This is short yet comprehensive lecture on oxygenation for Bsc nursing students. This lecture comprises of various devices of oxygen administration and their uses, advantages and disadvantages.

2. Oxygen is a clear, odorless gas that
constitutes approximately 21 % of the air
we breathe.
It is necessary for proper functioning
of all living cells

3. It is a process, which uses a device to
administer the oxygen to the patient in order
to increase the arterial oxygenation

4. -The body takes up oxygen and releases carbon dioxide
-If this process is inadequate, oxygen levels in the blood
decrease, and the patient may need supplemental oxygen
-The purpose of oxygen administration is to increase oxygen
saturation in tissues where the saturation levels are low

5. 1) Treat Hypoxemia
2) Decrease work of breathing
3) Decrease Myocardial work

6. • Acute respiratory failure
• Acute myocardial infarction
• Cardiac failure
• Shock
• Hypermetabolic state
• Anemia
• Cyanide poisoning
• During CPR
• During anesthesia for surgery

7. • Must be prescribed by a doctor
• Prescription should be dated by the doctor
• Doctor must indicate duration of oxygenation
• The oxygen concentration must be indicated
• The flow rate must be determined and
prescribed

9. • NASAL CANNULA
• SIMPLE MASK
• PARTIAL RE- BREATHER MASK
• NON REBREATHER MASK
• VENTURI MASK
• OXYGEN HOOD
• OXYGEN TENT
• AMBU BAG
• TRACHEOSTOMY COLLAR
• T-PIECE

10. • Also called nasal prongs
• Disposable plastic device
with 2 protruding prongs for
insertion into nostrils,
connected to an oxygen
source
• Low flow system
•

11. &
1l
2
l
3
l
4
l
5l
6
l
= 24 %
= 28 %
= 32 %
= 36%
= 40 %
= 44 %

12. • Client able to talk and eat with
oxygen in place
• Easy to use in home care setting
• Safe and simple
• Easily tolerated
• Delivers low concentration of
oxygen

13. • Unable to use with nasal obstruction
• Drying of mucous membrane is seen at higher
flow rate
• Can dislodge from nares easily
• Causes skin irritation or breakdown over ears
or at nare
• Not good for mouth breathers
• Patient’s breathing pattern may affect FiO2

14. • Be alert for skin breakdown
over ears and in nostrils
• Ensure that the straps are
not too tight
• Observe for mucosal
dryness
• ensure nasal prongs have
not dislodged.

16. • A clear plastic mask is placed on the patient’s face with
an elastic strap to secure it.
• The body of the mask stores oxygen between the
patient’s breaths.
• Side port openings located on either side of the mask
allow room air to mix with delivered oxygen and allow
exhaled air to escape.
• The percentage of delivered oxygen varies, depending on
the rate and depth of the patient’s breathing

17. • SIMPLE FACE MASK
• PARTIAL REBREATHER MASK
• NON RE BREATHER MASK
• VENTURI MASK

18. • Clear, flexible, plastic or rubber mask
that can be molded to fit the face
• Secured with elastic straps
• Metal clip that can be bent over the
bridge of the nose for better fit
• 7mm diameter of tubing
• Should not be used if oxygen flow
rate is less than 5 L due to chances
of carbondioxide retention

19. • Oxygen delivery - 35 to 60 %
• Flow rate - 6 to 10 litres per minute
• Has vents on its sides which allows
room for air to leak in at many places,
thereby diluting source oyxgen
• Increased delivery of oxygen in short
period of time

20. • 5-6 L = 40% FiO2
• 6-7 L = 50% FiO2
• 7-8 L = 60% FiO2

21. • Meets the requirement of
increased delivery of oxygen
for short period of time
• Simple, lightweight
• can be used with humidity
• FiO upto 60 %

22. • Tight seal required to deliver higher
concentration
• Difficult to keep mask in position
over nose and mouth
• Potential for skin breakdown due to
buildup of moisture
• uncomforatble for patient while
eating or talking
• Expensive

23. • Monitor client frequently to
check placement of the
mask
• secure physician’s order to
replace mask with nasal
cannula during meal time

24. • The mask is with reservoir bag that
must remain inflated during
inspiration and expiration
• It collects of part of the patient’s
exhaled air
• For the next inhalation the air present
in the reservoir bag is mixed with
100% oxygen allowing patient to
rebreathe first 1/3rd of exhaled air

25. • Used to deliver oxygen concentrations
up to 35 to 80%
• The Oxygen flow rate must be
maintained at minimun of 6L /min to
ensure that the patient does not re-
breathe large amounts of exhaled air.
• The remaining exhaled air exits through
vents

26. • Exhaled oxygen from
anatomic dead space is
conserved
• Client can inhale room air
through the opening in mask
if oxygen supply is briefly
interrupted

27. • Insufficient flow rate may
lead to rebreathing of CO2
• Chances of breakdown
• Drying and irritation of eyes
• Chances of skin breakdown
• Requires a tight seal
• uncomfortable during eating,
talking etc.

28. • Set flow rate so mask
remains two thirds full
during inspiration
• Keep reservoir bag free of
twists or kink

29. • This mask provides the
highest concentration of
oxygen (95 to 100%) at a
flow rate of 6 -15 l/min
• It is similar to the partial re
breather mask except two
one way valves prevent
conservation of exhaled air

30. • 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
rebreathing any of the expired gas

31. • Delivers the highest possible
oxygen concentration
• suitable for patient
breathing spontaneous with
severe hypoxemia

32. • Impractical for long term
therapy
• Malfunction can cause CO2
buildup
• Suffocation
• Expensive
• Uncomfortable

33. • Maintain flow rate so reservoir
bag collapses only slightly
during inspiration
• Check that valves and rubber
flaps are functioning properly
(open during expiration)
• Monitor SaO2 with pulse
oximeter

34. • The venturi mask has got its name from
the effect named as “Venturi effect”
• The venturi effect states that in a
situation with constant mechanical
energy, the velocity of a fluid passing
through a constricted area will increase
and its static pressure will decrease

35. • This mask allows the delivery of preset
specific concentration of oxygen
• These types of masks are used for critically
ill patients who require a specific
concentration of oxygen.
• Mask has a large tube with an oxygen inlet.
• It consists of a mask with holes on each
sides that helps in the escape of exhaled air

36. • There are color coded ports that
are present at the base of mask,
that allow the regulation of
different concentrations of oxygen
to be administered.

37. • A fixed and specific
concentration of oxygen
delivered
• Does not dry the mucus
membrane

38. • In case of COPD patients, if
oxygen is delivered at high
concentrations, it may
produce respiratory
depression
• Skin irritation
• Uncomfortable for patients

39. • Used to deliver oxygen directly
into the lungs
• Bypass the upper airways and
the oxygen is delivered through
the catheter, which is placed
directly in the trachea.
• Minimally invasive procedure

40. • It is a minimally invasive procedure.
• CPAP is a form of positive airway
pressure ventilation in which a constant
level of pressure greater than
atmospheric pressure is continously
applied to the upper respiratory tract of
a person
( )

41. • Patient whose condition is
not improving with oxygen
therapy
• The patient with respiratory
distress or respiratory
failure
• Carbon monoxide poisoning
• Sleep apnea

42. • Respiratory arrest
• Agonal respiration
• Unconscious
• Shock
• Pneumothorax
• Penetrating Chest trauma
• Persistent Nausea and Vomitting
• Facial Anomalies or trauma

43. • Unable to follow commands
• BP 90 mmHg
• Known blebs

44. Monitor the following :
• Level of consciousness
• Respiratory assessment
• Heart rate
• Use of accessory muscles
• Oxygen requirements
• Pulse oximetry
• Compliance/comfort with therapy
• respiratory synchronization with bi level
ventilation

46. • Simplest method
• Least reliable of delivering specific
concentration of oxygen
• done using a large bore cannula or
oxygen tubing connected with
oxygen tent or face mask.
• Used for patients unable to tolerate
other types of oxygen device
•

47. • It is a plastic enclosure that surrounds
the neonate’s head
• A continous flow of oxygen is provided
to the patient by means of air
entrainment devices or an air oxygen
blender
• Oxygen concentration of 22-80% with
flow rate of 7-10L/min through hood
and 15-30L/min throughtent

48. • Most common method
• Low flow nasal cannula
delivers fractional
concentration of oxygen
using 2 soft nasal prongs
that are applied to the
anterior nares

49. • Used in respiratory failure
• flow rate 2-8L/min for neonates and
4-7L/min for children
• used to deliver large amount of
oxygen via nasal cannula, can be
connected to the ventilator to
deliver 60 -70L/min

51. • Oxygen is a flammable gas, it helps in
combustion of fire which is why there is
always a risk of fire if there a spark anywhere
close to the oxygen cylinder, outlet or near
patient.
• NO SMOKING sign and no Live fire sign should
be placed to prevent fire near the patient’s
bedside
•

52. • When only oxygen is being
given, it is rapidly and
completely absorbed from
the alveoli and results in
collapse also known as
absorption atelectasis

53. • Oxygen therapy for prolonged period
of time can cause lung damage
• Due to administration of high amount
of oxygen, there is intracellular
generation of reactive metabolites
which has the ability to damage the
alveolar capillary membrane

54. • Due to this, the pulmonary capillary
permeability increases leading to
edema, thickened membranes and
finally to pulmonary fibrosis
• Pulmonary fibrosis may occur after
exposure to high concentration of
oxygen for a week

55. • Most common in COPD patients
• Patients with COPD have chronic
Carbondioxide retention ad hypoxic
respiratory drive to breathe
• oxygenation affects the hypoxic stimuli
where the hypercapnia maintains the
ventilation and doe not stimulates the
hypoxic drive for respiratory efforts.

56. • Prolonged exposure of hyperbaric O2 therapy
can lead to pulmonary, optic and central nervous
system toxicity.
• Symptoms includes: retrosternal burning, cough
and chest tightness
• can cause narrowing of visual fields
• CNS symptoms: behavior change, nausea, vertigo,
facial twitching and tonic clonic seizures.

57. • There is risk of cross
infection
• irritation and skin breakdown
can be there.