2. LEARNING OBJECTIVES
At the end of the discussion, you will be able to:
♥ Describe conditions for which supplemental oxygen is used.
♥ Recognize the different types of delivery systems for oxygen therapy.
♥ Explain safety considerations for the use of oxygen.
♥ Identify the precautionary measures when using an oxygen cylinder in the
ward.
3. OUTLINE
♥ Definition of Oxygen Therapy
♥ Indications for Oxygen Therapy
♥ Clinical goals of oxygen and factors that determine which system to use
♥ To ensure safe and effective treatment
♥ Oxygen supply
♥ Devices used for administration of oxygen
♥ Oxygen delivery system
♥ Safety precautions using oxygen cylinder in the ward or hospital
♥ Safety precautions using oxygen cylinder at home
4. OXYGEN THERAPY
o is the administration of oxygen as a medical intervention,
which can be for a variety of purposes in both chronic and
acute patient care
o Oxygen is often prescribed for people to prevent hypoxia
because of the following conditions:
1.Difficulty ventilating all areas of their lungs
2.Impaired gas exchange
3.Heart failure
o Prescribed by the physician who specifies the following:
1.Concentration
2. Liter per minute
3.Method of delivery
6. CLINICAL GOALS OF O2 THERAPY
1. Treat hypoxemia
2. Decrease work of breathing
3. Decrease myocardial work
FACTORS THAT DETERMINE WHICH SYSTEM TO
USE
1. Patient comfort
2. The level of fio2 that is needed
3. The requirement that the fio2 be controlled within a certain range.
4. The level of humidification and or nebulization
7. OXYGEN THERAPY TO ENSURE SAFE AND
EFFECTIVE TREATMENT
1.Oxygen is required for the functioning and survival of all body
tissues and deprivation for more than a few minutes is fatal.
2.In immediately life threatening situations oxygen should be
administered.
3. Hypoxemia.
4. Acute hypotension.
5. Breathing inadequacy.
6. Trauma.
7. Acute illness.
8. CO2 poisoning.
7
8. 9. Severe anemia.
10. During the peri-operative period.
11. Prescriptions should include
-Flow rate.
-Delivery system.
-Duration.
12. Monitoring respiratory and oxygen saturation
8
OXYGEN THERAPY TO ENSURE SAFE AND
EFFECTIVE TREATMENT
9. OXYGEN SUPPLY
1. Piped in wall outlets – at the client’s bedside
2. Portable (Tanks or cylinders) – for transporting
oxygen, dependent clients and in home use
Humidifier – add water vapor to inspired air because
Oxygen is a dry gas that dehydrates respiratory mucous
membrane
o Prevents mucous membrane from drying and becoming
irritated
o Loosens secretions for easier expectoration
10. DEVICES USED FOR ADMINISTRATION OF
OXYGEN
oPRESSURE REGULATOR -
used to control the high pressure of
oxygen delivered from a cylinder (or
other source) to a lower pressure. This
lower pressure is then controlled by a
flowmeter.
FLOWMETER – controls the
lower pressure which may be preset or
selectable, and this controls the flow in a
measure such as litres per minute (lpm).
11. OXYGEN DELIVERY
SYSTEM
1. NASAL CANNULA
o is a thin tube with two small nozzles that protrude into the patient's
nostrils.
o Most common and inexpensive device
o provides oxygen at low flow rates, 2–6 litres per minute (LPM),
delivering a concentration of 24–45%.
o allows the patient to continue to talk, eat and drink while still
receiving the therapy.
o associated with greater overall comfort, and improved oxygenation
and respiratory rates than with face mask oxygen.
Limitation:
o Unable to deliver higher concentration of oxygen
o Can be drying and irritating to mucous membrane
12. 2. SIMPLE FACE MASK
• Covers the patient’s nose and mouth.
• Exhalation ports at the sides of the mask
allow to exhale CO2 to escape
• Often used at between 5 and 8 LPM,
with a concentration of oxygen to the
patient of between 40 – 60%.
OXYGEN DELIVERY SYSTEM
13. 3. AIR-ENTRAINMENT MASK also known
as VENTURI MASKS
o Has a wide bore tubing and color coded jet adapters
( blue adapter – 24% at 4-10 L/min; green adapter
– 35% at 8 L/min)
o can accurately deliver a predetermined oxygen
concentration to the trachea up to 24 - 50% at 4- 10
L/min .
4. PARTIAL REBREATHING MASK – has
a reservoir bag, which increases the provided oxygen
rate to 60–90% oxygen at 6 to 10 L/min.
OXYGEN DELIVERY SYSTEM
14. 5. NON-REBREATHER MASKS (
RESERVOIR MASK) - draw oxygen from an
attached reservoir bags, with one-way valves that direct
exhaled air out of the mask.
o Delivers the highest oxygen concentration when
properly fitted and used at flow rates of 8-10 L/min
or higher, they deliver close to 100% oxygen. This
type of mask is indicated for acute medical
emergencies.
OXYGEN DELIVERY SYSTEM
6. FACE TENT
Can replace oxygen mask when masks are poorly
tolerated by clients
Provides oxygen concentration at 30 – 50% with
flow rates of 4- 8 L/min
15. 7. BAG-VALVE-MASK (BVM) - a malleable bag attached to a face mask (or
invasive airway such as an endotracheal tube or laryngeal mask airway), usually
with a reservoir bag attached, which is manually manipulated by the healthcare
professional to push oxygen (or air) into the lungs.
o Used in many emergency medical service and first aid personnel
OXYGEN DELIVERY SYSTEM
16. TYPES
CHARACTERISTI
C
CONCENTRATIO
N
LPM
1. Nasal Cannula
provides oxygen at
low flow rates
24–45%.
, 2–6 litres per
minute (LPM),
2. Simple face mask 40 – 60%. 5 - 8 LPM
3. Air-entrainment
masks also known as
Venturi masks,
blue adapter – 24%
green adapter – 35%
At trachea : 24 -
50%
4-10 lpm;
8 lpm
4- 10 lpm .
4. Partial rebreathing
mask –
has a reservoir bag 60–90% 6 to 10 LPM.
5. Non-rebreather
masks ( reservoir
mask),
Delivers the highest
oxygen
concentration
Close to 100%
of 8-10 LPM or
higher, they deliver
close to
OXYGEN DELIVERY SYSTEM
17. SAFETY PRECAUTIONS USING OXYGEN
CYLINDER IN THE WARD OR HOSPITAL
Keep electrical equipment more than one foot away from where
the oxygen flows to your face or breathing tube. This includes:
∞ Keeping equipment away from the nasal cannula or face mask.
∞ Any equipment that involves a motor, such as electric razors and hair
dryers.
∞ Curling irons, heating pads, or other products with a heat source.
Do not stand oxygen cylinders upright unless they are well
secured. If the cylinder falls, the regulator or valve could become
damaged or cause injury.
Do not drag or roll cylinders.
Do not carry a cylinder by the valve or regulator.
18. Do not hold onto protective valve caps or guards when
moving or lifting cylinders.
Do not deface, alter or remove any labeling or markings
on the oxygen cylinder.
Never use oxygen without a safe regulator that fits
properly.
When the tank is not in use keep valves closed even if the
tank is empty.
Do not store oxygen cylinders near flammables or hot
water heaters, near electric or phone boxes
19. SAFETY PRECAUTIONS USING OXYGEN
CYLINDER AT HOME
∞ Teach family members to smoke only outside or away from the patient and
oxygen equipment. Instruct the patient and visitors about the hazard of
smoking with oxygen in use.
∞ Provide cotton gown and blankets . Synthetics and wool may generate sparks
of static electricity
∞ Avoid the use of volatile, flammable materials such as oils, greases, alcohol,
ether and acetone near clients receiving oxygen
∞ Remove matches, lighters, ashtrays, and any friction-type or battery
operated toys or devices from bedside
∞ Be sure that electric monitoring equipment , suction machines, and portable
diagnostic machines are electrically grounded.
∞ Locate fire extinguishers and oxygen meter turn-off lever.
21. RECOMMENDATIONS
1. Always be aware the importance of oxygen
therapy.
2. Be aware of the different types of oxygen delivery
mode.
3. Keep patient always comfortable when on oxygen.
4. Always maintain safety when using a portable
oxygen cylinder.
