Oxygen administration Prepared by : Christian RavinaM.sc.(N), 2nd yearM.T.I.N.Changa

Definition • Oxygen therapy is defined as the administration

of oxygen by inhalation from a cylinder , piped in system liquid oxygen reservoir or oxygen concentration by various methods to relieve anoxemia (reduction in oxygen content of blood )

Purposes • To facilitate normal metabolism of the tissues

• To reduce / correct arterial hypoxaemia ( low concentration of oxygen in the blood ) & tissue hypoxia

Indications • Breathlessness or labored breathing

• High altitudes

• Shock & circulatory failure • Patient under anesthesia

• Patients who are critically ill

• Patients with a decreased respiratory capacity

contraindications• Administer with caution to the patient with COPD(emphysema + chronic bronchitis + asthma) as it includes hypoventilation

• Atelectasis (collapse of lung) • Oxygen toxicity

Methods of oxygen delivery 1. Nasal catheter :

• The nasal catheter is inserted into the nostrils reaching up to the uvula & is held by adhesive tapes

• The catheter does not interfere with the patients freedom to eat , to talk & to move in bed

• Flow of 1 to 4 liters of oxygen will be sufficient to maintain the concentration of 22 to 30 % oxygen

2. Nasal cannula : • A nasal cannula is a simple comfortable

device , the two cannula about 1.5 cm (half inch ) long , protrude from the centre of a disposable tube & are inserted into the nose

• Low flow, Up to 5 liter of oxygen can provide through nasal cannula

3. Oxygen by mask : • Oxygen mask covers the patient’s nose &

mouth • Mask is advantageous for those patients

who are unable to breathe through the nose

• Flow of 8 to 12 liters of oxygen will maintain the concentration of 25 to 60 % of oxygen

4. Oxygen tent :

• When a patient has a facial injury or for any other reason cannot tolerate an oxygen mask , then this method can be used

• Certain advantages & disadvantages for using a oxygen tent

• It provides an environment for patient with controlled oxygen concentration , temperature regulation & humidity control

• It allows freedom for free movement in bed

• Create feeling of isolation

• It requires high volume of oxygen ( 10 to 12 liter/ minute )

• There is increased chances of fire

• It requires much time & effort to clean & maintain a tent

Care of oxygen cylinder• Always use cylinder of metal case to prevent

danger of falling & breaking

• Oxygen cylinder should be placed at head end of the bed

• Any source of fire should be kept away from cylinder for fear of fire

• Oxygen cylinder should be placed at cool temperature

• When cylinder are empty , always marks i.e. “ empty “ & send for filling

• Inspect the apparatus at frequent intervals & make sure for its good working condition

• To test any leakage in the regulator soap leather may be used

Nurse’s responsibility for administration of oxygen • Check the name & bed no. & other identification

of patient

• Check the diagnosis & need for oxygen therapy

• Check the doctors order for the initiation of the therapy , the dosage etc

• Check the doctors order for specific precaution regarding the movement of the positioning of the patient

• Assess the patient for any sign of clinical analysis ex: cyanosis

• Check the patients vital sign • Check the result of arterial blood gas analysis

• Note any signs of pulmonary dysfunction

• Check the patients mental state & the ability to follow instructions

• Check the articles available in the unit

• Check the oxygen cylinder for its accessories & their working condition

Procedure

Articles • Oxygen cylinder with stand , central supply oxygen

with a flow meter , humidifier / connecting tubing

• A tray containing :

• Nasal catheter / O2 mask / cannula

• Water soluble lubricating jelly

• Adhesive tape

• A bowl of water

• Swab sticks & normal saline

• No smoking indication

Steps of procedure • Wash hands

• Attach cannula / catheter mask to oxygen tubing & humidified oxygen source adjusted to prescribe flow rate

• Place tips of cannula into the patients nose If masks apply snugly to face

• Check cannula / equipment every eight hours

• Keep the humidification jar filled at all times

• Observe the patient nose & superior surface of both ears & skin for preventing the drying of nose

• Check the oxygen flow rate & the physician’s orders every 8 hours

• Wash hands before removing the oxygen mask or tube

• Inspect the patient for relief of symptoms associated with hypoxia

• Record procedure in the nurse’s record

After care of the patient & article • Stay with patient

• Keep the patient warm & comfortable

• Evaluate the patients progress by observing the vital signs

• Watch the patient for any deteriorating symptoms after the removal of oxygen inhalation

• Requests for an arterial blood gas analysis • Take all articles to utility room • Clean nasal catheter with cold water , then warm soapy water & finally with clean water . Boil , store & send them for sterilization

Thank you …