Oxygen therapy refers to the administration of supplemental oxygen to patients to correct low oxygen blood levels or hypoxia. The goals of oxygen therapy are to stabilize oxygen saturation levels, decrease shortness of breath and anxiety, and allow for non-labored breathing. Indications for oxygen therapy include hypoxia, acute/chronic hypoxemia, and various respiratory conditions. Equipment used includes low and high flow devices like nasal cannulas, masks, and venturi masks. Complications can include drying of tissues, skin breakdown, and oxygen toxicity, so precautions like humidification and monitoring are important.

1. OXYGEN THERAPY
Group 3:
Vanessa Haye
Crystal Carty
Sharna Kaye Scott
Theodore Duncan
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2. Oxygen
Therapy
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3. Objectives
At the end of this session students should be able
to:
1. Define the term ‘oxygen therapy’.
2. List four (4) goals of oxygen therapy.
3. State six (6) indications for oxygen therapy.
4. List the equipment used in the delivery of
oxygen.
5. Separate the delivery devices into high and low
flow systems.
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4. Objectives (contd)
6. Describe five (5) devices most likely to be used
to deliver oxygen in your area of practice.
7. Describe five (5)physiologic complications
associated with oxygen therapy.
8. State the precautions to be taken to prevent
complications of oxygen therapy.
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5. What is Oxygen Therapy?
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6. Oxygen Therapy
• Oxygen therapy refers to the administration of
supplemental oxygen as part of managing illness
(Robertson, 2015). It is the administering of
oxygen to patients to correct hypoxemia (low
oxygen blood levels) or supplemental oxygen
given to a patient as a medical treatment in
managing respiratory diseases that alter oxygen
supply to tissue cells (hypoxia).
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7. What are the goals of oxygen therapy?
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8. Goals of oxygen therapy
• To stabilize oxygen saturation level.
• For patients to have nonlabored respirations.
• To decrease anxiety.
• To decrease shortness of breath.
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9. What are the indications for
oxygen therapy?
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10. Indications for oxygen therapy are:
• Hypoxia- deficiency in the amount of oxygen
reaching the tissues, (Oxygen saturation of
<92%).
• Acute and chronic hypoxemia- an abnormally
low level of oxygen in arterial blood which
leads to tissue hypoxia (PaO2 <65mmHg,
Oxygen saturation <92%).
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11. Indications Cont’d
• Peri and post cardiac or respiratory arrest
• Post operatively (dependent on instructions
from surgical team)
• Respiratory failure
• Low cardiac output and metabolic acidosis
(HCO3 <18 mmol/L)
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12. Equipment used to deliver oxygen
• Oxygen delivery devices are used to deliver
oxygen to patients at different concentration.
• Low flow oxygen devices work by supplying
oxygen at flow rates less than the patient’s
inspiratory volume, usually 1 to 10 litres per
minute.
• High flow oxygen devices supply flow rates high
enough to accommodate two to three (2-3) times
the patient’s inspiratory volume at 1to 40 litres
per minute (Mortan & Fonatine,2013).
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13. Equipment used to deliver Low flow
and High flow oxygen
Low flow High flow
• Low flow nasal cannula
• Face mask
• Face tent
• Venturi mask
• Nonrebreather mask
• Tracheostomy collar and T-
piece
• Nasal catheter
• Transtracheal catheter
• Partial rebreather mask
• High flow nasal cannula
• AquinOx system
• Mechanical ventilators
• Hyperbaric oxygen chambers
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14. Devices used to deliver oxygen
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15. Nasal cannula
 consists of a flexible tube that is placed inside the nares.
 easy to apply and does not interfere with the client’s
ability to eat or talk.
 permits some freedom of movement and is well tolerated
by the client.
 It delivers a relatively low concentration of oxygen (21%
to 44%) at flow rate 1 to 6 L per minute [1 litre- 21-25%,
2 litres- 28%, 3 litres -32%, 4 litres- 36%, 5 litres - 40%,
6 litres -44% oxygen].
•
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17. Face mask
 The simple face mask covers the client nose and
mouth but contain port in the body that allows
exhale air to escape.
 Delivers oxygen concentrations from 40% to
60% at liter flows of 5-8 L per minute.
 Provides low-flow oxygen and is suitable for
patients with normal respiratory patterns, rates,
and ventilation volumes.
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19. The nonrebreather mask
 One-way valves on the mask and between the reservoir bag
and the mask prevent the room air and the client exhaled air
from entering the bag so only the oxygen in the bag is
inspired.
 To prevent carbon dioxide build-up, the nonrebreather bag
must not totally deflate during inspiration. If this occurs, the
liter flow of oxygen should be increased (Kozier and Erb’s,
2008).
 delivers the highest oxygen concentration possible 95% to
100% by means other than intubation or mechanical
ventilation, at liter flows 10 to 15 L per minute.
 It is used in severe hypoxemia to deliver the highest oxygen
concentration (Morton et al, 2013).
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21. Venturi mask
 has wide-boring tubing and colour-coded jet adapters
that correspond to a precise oxygen concentration and
liter flow. For example, a blue adapter delivers a 24%
concentration of oxygen at 4 L per minute (Kozier and
Erb, 2008).
 Delivers an exact percentage of oxygen regardless of the
patient’s tidal volume (Morton et al 2013).
 Oxygen concentrations varying from 24% to 40% or 50%
at liter flows of 4 to 10 L per minute.
 Used for patients with COPD to maintain constant
oxygen concentration.
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24. Face tent
 Replace oxygen masks when masks are poorly
tolerated by the client.
 Oxygen delivery of 21% to 50% depends on
patient breathing (21% delivered with
compressed air and up to 50% delivered with 10
L/min oxygen flow attached).
 Often used for humidification as well as oxygen
delivery in patients who do not like the
claustrophobic feeling associated with more
traditional masks (Morton, 2010).
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27. T-Piece
 The T-piece is a T-shaped adapter used to provide oxygen to either
an endotracheal or Tracheostomy tube.
 The flow rate should be at least 10 L/min with humidification. Flow
can also be provided by a ventilator.
 Used to provide a high-enough flow rate to ensure that there is a
minimal amount of entrained room air.
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29. Physiologic complications associated
with oxygen therapy
• Drying of mucous membranes.
• Skin breakdown
• Oxygen toxicity
• Suppression of ventilation
• Potential of contamination and infection to
patients.
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30. What are the precautions to be taken
to prevent complications of oxygen
therapy?
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31. Precautions to be taken to prevent
complications of oxygen therapy
• Ensure that humidification system is applied
when a patient needs high flow litre oxygen.
• Inspect the skin for skin integrity impairment
and prompt application of barrier creams and
cushions.
• Ensure that patients are administered the
minimal amount of oxygen to achieve and
maintain a baseline Partial Pressure of arterial
oxygen (PaO2) of 60mmHg.
• Administer oxygen only when required and use
for the shortest time possible.
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32. Precautions to be taken to prevent
complications of oxygen therapy (contd.)
• Utilize the best Positive end-expiratory pressure
(PEEP) and Continuous positive airway pressure
(CPAP) when oxygen therapy is in used to
prevent the cellular damages that can occur from
oxygen toxicity.
• Administer oxygen at low flow concentration
levels and closely monitor patient’s respiratory
status.
• Follow manufacturer policy on care and
institution policy on infection control.
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33. References
• Bare, B.G., Day, R.A, Paul, P., Smeltzer, S.C., &
Williams, B. (2007). Brunner & Suddarth’s
Textbook of Medical- Surgical Nursing
Canadian (1st ed) Philadelphia: Wolters Kluwer/
Lippincott Williams & Wilkins
• Bare, B.G., Cheever, K.H., Hinkle, J.L. & Smeltzer,
S.C. (2008). Brunner & Suddarth’s Textbook of
Medical-Surgical Nursing (11th ed) Philadelphia:
Wolters Kluwer/ Lippincott Williams & Wilkins
• Berman, A. Burke, A. Kozier, B. Glenora, E. (2006).
Fundamentals of Nursing. Upper Saddle River,
NJ: Prentice Hall Health
33

34. References Cont’d
• Berman, A. Erb, L.G. Kozier, B. Synder, J.S. (2008).
Kozier & Erb’s Fundamentals of Nursing: Concepts,
Process and Practise, 8th Ed. New Jersey: Pearson
Education Inc
• College of respiratory therapist of Ontario. (2013).
Oxygen therapy clinical best practice guide lines.
Retrieved on September 17, 2017 from:
http://www.crto.on.ca/pdf/PPG/Oxygen_Therapy_
CBPG.pdf
• Hatter, H.E. (2014). Oxygen therapy administration in a
non -emergency situation. Retrieved on September
17, 2017 from: http://www.gosh.nhs.uk/health-
professionals/clinical-guidelines/oxygen-therapy-
administration-non-emergency-situation
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35. References (contd.)
• Heitz, D. (2017). Nasal Cannulas and Face Masks.
Healthline. Retrieved on September 17,2017 from:
http://www.healthline.com/health/nasal-cannulas-
and-face-masks#overview1
• Journal, Indian Academy of Clinical Medicine, Vol. 2,
No. 3. (2001). Oxygen Therapy. Retrieved on
September 17,2017 from:
http://medind.nic.in/jac/t01/i3/jact01i3p178.pdf.18
• Klein, D.G. Moseley, M.J. & Sole, M.L. (2005).
Introduction Critical Care Nursing
(4th ed) Missouri: Elsevier Saunders
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36. Reference Cont’d
• Morton, P.G. & Fontaine, D. (2013). Critical Care
Nursing: A Holistic Approach, (10th ed).
Philadelphia: Wolters Kluwer/ Lippincott
Williams & Wilkins
• Morton P.G. & Fontaine, D. (2017). Critical Care
Nursing: A Holistic Approach
(11th ed) Philadelphia: Wolters Kluwer/
Lippincott Williams & Wilkins
• ProResp Inc, Home oxygen and respiratory care.
(2017). Oxygen therapy. Retrieved on September
17,2017 from:
https://www.proresp.com/oxygen-therapy
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37. References (contd.)
• Robertson, S. (2015). What is Oxygen Therapy. Retrieved on
September 17,2017 from: https://www.news-
medical.net/health/What-is-Oxygen-Therapy.aspx
• Schiffman, G. (2016). Oximetry. Medicinenet.com. Retrieved on
September 17,2017 from:
http://www.medicinenet.com/oximetry/article.html
• Silvistri, L. (2017). Saunders Comprehensive Review for the
NCLEX-RN Examination. St. Louis, Missouri: Elsevier
Stubblefield, H. (2016). Oxygen Therapy. Healthline.
Retrieved on September 17, 2017 from:
http://www.healthline.com/health/oxygen-therapy#overview1
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