STN Aina Sofeah

STN Khairunnisa Nasuha Hazizi

STN Amirah Hanisah

Oxygen is colorless, tasteless, and

odorless gas that is present in the air.

Although is essential for life.

Oxygen therapy

Principles in oxygen therapy

1. Give proper amount, lot of oxygen may be fatal for some patients.

2. Maintain an open airway through correctly positioning and suctioning the patient.

3. Give oral hygiene every 3-4 hours. Because oxygen therapy drying the tissues, makes mouth smell or taste bad.

4. Prevent infections by removing, cleaning or replacing nasal catheter.

5. Monitor the activities of patient.6. Do not discontinue oxygen flow immediately.

The level of blood falls drastically as soon as oxygen turned off and may take 5-10minutes to return to normal.

7. Observe safety measures to prevent explosion of fire.

8. No smoking at bed side.9. Electrical equipments should be good working

conditions.

1. Cardiac output2. Arterial oxygen content.3. Concentration of Hgb4. Metabolic requirements5. Hypoxemia (decrease in the arterial oxygen

content in the blood)6. Hypoxia (decreased oxygen supply to the

tissues)

• ABGs• Pulse oximetry

• Clinical evaluation

• Oxygen toxicity – can occur with FLO2 > 50% longer than 48 hours.

• Suppression of ventilation – will lead to increased CO2 and carbon dioxide narcosis.

• Danger of fire.• Infection

CAUTIONS FOR OXYGEN THERAPY !!

• Oxygen source• The flow meter• Humidifier• The tubing• Appropriate

appliance for the method being used.

The Flow Meter and Humidifier

• The flow meter is attached to piped-in oxygen and regulates the amount.

• The rate of flow is prescribed by physician range from 2-12/minute.

• Humidifier is attached to the flow meter between the flow meter and tubing’s.

• The oxygen is moisturized before entering the air passages.

1. Piped in 2. Cylinder3. Oxygen concentrator

• Obtain oxygen cylinder from central service or the respiratory therapy department.

• Stand the cylinder securely to prevent from falling.

• Put cylinder beside the head of the bed away from doors, heater etc..

• Check the cylinder tag : ‘full’ , ‘in use’ , ‘empty’

1.Low flow systems :• Contribute partially

to inpired gas client breathes

• Do not provide constant FLO2

• Example : nasal cannula,simple mask,mask partial rebreather & non rebreather.

2. High flow systems• Deliver specific and

constant percent of oxygen independent of client’s breathing.

• Example : Venturi mask, mask aerosol, face tent, transtracheal catheter.

NASAL CANNULA• For low medium

concentration of oxygen.• Simple• Can use continuously

with meals and activity.• Flow rates in excess of 4L

cause drying and irritation.

• Depth and rate of breathing affect amount of oxygen reaching lungs.

SIMPLE MASK• Low to medium concentration of

oxygen.• Client exhales through ports on

sides of mask.• Should not be used for controlled

oxygen levels.• Oxygen flow rate – 6 to 8 L• Simple to use : inexpensive.• Can cause skin breakdown. Must

remove to eat.

• Consists of mask with exhalation ports and reservoir bag.

• Reservoir bag must remain inflated.

• O2 flow rate : 8 to 10L• Client can inhale gas from

mask, bag, exhalation port.

• Poorly fitting , must remove to eat.

PARTIAL REBREATHER

MASK

• Similar in design to partial re-breathing mask.• Has 2 valves• 1st valve : 1 way valve between the reservoir

bag and base of the mask.• 2nd valve : in the exhalation port.• The one valve prevent room air from entering

the mask during inhalation.• Exhale gases to exit the mask on exhalation.

NON-REBREATHER MASK

• Consists of mask, reservoir bag, 2 one-way valves at exhalation ports and bag.

• Client can only inhale from reservoir bag.

• Bag must remain inflated at all times.

• O2 flow rate 10 to 15L• Poorly fitting ; must remove to

eat.

NON-REBREATHER MASK

• Most reliable & accurate method for delivering a precise o2 concentration.

• Consist of a mask with a jet.• Excess gas leaves by exhalation ports.• O2 flow rate : 4 to 5L• Can cause skin breakdown ; must remove to

eat.

VENTURI MASK

• O2 flow rate 8 to 10 L• Provides accurate FLO2• Provides good humidity ; comfortable

TRACHEOSTOMY COLLAR/MASK

• Used an end of ET tube when weaning from ventilator.

• Provides accurate FLO2• Provides good humidity.

• Non-invasive monitoring technique that estimates the oxygen saturation on Hgb (SaO2)

• May be used continuously or intermittently.• Must correlate values with physical

assessment findings.• Normal SaO2 values : 95% to 100%

PULSE OXIMETRY

Low perfusion

states

• Vasoconstrictor medications

Motion artifactIntravascular

dye

Abnormal Hgb

Nail polish when using a finger probe.

Too much light

exposure

PROCEDURE

OXYGEN ADMINISTRATIONS OF NASAL PRONG AND MASK

NO STEPS RATIONAL

1. Check prescription for mode, amount and duration.

To check doctor ordered.

2 Verify, greet and explain to patient indication of oxygen, procedure to patient.

To cooperation from patient and to patient understand.

3. Assess patient:• Skin color and nature• Respiration pattern•Level of consciosness

To detect abnormalities.

NO STEPS RATIONAL

4. Assess oxygen supply and oxygen set• Cylinder( check if enough oxygen from oxygen gauge)•Wall oulet.

To recheck the function oxygen set.

5. Prepare equipment•Fill the humidifier with distilled water to the level specified and close tightly.•Attach flow meter to the wall outlet or cylinder.•Attach oxygen tubing to the humidifier outlet.

To prepare the equipment before administer and to make sure all the equipment function well.

NO STEPS RATIONAL

6. Test the oxygen flow• On the regulator to check oxygen bubbles through the distilled water in the humidifier.•Feel the oxygen flow out of the oxygen tubing on the back of the palm.

To the make sure oxygen flow.

7. Clean of any oil or sweat from patient’s face,nose and around mouth.

To prevent the tubing out from the nose.

8. Wash hand To maintain hygiene.

NO STEPS RATIONAL

9. 1.Administer oxygen through nasal prong.• Attach nasal prongs to the oxygen tubing and turn on to check the oxygen flow.• Clean patient’s nonstrils with cotton tip dipped in saline to remove any dried secretion that can obstruct oxygen flow.• Place the nasal prong into both the patient’s nonstrile and under the chin.•Anchor the nasal prong tubing behind patient’s ear and under the chin.•Slide the adjuster upward under the chin to anchor tubing.

NO STEPS RATIONAL2.Administer oxygen via face mask.• Attach mask to the oxygen tubing and turn on regulator to check the oxygen flow.•Place mask covering mouth and nose.•Fix mask tapes securely behind patients head according to patient’s comfort.

10. Adjust the flow meter according to the amount ordered.

To make sure correct amount flow meter.

11. Anchor the tube with tape by patient’s bed or pillow.

To prevent the tube no attach to patient.

NO STEPS RATIONAL12. Instruct patient regarding risk of

fire.•Not use matches or lighter by the bedside.•Instruct no smoking.•Place ‘no smoking’ sign by bedside for information.

To prevent fire occur .

13. Ensure patient is comfortable.•Provide face wipes regularly.•Mouth care to prevent drying of mucous membranes.

To provide patient comfort and prevent dehydration.

14. Comfort the patient physically and emotionally.

To reduce patient anxiety.

NO STEPS RATIONAL

15. Monitor patient’s•Respiration pattern•Cyanosis•Anxiety or confusion•SPO2

To detect abnormalities.

16. Document and report. To as a references.

17. Wash hand. To maintain hygien.

THANK YOU…..