptx
Oxygen Inhalation.pptx
bhavanibb
 
Oxygen therapy -
Oxygen therapy - Oxygen therapy -
Oxygen therapy -
Ganga Tiwari
 
#Nasal canulae
#Nasal canulae#Nasal canulae
#Nasal canulae
Nisar Arain
 
O2 therapy procedure
O2 therapy procedureO2 therapy procedure
O2 therapy procedure
KHUSHBU PATEL
 
oxygen (1).pptx
oxygen (1).pptxoxygen (1).pptx
oxygen (1).pptx
SikoBikoAreru
 
Oxygen administration
Oxygen administrationOxygen administration
Oxygen administration
ABHIJIT BHOYAR
 
OXYGEN ADMINSTRATION.pptx
OXYGEN ADMINSTRATION.pptxOXYGEN ADMINSTRATION.pptx
OXYGEN ADMINSTRATION.pptx
AnamikaVerma840455
 
Oxygen therapy
Oxygen therapyOxygen therapy
Oxygen therapy
Joel PD
 
Oxygenation
OxygenationOxygenation
Oxygenation
bypo hemalatha
 
0xygen therapy
0xygen therapy0xygen therapy
0xygen therapy
Royal Medical Services
 
Oxygen administration
Oxygen administrationOxygen administration
Oxygen administration
Tanoj Patidar
 
Oxygenation.ppt
Oxygenation.pptOxygenation.ppt
Oxygenation.ppt
formanite2
 
Oxygen
OxygenOxygen
Oxygen
sreeps003
 
Na Ii Ppt Module 2
Na Ii Ppt Module 2Na Ii Ppt Module 2
Na Ii Ppt Module 2natrainer
 
Unit 18-2.pptx
Unit 18-2.pptxUnit 18-2.pptx
Unit 18-2.pptx
Sagunlohala1
 
11. oxygen therapy 2.pptx
11. oxygen therapy 2.pptx11. oxygen therapy 2.pptx
11. oxygen therapy 2.pptx
AMANUELMELAKU5
 
10 airway-management-suction-oropharyngeal
10 airway-management-suction-oropharyngeal10 airway-management-suction-oropharyngeal
10 airway-management-suction-oropharyngealsojhk
 
Seminar Presentation on Oxygen Administration.pptx
Seminar Presentation on Oxygen Administration.pptxSeminar Presentation on Oxygen Administration.pptx
Seminar Presentation on Oxygen Administration.pptx
RebiraWorkineh
 

Similar to Oxygen inhalation (20)

Oxygen therapy
Oxygen therapyOxygen therapy
Oxygen therapy
 
Oxygen Inhalation.pptx
Oxygen Inhalation.pptxOxygen Inhalation.pptx
Oxygen Inhalation.pptx
 
Oxygen therapy -
Oxygen therapy - Oxygen therapy -
Oxygen therapy -
 
#Nasal canulae
#Nasal canulae#Nasal canulae
#Nasal canulae
 
O2 therapy procedure
O2 therapy procedureO2 therapy procedure
O2 therapy procedure
 
oxygen (1).pptx
oxygen (1).pptxoxygen (1).pptx
oxygen (1).pptx
 
Oxygen administration
Oxygen administrationOxygen administration
Oxygen administration
 
OXYGEN ADMINSTRATION.pptx
OXYGEN ADMINSTRATION.pptxOXYGEN ADMINSTRATION.pptx
OXYGEN ADMINSTRATION.pptx
 
Oxygen therapy
Oxygen therapyOxygen therapy
Oxygen therapy
 
Oxygenation
OxygenationOxygenation
Oxygenation
 
0xygen therapy
0xygen therapy0xygen therapy
0xygen therapy
 
Oxygen administration
Oxygen administrationOxygen administration
Oxygen administration
 
Oxygenation.ppt
Oxygenation.pptOxygenation.ppt
Oxygenation.ppt
 
Oxygen
OxygenOxygen
Oxygen
 
Na Ii Ppt Module 2
Na Ii Ppt Module 2Na Ii Ppt Module 2
Na Ii Ppt Module 2
 
Unit 18-2.pptx
Unit 18-2.pptxUnit 18-2.pptx
Unit 18-2.pptx
 
11. oxygen therapy 2.pptx
11. oxygen therapy 2.pptx11. oxygen therapy 2.pptx
11. oxygen therapy 2.pptx
 
10 airway-management-suction-oropharyngeal
10 airway-management-suction-oropharyngeal10 airway-management-suction-oropharyngeal
10 airway-management-suction-oropharyngeal
 
Seminar Presentation on Oxygen Administration.pptx
Seminar Presentation on Oxygen Administration.pptxSeminar Presentation on Oxygen Administration.pptx
Seminar Presentation on Oxygen Administration.pptx
 
oxygen therapy
oxygen therapyoxygen therapy
oxygen therapy
 

More from Nursing Path

Psychosocial care of coronavirus disease 2019
Psychosocial care of coronavirus disease 2019Psychosocial care of coronavirus disease 2019
Psychosocial care of coronavirus disease 2019
Nursing Path
 
Isolation facility for covid-19
Isolation facility for covid-19Isolation facility for covid-19
Isolation facility for covid-19
Nursing Path
 
Guidelines on clinical management of covid 19
Guidelines on clinical management of covid   19Guidelines on clinical management of covid   19
Guidelines on clinical management of covid 19
Nursing Path
 
Fluid and electrolyte balance
Fluid and electrolyte balanceFluid and electrolyte balance
Fluid and electrolyte balance
Nursing Path
 
Hospital Infection Control Programme
Hospital Infection Control ProgrammeHospital Infection Control Programme
Hospital Infection Control Programme
Nursing Path
 
Outcome based education
Outcome based educationOutcome based education
Outcome based education
Nursing Path
 
Assessment
AssessmentAssessment
Assessment
Nursing Path
 
Anxiety disorders
Anxiety disordersAnxiety disorders
Anxiety disorders
Nursing Path
 
Selection and organization of learning experience
Selection and organization of learning experienceSelection and organization of learning experience
Selection and organization of learning experience
Nursing Path
 
Universal Health Coverage
Universal Health CoverageUniversal Health Coverage
Universal Health Coverage
Nursing Path
 
Pneumonia
PneumoniaPneumonia
Pneumonia
Nursing Path
 
Swine flu
Swine fluSwine flu
Swine flu
Nursing Path
 
Cardiopulmonary resuscitation
Cardiopulmonary resuscitationCardiopulmonary resuscitation
Cardiopulmonary resuscitation
Nursing Path
 
Abortion
AbortionAbortion
Abortion
Nursing Path
 
Microbiology
MicrobiologyMicrobiology
Microbiology
Nursing Path
 
Fundamental of nursing practice exam 4
Fundamental of nursing practice exam 4Fundamental of nursing practice exam 4
Fundamental of nursing practice exam 4
Nursing Path
 
Fundamentals of nursing practice exa1
Fundamentals of nursing practice exa1Fundamentals of nursing practice exa1
Fundamentals of nursing practice exa1
Nursing Path
 
Fundamentals of nursing practice exam
Fundamentals of nursing practice examFundamentals of nursing practice exam
Fundamentals of nursing practice exam
Nursing Path
 
Fundamentals of nursing practice exam
Fundamentals of nursing practice examFundamentals of nursing practice exam
Fundamentals of nursing practice exam
Nursing Path
 
The enterobacteriaceae basic properties.ppsx x
The enterobacteriaceae basic properties.ppsx xThe enterobacteriaceae basic properties.ppsx x
The enterobacteriaceae basic properties.ppsx x
Nursing Path
 

More from Nursing Path (20)

Psychosocial care of coronavirus disease 2019
Psychosocial care of coronavirus disease 2019Psychosocial care of coronavirus disease 2019
Psychosocial care of coronavirus disease 2019
 
Isolation facility for covid-19
Isolation facility for covid-19Isolation facility for covid-19
Isolation facility for covid-19
 
Guidelines on clinical management of covid 19
Guidelines on clinical management of covid   19Guidelines on clinical management of covid   19
Guidelines on clinical management of covid 19
 
Fluid and electrolyte balance
Fluid and electrolyte balanceFluid and electrolyte balance
Fluid and electrolyte balance
 
Hospital Infection Control Programme
Hospital Infection Control ProgrammeHospital Infection Control Programme
Hospital Infection Control Programme
 
Outcome based education
Outcome based educationOutcome based education
Outcome based education
 
Assessment
AssessmentAssessment
Assessment
 
Anxiety disorders
Anxiety disordersAnxiety disorders
Anxiety disorders
 
Selection and organization of learning experience
Selection and organization of learning experienceSelection and organization of learning experience
Selection and organization of learning experience
 
Universal Health Coverage
Universal Health CoverageUniversal Health Coverage
Universal Health Coverage
 
Pneumonia
PneumoniaPneumonia
Pneumonia
 
Swine flu
Swine fluSwine flu
Swine flu
 
Cardiopulmonary resuscitation
Cardiopulmonary resuscitationCardiopulmonary resuscitation
Cardiopulmonary resuscitation
 
Abortion
AbortionAbortion
Abortion
 
Microbiology
MicrobiologyMicrobiology
Microbiology
 
Fundamental of nursing practice exam 4
Fundamental of nursing practice exam 4Fundamental of nursing practice exam 4
Fundamental of nursing practice exam 4
 
Fundamentals of nursing practice exa1
Fundamentals of nursing practice exa1Fundamentals of nursing practice exa1
Fundamentals of nursing practice exa1
 
Fundamentals of nursing practice exam
Fundamentals of nursing practice examFundamentals of nursing practice exam
Fundamentals of nursing practice exam
 
Fundamentals of nursing practice exam
Fundamentals of nursing practice examFundamentals of nursing practice exam
Fundamentals of nursing practice exam
 
The enterobacteriaceae basic properties.ppsx x
The enterobacteriaceae basic properties.ppsx xThe enterobacteriaceae basic properties.ppsx x
The enterobacteriaceae basic properties.ppsx x
 

Recently uploaded

Lapbook sobre os Regimes Totalitários.pdf
Lapbook sobre os Regimes Totalitários.pdfLapbook sobre os Regimes Totalitários.pdf
Lapbook sobre os Regimes Totalitários.pdf
Jean Carlos Nunes Paixão
 
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
Levi Shapiro
 
Sha'Carri Richardson Presentation 202345
Sha'Carri Richardson Presentation 202345Sha'Carri Richardson Presentation 202345
Sha'Carri Richardson Presentation 202345
beazzy04
 
The geography of Taylor Swift - some ideas
The geography of Taylor Swift - some ideasThe geography of Taylor Swift - some ideas
The geography of Taylor Swift - some ideas
GeoBlogs
 
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
siemaillard
 
Adversarial Attention Modeling for Multi-dimensional Emotion Regression.pdf
Adversarial Attention Modeling for Multi-dimensional Emotion Regression.pdfAdversarial Attention Modeling for Multi-dimensional Emotion Regression.pdf
Adversarial Attention Modeling for Multi-dimensional Emotion Regression.pdf
Po-Chuan Chen
 
special B.ed 2nd year old paper_20240531.pdf
special B.ed 2nd year old paper_20240531.pdfspecial B.ed 2nd year old paper_20240531.pdf
special B.ed 2nd year old paper_20240531.pdf
Special education needs
 
The basics of sentences session 5pptx.pptx
The basics of sentences session 5pptx.pptxThe basics of sentences session 5pptx.pptx
The basics of sentences session 5pptx.pptx
heathfieldcps1
 
CACJapan - GROUP Presentation 1- Wk 4.pdf
CACJapan - GROUP Presentation 1- Wk 4.pdfCACJapan - GROUP Presentation 1- Wk 4.pdf
CACJapan - GROUP Presentation 1- Wk 4.pdf
camakaiclarkmusic
 
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
MysoreMuleSoftMeetup
 
2024.06.01 Introducing a competency framework for languag learning materials ...
2024.06.01 Introducing a competency framework for languag learning materials ...2024.06.01 Introducing a competency framework for languag learning materials ...
2024.06.01 Introducing a competency framework for languag learning materials ...
Sandy Millin
 
Guidance_and_Counselling.pdf B.Ed. 4th Semester
Guidance_and_Counselling.pdf B.Ed. 4th SemesterGuidance_and_Counselling.pdf B.Ed. 4th Semester
Guidance_and_Counselling.pdf B.Ed. 4th Semester
Atul Kumar Singh
 
The Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdfThe Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdf
kaushalkr1407
 
The Challenger.pdf DNHS Official Publication
The Challenger.pdf DNHS Official PublicationThe Challenger.pdf DNHS Official Publication
The Challenger.pdf DNHS Official Publication
Delapenabediema
 
Thesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.pptThesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.ppt
EverAndrsGuerraGuerr
 
How to Make a Field invisible in Odoo 17
How to Make a Field invisible in Odoo 17How to Make a Field invisible in Odoo 17
How to Make a Field invisible in Odoo 17
Celine George
 
Honest Reviews of Tim Han LMA Course Program.pptx
Honest Reviews of Tim Han LMA Course Program.pptxHonest Reviews of Tim Han LMA Course Program.pptx
Honest Reviews of Tim Han LMA Course Program.pptx
timhan337
 
Overview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with MechanismOverview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with Mechanism
DeeptiGupta154
 
Polish students' mobility in the Czech Republic
Polish students' mobility in the Czech RepublicPolish students' mobility in the Czech Republic
Polish students' mobility in the Czech Republic
Anna Sz.
 
Unit 2- Research Aptitude (UGC NET Paper I).pdf
Unit 2- Research Aptitude (UGC NET Paper I).pdfUnit 2- Research Aptitude (UGC NET Paper I).pdf
Unit 2- Research Aptitude (UGC NET Paper I).pdf
Thiyagu K
 

Recently uploaded (20)

Lapbook sobre os Regimes Totalitários.pdf
Lapbook sobre os Regimes Totalitários.pdfLapbook sobre os Regimes Totalitários.pdf
Lapbook sobre os Regimes Totalitários.pdf
 
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
 
Sha'Carri Richardson Presentation 202345
Sha'Carri Richardson Presentation 202345Sha'Carri Richardson Presentation 202345
Sha'Carri Richardson Presentation 202345
 
The geography of Taylor Swift - some ideas
The geography of Taylor Swift - some ideasThe geography of Taylor Swift - some ideas
The geography of Taylor Swift - some ideas
 
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
 
Adversarial Attention Modeling for Multi-dimensional Emotion Regression.pdf
Adversarial Attention Modeling for Multi-dimensional Emotion Regression.pdfAdversarial Attention Modeling for Multi-dimensional Emotion Regression.pdf
Adversarial Attention Modeling for Multi-dimensional Emotion Regression.pdf
 
special B.ed 2nd year old paper_20240531.pdf
special B.ed 2nd year old paper_20240531.pdfspecial B.ed 2nd year old paper_20240531.pdf
special B.ed 2nd year old paper_20240531.pdf
 
The basics of sentences session 5pptx.pptx
The basics of sentences session 5pptx.pptxThe basics of sentences session 5pptx.pptx
The basics of sentences session 5pptx.pptx
 
CACJapan - GROUP Presentation 1- Wk 4.pdf
CACJapan - GROUP Presentation 1- Wk 4.pdfCACJapan - GROUP Presentation 1- Wk 4.pdf
CACJapan - GROUP Presentation 1- Wk 4.pdf
 
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
 
2024.06.01 Introducing a competency framework for languag learning materials ...
2024.06.01 Introducing a competency framework for languag learning materials ...2024.06.01 Introducing a competency framework for languag learning materials ...
2024.06.01 Introducing a competency framework for languag learning materials ...
 
Guidance_and_Counselling.pdf B.Ed. 4th Semester
Guidance_and_Counselling.pdf B.Ed. 4th SemesterGuidance_and_Counselling.pdf B.Ed. 4th Semester
Guidance_and_Counselling.pdf B.Ed. 4th Semester
 
The Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdfThe Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdf
 
The Challenger.pdf DNHS Official Publication
The Challenger.pdf DNHS Official PublicationThe Challenger.pdf DNHS Official Publication
The Challenger.pdf DNHS Official Publication
 
Thesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.pptThesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.ppt
 
How to Make a Field invisible in Odoo 17
How to Make a Field invisible in Odoo 17How to Make a Field invisible in Odoo 17
How to Make a Field invisible in Odoo 17
 
Honest Reviews of Tim Han LMA Course Program.pptx
Honest Reviews of Tim Han LMA Course Program.pptxHonest Reviews of Tim Han LMA Course Program.pptx
Honest Reviews of Tim Han LMA Course Program.pptx
 
Overview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with MechanismOverview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with Mechanism
 
Polish students' mobility in the Czech Republic
Polish students' mobility in the Czech RepublicPolish students' mobility in the Czech Republic
Polish students' mobility in the Czech Republic
 
Unit 2- Research Aptitude (UGC NET Paper I).pdf
Unit 2- Research Aptitude (UGC NET Paper I).pdfUnit 2- Research Aptitude (UGC NET Paper I).pdf
Unit 2- Research Aptitude (UGC NET Paper I).pdf
 

Oxygen inhalation

  • 1. OXYGEN INHALATION Dr. JayeshPatidar www.drjayeshpatidar.blogspot.com 1
  • 2. DEFINITION 9/17/2014 2 www.drjayeshpatidar.blogspot.com
  • 3. Administration of oxygen is a process of providing the 02 supply to child for the treatment of low concentration of 02 in the blood. Children with respiratory dysfunctions are treated with oxygen inhalation to relieve anoxaemiaor hypoxaemia(deficiency of oxygen in the blood). The normal amount of oxygen in the arterial blood should be in the range of 80 to 100 mm of Hg. If it falls below 60 mm of Hg; irreversible physiologic effects may occur. The oxygen administration treats the effects of oxygen deficiency but it does not correct the underlying causes 9/17/2014 3 www.drjayeshpatidar.blogspot.com
  • 5. PURPOSES OF OXYGEN INHALATION 9/17/2014 5 www.drjayeshpatidar.blogspot.com
  • 6. •To manage the condition of hypoxia •To -maintain the oxygen tension in blood plasma •To increase the oxy hemoglobin in red blood cells •To maintain the ability of cells to carry out the normal metabolic function •To reduce the risk of complications 9/17/2014 6 www.drjayeshpatidar.blogspot.com
  • 7. COMMON INDICATIONS FOR OXYGEN ADMINISTRATION 9/17/2014 7 www.drjayeshpatidar.blogspot.com
  • 8. Cyanosis: Bluish discoloration of skin, nail buds, mucus membranes, resulting from a decreased amount of oxygen in the hemoglobin of the blood. 9/17/2014 8 www.drjayeshpatidar.blogspot.com
  • 9. Breathlessness or labored breathing: By some diseases such as -emphysema, pulmonary embolism, coronary thrombosis etc. 9/17/2014 9www.drjayeshpatidar.blogspot.com
  • 10. Anemia Diseases such as -pulmonary edema, pneumonia, chest trauma etc Environment with low oxygen content e.g. high attitudes Poisoning with chemicals that alter the tissues ability to utilize oxygen e.g. cyanide poisoning Hemorrhage 9/17/2014 10 www.drjayeshpatidar.blogspot.com
  • 11. ARTICLES NEEDED FOR OXYGEN ADMINISTRATION 9/17/2014 11 www.drjayeshpatidar.blogspot.com
  • 12. Oxygen source -02 cylinder, central supply 9/17/2014 12 www.drjayeshpatidar.blogspot.com
  • 13. Oxygen instrument according to methods like –oxygen mask, oxygen hood, nasal prongs, nasal catheter, oxygen tent or canopy9/17/2014 13 www.drjayeshpatidar.blogspot.com
  • 14. Humidifier 9/17/2014 14 www.drjayeshpatidar.blogspot.com
  • 15. Flow meter 9/17/2014 15 www.drjayeshpatidar.blogspot.com
  • 16. Gauze pieces Adhesive tape 9/17/2014 16 www.drjayeshpatidar.blogspot.com
  • 17. ‘No smoking' signs 9/17/2014 17 www.drjayeshpatidar.blogspot.com
  • 18. Spinner to open the main valve of oxygen cylinder 9/17/2014 18 www.drjayeshpatidar.blogspot.com
  • 19. Bowel with water to check the patency of the tube 9/17/2014 19 www.drjayeshpatidar.blogspot.com
  • 20. METHODS OF OXYGEN ADMINISTRATION 9/17/2014 20www.drjayeshpatidar.blogspot.com
  • 21. Oxygen administration depends upon the condition of child, age, concentration desired, facilities available and the preference of the doctor. Oxygen administration can be given continuously or intermittently. It depends on the requirement of the child. It is given in 40 to 60 percent concentration. There are following methods of oxygen administration 9/17/2014 21 www.drjayeshpatidar.blogspot.com
  • 22. ADMINISTRATION OF 02 BY NASAL CATHETER This is very common method of 02 administrations in hospital settings. A catheter is inserted into the nostril reaching up to the uvula and is held in place by adhesive tapes This catheter does not interfere with the Childs freedom to eat, to talk and to move on the bed. Catheter no. 4 to 6 is used and it should be 7.5 to 10 cm inserted in the nasopharynx. The catheter should be removed every 8 hourly, and new catheter should be inserted by using other nostril alternatively. Catheter method is used for the older children. The amount of oxygen should be 4 liter per minute 9/17/2014 22 www.drjayeshpatidar.blogspot.com
  • 24. ADMINISTRATION OF OXYGEN BY THE MASK Today, there are various face masks available that cover the Childs mouth and nose for 02 administration. The mask size should be according to the child's size. It should be properly fitted and if it does not fit properly, 02 will be lost from the mask. It should be removed after every four hours and-wine the face. The masks are advantageous for those patients who are unable to breathe through nose. The flow of oxygen should be about 2-3 litrefor young children and 1-2 litre/minute for the infants. 9/17/2014 24www.drjayeshpatidar.blogspot.com
  • 26. ADMINISTRATION OF OXYGEN BY THE TENT METHOD The oxygen tent method consists of a canopy over the patients bed, that cover the patient fully or partially. Oxygen tent is made up of plastic material, transparent and prevent absorption of oxygen. The lower part of the canopy is tucked under the bed to prevent the escape of oxygen. There are certain advantages and disadvantages for using a oxygen tent method. Oxygen tent provides the environment for the patient with controlled oxygen concentration, temperature regulation and humidity control. 9/17/2014 26 www.drjayeshpatidar.blogspot.com
  • 28. PROCEDURES 9/17/2014 28 www.drjayeshpatidar.blogspot.com
  • 29. Assemble the 02 headboxPlace the headboxproperly covering head, face and neck. Seal the opening of headboxaround neck to minimize 02 leakingAttach thermometer probe to head box via aperture or use disposable thermometer 9/17/2014 29 www.drjayeshpatidar.blogspot.com
  • 30. Adjust 02 and air flow rates to achieve prescribed oxygen concentration the total flow should be between 6 and 8 liters per minute to prevent accumulation of carbon dioxide in the head box. Place sensor of oxygen analyzer into headboxalongside infant's nose (within 8 cm) to check oxygen concentration in headbox 9/17/2014 30 www.drjayeshpatidar.blogspot.com
  • 31. NURSING PRINCIPLES 9/17/2014 31 www.drjayeshpatidar.blogspot.com
  • 32. Monitor oxygen concentration hourly Check frequently for loose connections in the circut Ensure position of oxygen analyzer sensor is close to infant's nose and not in mainstream of the oxygen hose Maintain the infant's head inside the headbox Fill humidifier to appropriate level with distilled water PRN 9/17/2014 32www.drjayeshpatidar.blogspot.com
  • 33. G. Maintain inspired gas temperature as indicated below Weight in kg 0.5 1 2 3 4 Temperature=C 35-37 34-36 33-35 31-34 30-33 All procedures through open incubator doors or with infant partially out of the incubator should be carried out with the infant in headboxor with a mask connected to gas supply, and close to the infant's nose. 9/17/2014 33 www.drjayeshpatidar.blogspot.com
  • 34. DISADVANTAGES •It creates a feeling of isolation. •It requires high volume of oxygen which is not easily available. •When tent is opened, there is loss of 02 concentrations •It has more chances of fire. •It requires more time and cleanliness to maintain a tent. 9/17/2014 34 www.drjayeshpatidar.blogspot.com
  • 35. COMPLICATIONS OF 0XYGEN ADMINISTRATIONS 9/17/2014 35 www.drjayeshpatidar.blogspot.com
  • 36. Infection: By using the contaminated equipments, the causative organisms can be present in such places as tracheotomy or endotrachealtubes, catheters, humidifying water and masks etc. Drying of mucus membrane of the respiratory tract: It can occur when oxygen is administered without sufficient humidity. It can cause irritation and drying of the mucus membrane. Combustion (fire) : 02 itself does not burn, but it supports combustion. 9/17/201436 www.drjayeshpatidar.blogspot.com
  • 37. Oxygen toxicity: Symptoms of toxicity includes tracheal irritation and cough. Atelectasis: Collapse of alveoli develops as a result of increased oxygen concentration in the inspired air. This is due to elimination of nitrogen. Oxygen induced apnoea: The carbon dioxide is washed off completely from the blood by a high concentration of oxygen. The respiratory center is not stimulated sufficiently. 9/17/2014 37 www.drjayeshpatidar.blogspot.com
  • 38. Asphyxia: Patient who receives 02 by masks and close tents must be protected from asphyxia. Retrolentalfibroplasia: The hazards of oxygen may affect the eyes. It is noted in premature infants who have a high concentration of oxygen inhalation. Some others are -Bronchopulmonary, dysplasia, respiratory depression, seizure disorders and epilepsy. 9/17/2014 38 www.drjayeshpatidar.blogspot.com
  • 39. IMPORTANT INSTRUCTIONS FOR OXYGEN INHALATION 9/17/2014 39 www.drjayeshpatidar.blogspot.com
  • 40. Oxygen should be prescribed in specific dose. It acts as a drug and cause oxygen toxicity. Always use humidifier and regulator. All the articles should 'be cleaned and use the disposable nasal catheter and change the nasal catheter every 8 hourly. Lubricate the nasal catheter before inserting. 9/17/2014 40 www.drjayeshpatidar.blogspot.com
  • 41. Control valve of cylinder should be adjusted only when catheter is out of nose. or during oxygenation, do not alter the valve. Discontinue of oxygen should be gradually. Leave a calling signal or bell near the patient while going away from the patient. Keep in close observation conditions, which can interfere with the flow of oxygen from the source to the patient. Keep ready one cylinder to prevent the deprivation of oxygen. 9/17/2014 41 www.drjayeshpatidar.blogspot.com
  • 42. Give oxygen in low concentration to the premature babies to prevent the. retrolentalfibroplasia. Continuously monitoring of patient to find out the oxygen toxicity symptoms. Empty cylinder should mark "empty" and keep separately from full cylinders. 9/17/2014 42 www.drjayeshpatidar.blogspot.com
  • 43. While oxygen administration, paste the "No Smoking" signs, near the patient bed or on the door. Proper recording and reporting should be followed 9/17/2014 43 www.drjayeshpatidar.blogspot.com