Oxygen Therapy Prepared by Dr Irene Roco Oxygen

Oxygen Therapy Prepared by Dr. Irene Roco

Oxygen therapy • is the administration of oxygen as a medical intervention, which can be for a variety of purposes in both chronic and acute patient care • 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 • Prescribed by the physician who specifies the following: 1. Concentration 2. liter per minute 3. Method of delivery

Oxygen supply 1. Piped in wall outlets – at the client’s bedside 2. Portable (Tanks or cylinders) – for transporting oxygen dependent clients, in home use; Humidifier – add water vapor to inspired air because Oxygen is a dry gas that dehydrates respiratory mucous membrane • Prevents mucous membrane from drying and becoming irritated • Loosens secretions for easier expectoration

Safety Precautions for Oxygen Administration • Teach family members to smoke only outside away from the client and oxygen equipment. • Set up “No Smoking: and “oxygen in Use” signs at the site of administration and at the door, according to agency policy. • Instruct the client 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

Safety Precautions for Oxygen Administration • 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.

Various devices used for administration of oxygen. • Pressure 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).

Oxygen Delivery System 1. Nasal cannula (NC) • is a thin tube with two small nozzles that protrude into the patient's nostrils. • Most common and inexpensive device • provides oxygen at low flow rates, 2– 6 litres per minute (LPM), delivering a concentration of 24– 45%. • allows the patient to continue to talk, eat and drink while still receiving therapy. • associated with greater overall comfort, and improved oxygenation and respiratory rates than with face mask oxygen.

Oxygen Delivery System 1. Nasal cannula (NC) Limitation: • Unable to deliver higher concentration of oxygen • Can be drying and irritating to mucous membrane

Oxygen Delivery System 2. Simple face mask • covers the patient’s nose and mouth. • Exhalation ports at the sides of the mask allow exhaled CO 2 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 3. Air-entrainment masks, also known as Venturi masks, • Has a wide bore tubing and color coded jet adapters ( blue adapter – 24% at 4 -10 lpm; green adapter – 35% at 8 lpm) • can accurately deliver a predetermined oxygen concentration to the trachea up to 24 - 50% at 4 - 10 lpm. 4. Partial rebreathing mask – has a reservoir bag, which increases the provided oxygen rate to 60– 90% oxygen at 6 to 10 LPM.

Oxygen Delivery System 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. • Delivers the highest oxygen concentration when properly fitted and used at flow rates of 8 -10 LPM 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 LPM

Oxygen Delivery System 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. • Used in many emergency medical service and first aid personnel

Oxygen Delivery System Characteristic Concentration LPM 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. 60– 90% 6 to 10 LPM. 5. Non-rebreather masks ( Delivers the highest reservoir mask), oxygen concentration Close to 100% of 8 -10 LPM or higher, they deliver close to 6. Face Tent 30 – 50% 4 - 8 LPM or higher 1. Nasal Cannula 4. Partial rebreathing mask – has a reservoir bag

Let’s Review!

References: • Kozier & Erb’s Fundamentals of Nursing. Eighth Edition