OXYGENATION

ADMINISTRATION
WHAT IS OXYGEN THERAPY

 Oxygen therapy is a treatment that delivers oxygen gas for you to breathe. This treatment increases the
amount of oxygen your lungs receive and deliver to your blood.
 INDICATION OF OXYGEN THERAPY

•
• The need of oxygen administration is assessed by arterial blood gas analysis, oximetry monitoring and clinical examinations
•
•  Reduced arterial blood oxygen
•  Increased work of breathing
•  To decrease myocardial workload
•
 WHAT IS HYPERBARIC OXYGEN THERAPY (HBOT)?

•  Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room or tube.
•  The air pressure is increased to three times higher than normal air pressure. Under these conditions,
your lungs can gather more oxygen than would be possible breathing pure oxygen at normal air
pressure.
•  Your blood carries this oxygen throughout your body. This helps fight bacteria and stimulate the
release of substances called growth factors and stem cells, which promote healing.
METHODS OF OXYGEN THERAPY

• 1. Nasal Cannula- nasal prongs that deliver low flow of oxygen.

• Advantages
•  Safe and simple
•  Comfortable and easily tolerated
•  Fit to face
•  Effective low O2 concentations
•  Allow movement, eating and talking
•  Inexpensive and disposable
• Disadvantage
•  Can’t deliver concentrations higher than 40 %
•  Can’t be used in complete nasal obstruction
•  May cause headaches or dry mucous membranes if flowrates exceeds 6 liters
•  Can dislodge easily
2. SIMPLE MASK- MASK DELIVERS MODERATE OXYGEN FLOW
TO NOSE AND MOUTH. DELIVERS OXYGEN CONCENTRATIONS
OF 40%- 60%

• Advantages
•  Can deliver concentrations of 40%- 60%
• Disadvantage
•  Hot and confining
•  May irritate skin
•  Discomfort
•  Interferes with talking and eating
•  Long therapy because of imprecision
3. VENTURI MASK- MASK WITH DEVICE THAT MIXES AIR AND
OXYGEN TO DELIVER CONSTANT OXYGEN CONCENTRATION.

• Advantage

•  Deliver high accurate O2 concentration

•  Dilute jets can be changes or dial turned to change oxygen concentration

•  Doesn’t fry mucous membranes

•  Humidity or aerosol can be added

• Disadvantage

•  Confining and may irritate skin

•  O2 concentration may be altered if mask fits loosely

•  Intake ports are blocked when tubing kinks

•  Interferes eating and talking

•  Condensate may collect and drip on the patient if humidification is used.

4. PARTIAL REBREATHER MASK- HAS AN INFLATABLE BAD THAT
RESTORES 100 % OXYGEN

• Advantage
•  Effectively delivers concentrations of 40%- 60% openings in mask allowing patient to inhale room air if oxygen source fails.
• Disadvantage
•  Tight seal may cause discomfort
•  Interferes with eating and talking
•  Hot and confining
•  Irritate skin
•  Bag may twist or kink
•  Impractical for long term therapy
5. NON- REBREATHING MASK- HAS AN INFLATABLE BAG TO
STORE 100% OXYGEN AND ONE-WAY VALVE BETWEEN THE
BAD AND MASK TO PREVENT EXHALED AIR FROM ENTERING
THE BAG.

• Advantage

•  Delivers highest oxygen concentration possible (60%- 90%) short of intubation and mechanical ventilation

•  Effective for short term therapy

•  Doesn’t dry mucous membranes

•  Can be converted to partial rebreather mask, if necessary, by removing the one-way flap.

• Disadvantage

•  Requires tight seal causing discomfort

•  Irritate skin

•  Impractical for long-term therapy

6. TRANSTRACHEAL CATHETER- ACCOMPLISHED BY WAY OF A
SMALL (8F) CATHETER INSERTED BETWEEN THE SECOND AND
THIRD TRACHEAL CARTILAGE

• Advantage

•  Supplies oxygen to the lungs throughout the respiratory cycle

•  Provides continuous oxygen without hindering mobility

•  Doesn’t interfere with eating or talking

•  Doesn’t dry mucous membranes

•  Catheter be easily concealed by shirt or scarf

• Disadvantage

•  Not suitable for use in patients at risk for bleeding

•  With severe bronchospasm uncompensated respiratory acidosis, pleural herniation into base of neck or high corticosteroid dosages
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) MASK-
USED TO PROVIDE EXPIRATORY AND INSPIRATORY POSITIVE
AIRWAY PRESSURE IN A MANNER SIMILAR TO POSITIVE END-
EXPIRATORY PRESSURE (PEEP) AND WITHOUT
ENDOTRACHEAL INTUBATION
•

• Advantage

•  Non invasively improves arterial oxygenation by increasing functional residual capacity

•  Allows the patient to avoid intubation

•  Allows patient to talk and cough without interrupting positive pressure

• Disadvantage

•  Requires tight fit

•  Heightened risk of aspiration if patient vomits

•  Increased risk of pneumothorax, diminished cardiac output and distention

•  Contraindicate din patients with chronic obstructive pulmonary disease, bullous lung disease, low cardiac output or tension pneumothorax
EQUIPMENTS:

• 1. Oxygen source (wall unit, cylinder, liquid tank or concentrator)

• 2. Flow meter

• 3. Adapter if using wall unit or pressure reduction gauge

• 4. Sterile humidity bottle adapters

• 5. Sterile distilled water

• 6. Oxygen precaution sign

• 7. Appropriate oxygen delivery system

• 8. Small diameter and large diameter connection tubing

• 9. Flashlight (for nasal cannula)

• 10. Water soluble lubricant

• 11. Gauze pads and tape for oxygen mask

• 12. Jet adapter for venture mask

• 13. Oxygen analyzer

PROCEDURE

• 1. Determine need for oxygen therapy in patient

• 2. Check physician order for rate ,device used for concentration.
• 3. Perform an assessment of vital signs, level of consciousness ,lab values etc. and record.
• 4. Assess risk factors of oxygen therapy in patients and environment such as patient with hypoxia drive, faulty
electrical connections
• 5. Explain procedure to the patient and relative and inform them how to cooperate.
• 6. Post “no smoking” sign on the patient’s door in view of patient and visitors and explain to them the dangers of
smoking when oxygen is on flow.
PROCEDURE

• 7. Wash hands
• 8. Set up oxygen equipment and humidifier
• 9. Fill humidifier upto the level marked on it with sterile water.
• 10. Attach flow meter to the source, set flow meter in off position
• 11. Attach humidifier to base of flow meter
• 12. Attach tubing and nasal canula/ face mask to humidifier( if venture mask is used attach the the color coded ventruriadapter to
mask as appropriate .
• 13. Regulate flowmeter to prescribed level
• 14. Ensure proper functioning by checking for bubbles in humidifier or feeling oxygen at the outlet.
FOR NASAL CANNULA

• 1. Place tips of nasal cannula to patient’s nares and adjust straps around ear for snug fit it. The elastic band may be fixed behind head or
under chin.
• 2. Pad tubing with gauze pads over ear and inpect skin behind ear periodically for irritation and breakdown.
• 3. Inspect patient and equipment frequently for flow rate, clinical condition , level of water in humidifier.
• 4. Ensure that safety precautions are followed.
• 5. Wash hands
• 6. Document time, flow rate and observations made on patient.
• 7. Encourage patient to breaththrough his/her nose with mouth closed.
• 8. Remove and clean the cannula with with soap and water, dry and replace every 8 hours. Assess nares at least every 8 hrs.
PRECAUTIONS

• 1. Never deliver more than 2-3 litres of oxygen to patients with chronic lung disease
• 2. Check frequent that both prongs are in patients nares.
MASK METHOD

• 1. Guide mask to patient’s face and apply it from nose downward.

• 2. Fit the metal piece of mask to conform to shape of nose.
• 3. Secure elastic band around around patient’s head
• 4. Apply padding behind ears as well as scalp where elastic band passes.
• 5. Ensure that safety precautions are followed
• 6. Inspect patient and equipment frequently for flow rate, clinical condition , level of water in humidifier
• 7. Wash hands
• 8. Remove the mask and dry the skin every 2-3 hrs if oxygen is administered continuously.
• 9. Document relevant data in patient’s record.
HAZARDS OF OXYGEN ADMINISTRATION

• 1. Oxygen toxicity
• 2. Suppression of ventilation
• 3. combustion