OXYGEN ADMINISTRATION

OXYGEN ADMINISTRATION – Definition of Terms, Effects of Oxygen on Body, Indications, Purpose, Classifications, Home Oxygen Therapy, Complications of Oxygen and Oxygen Safety

UPDATED 2024

Oxygen (O₂) is administered as a corrective treatment for conditions resulting in hypoxia (low level of oxygen in the blood). Oxygen is classed as a medication and must be prescribed by a doctor and administered correctly to prevent over or under-oxygenation. Remember oxygen is non flammable, but it does aid combustion. Patients and visitors should therefore be educated about the increased risk of fire and the precautions necessary to reduce the risk when supplementary oxygen is in use.

Oxygen must only be administered at the rate and percentage prescribed, as over-oxygenation can be dangerous for some individuals, particularly those with dangerous for some individuals, particularly those with chronic lung disease who are retaining carbon dioxide, and infants, where there is also a risk of retinopathy.

DEFINITION OF TERMS

FiO₂: fraction of inspired oxygen (%)

PaCO₂: the partial pressure of CO₂ in arterial blood. It is used to assess the adequacy of ventilation

PaO₂: the partial pressure of oxygen in arterial blood. It is used to assess the adequacy of oxygenation

SaCO₂: arterial oxygen saturation measured via pulse oximetry

Heat moisture exchange (HME) product: are devices that retain heat and moisture minimizing moisture loss to the patient airway

High flow: high flow systems are specific devices that deliver the patient’s entire ventilatory demand, meeting, or exceeding the patients peak inspiratory flow rate (PIFR), thereby providing an accurate FiO₂, where the total flow delivered to the patient meets or exceeds their peak inspiratory flow rate the FiO₂ delivered to the patient will be accurate. High flow is in approved areas only. Consult your NUM if unsure

Humidification: it is the addition of heat and moisture to a gas. The amount of water vapor that a gas can carry increases with temperature

Hypercapnia: increased amounts of carbon dioxide in the blood

Hypoxemia: low arterial oxygen tension (in the blood)

Hypoxia: low oxygen level at the tissues

Low flow: low flow systems are specific devices that do not provide the patient’s entire ventilatory requirements; room air is entrained with the oxygen, diluting the FiO₂

Minute ventilation: the total amount of gas moving into and out of the lungs per minute. The minute ventilation (volume) is calculated by multiplying the tidal volume by the respiration rate, measured in liters per minute

Peak inspiratory flow rate (PIFR): the fastest flow rate of air during inspiration, measured in liters per second

Tidal volume: the amount of gas that moves in, and out, of the lungs with each breath, measured in millimeters (6-10 ml/kg)

Ventilation-Perfusion (VQ) mismatch: an imbalance between alveolar ventilation and pulmonary capillary blood flow

EFFECTS OF OXYGEN ON BODY

Oxygen is a gas, which has no smell or color and is heavier than air
It is stored at high pressure in black and white cylinders
With oxygen there is always a serious fire risk
Smoking is not allowed anywhere nearby oxygen cylinder
No open fire or any inflammable material should be kept near the oxygen cylinder
Oil, grease or alcohol should never be used on the connections of the cylinder
The cylinder is mounted on a stand for easy and should be tested before taking it to the bedside
To test it open the cylinder with the key and then open the small valve very little and test the flow of oxygen from the cylinder into a bottle half filled with water (wolf bottle)
The bottle has a rubber cork with two holes tubes passing through it
The cylinder is connected by means of rubber tubing to the longer tube
Oxygen flows into the wolf bottle and then oxygen is given to the patient

DEFINITION

Oxygen administration treats the effects of oxygen deficiency (anoxemia) but it does not correct the underlying causes.

Oxygen therapy is important to keep a healthy level of tissue oxygenation

oxygen administration nursing procedure - nurseinfo

INDICATIONS

Breathlessness due to asthma, pulmonary embolism, emphysema, cardiac insufficiencies, etc
Obstructed airway due to growth, enlarged thyroid
Cyanosis
Shock and circulatory failure
After severe hemorrhage
Anemia
Patients under anesthesia
Asphyxia due to any reason, e.g. drowning, inhalation of poisonous gases, hanging, etc
Poisoning with chemicals that alter the tissues ability to utilize oxygen, e.g. cyanide poisoning
Carbon monoxide poisoning
Postoperative chest surgery and thyroidectomies
Insufficient oxygen in atmosphere
Air hunger

PURPOSE

To supply O₂ in conditions when there is interference with normal oxygenation of blood
To reduce the effects of anoxemia
To maintain healthy level is tissue oxygenation

CLASSIFICATIONS

Oxygen is administered by either low flow or high flow systems. Low flow administration devices include nasal cannula, oxygen mask, oxygen tent, etc. high flow administration devices include venturi mask, some devices can be used for both low and high flow administration, e.g. oxygen hood incubator, etc

Nasal Cannula

It is the most important low flow device used to administer oxygen of a rubber or plastic tube that extends around the face. Curved prongs that fit into the nostrils. One side of the tube connects to oxygen tubing and oxygen supply. The cannula is often held in place by an elastic band that fits around the clients head or under the chin

The nasal cannula is easy to apply and does not interfere with client’s ability to eat or talk. It is very comfortable and permits some freedom of movement. Oxygen is delivered via the cannula with a flow rate of up to 4 L/min. higher flow rates dry air mucous and do not further increases inspired oxygen concentrations

Equipment

Oxygen supply with a flow meter
Humidifier with sterile distilled water
Nasal cannula and tubing
Tape if needed to secure the cannula in place
Gauze to pad the tubing over the cheek

Procedure

Determine the need for oxygen therapy and the physicians order
Assist the client to a semi-Fowler’s position as possible. It permits easier chest expansion easier breathing
Explain about the procedure and inform the client and support persons about safety precautions connected with oxygen use
Set-up the oxygen equipment and humidified
Turn on the oxygen at the prescribed rate and ensure proper functioning
Put the cannula over the clients face
If the cannula will not stay in place tape if at sides of face
Slip gauze pads under the tubing over the cheek bones to prevent skin irritation as necessary
Assess the client regularly
Assess the vital signs, color, breathing pattern and chest movement
Check the equipment are working regularly
Make sure that safety precautions are being followed
Record initiation of therapy and all nursing assessments

Nasal Catheters

Nasal catheters are used infrequently, but they are not absolute. The procedure involves inserting an oxygen catheter into the nose to the nasopharynx. Because securing the catheter must be changed at least every 8 hours and inserted into the other nostril, for this reason, the nasal catheter is a less described method because the client may have pain when the catheter is passed into nasopharynx and because trauma can occur to the nasal mucosa. The nasal catheter permits free movements for the patient and nursing care may be given with much more ease

Oxygen Mask

An oxygen mask is a device used to administer oxygen, humidity it is shaped to fit tightly over the mouth and nose and is secured in place with a strap. There are four types of oxygen masks:

Simple face masks: used for short-term oxygen therapy. If delivers O₂ concentration from 40 to 60% at liter flows of 5-8 liter per minute
The partial rebreather mask: delivers O₂ concentrated of 60-90% liter flows of 6-10 L per minute
The nonbreather mask: delivers the highest O₂ can possible by means other than inhibition or mechanical ventilation that is 95-100% at liter flows of 6-15 L/minute
Venturi mask: delivers O₂ can precise to with 1.1 and is often used for clients with COPD O₂ can at from 24-40% /50% depending on the brand at liter flows of 4-8 L/minute. Initiating oxygen by mask in mucus the same as initiating O₂ by cannula

OXYGEN TENT

HOME OXYGEN THERAPY

OXYGEN COMPLICATIONS & SAFETY