Module Title: Oxygen Therapy-Set Up and Monitoring Flow Rate

Oxygen Therapy Oxygen is necessary for life. Oxygen is obtained

through inhalation unless a disease process prevents enough oxygen from feeding the body’s tissues.

Every cell in the human body produces the waste product: carbon dioxide (CO2)

CO2 is transported via venous blood to the lungs where it is eliminated through exhaling.

Death results if CO2 levels become too high due to lack of elimination

You will care for many patients who have problems related to the respiratory system.

Oxygen TherapySigns and Symptoms of Decreased Oxygenation:Changes in skin color-dusky, pale, blue or grayChanges in color of lips, nail beds, mucous membranes,

lining of the mouthCool, clammy skinSlow, rapid or irregular breathingShortness of Breath or dyspnea (difficult/labored

breathing)Noisy breathingGasping for breathChanges in mental status- restlessness, confusion,

drowsinessTachycardia

Oxygen TherapyOxygen is a prescription item that requires a

doctor’s orderDoctor will specify method of administration

and amount of flowNA II’s/PCT’s are not permitted to start, stop

or change the flow rate of oxygen unless you are trained in the procedure, permitted to do it in your facility and have an order to make the change

Oxygen Therapy3 Main Oxygen Sources

Wall OxygenCylinder Oxygen

Oxygen Concentrator

Oxygen TherapyWall Oxygen-

In the hospital setting, oxygen is pumped directly into the patient’s room through a wall outlet

A flow meter is plugged into the outlet to control the amount of O2 administered to the patient

After attaching a meter to the outlet, turn the knob to the right (clockwise) to start the flow of O2

Oxygen TherapyO2 flow rate is measured in liters per

minute (l/m)Green is the standard label color

coding for O2May require a humidifier bottle to

moisten the oxygen before it enters the patient. This is done to prevent drying out of the sinuses and nasal passages

Oxygen TherapyHumidifier BottlesUsed with high flow rates of O2Moisten the membranes of the nose, sinuses, throat, and lungs

When operating properly, the water should be bubbling

Oxygen TherapyCan be prefilled/disposable or refillableMust use distilled water in refillable

bottles to prevent Legionnaires diseaseAre not required for flow rates below 5

liters but follow your facility policy for use of humidifier bottles

Bottles should be changed/refilled per facility policy and initialed and dated at the time of the change/refill

Oxygen TherapyCylinder Oxygen:Portable cylinders are used for transporting patients

from one area to another, for emergencies and for other areas without piped in O2.

There are various sizes of portable oxygen tanks. Each tanks requires a specific type of gauge

Gauges show how much oxygen is in the tank and how much pressure the oxygen is under

Portable tanks are considered empty when the pressure reaches 500 pounds.

How long a tank will last depends on the rate of O2 flowPortable tanks should always be secured in a base or

chained to a wall or carrier. Cylinders can explode when dropped.

Oxygen TherapyOxygen Concentrators-Used mainly in long-term care facilitiesDo NOT contain oxygen but convert room air to

oxygen then deliver it to the patientConcentrators are portable and also noisy, hot and

require electricity to runConcentrators can only handle small flow rates of

less than 5 l/mThis is the most economical method of O2 delivery

Oxygen TherapyDelivery methods

Nasal CannulaFace Mask

Trachea Collar

Oxygen TherapyNasal Cannula-Is a small tube with two slightly curved

prongs that fit into the patient’s nostrilsThe curve should point inward when inserted

into the noseUsed for low liter flowsAvailable in adult and pediatric sizesThe type of administration set will be decided

by the doctor based on patient needs

Oxygen Therapy Face Masks-

Simple Mask- fits over the patient’s nose, mouth and chin

Small tube connects the mask to the O2 sourceUsed with high flow rates and for mouth breathersShould NOT be used for flow rates under 5 liters

because it may cause re-breathing of exhaled CO2 and have a smothering effect

Special masks are used for tracheostomy patients

Oxygen TherapyNonrebreathing Mask- is a modification of the

simple mask.Use for patients with sever hypoxemia (insufficient

oxygen in the blood)Has one-way plastic flaps on the sides of the mask

that allow the exhalations to escape but outside air cannot enter

A reservoir bag is connected to the bottom of the mask and should be inflated at all times and should not collapse more than halfway during inspirations

This type of mask increases the amount of O2 delivered to the patient

Oxygen TherapyAir Entrainment Mask/ Venturi Mask-Similar to a simple mask but has a large

plastic tube at the bottom of the mask where it connects to the O2 source

This mask mixes oxygen with room air to obtain the percentage of O2 ordered by the physician

The settings on the mask are changed according to the physician’s order

Do not allow the patient to adjust the settings

Oxygen TherapySafety Guidelines for Oxygen UseBefore initiating Oxygen check room for safetyPost “Oxygen in Use” signs over the bed and on the

door of the room OR according to facility policyAvoid sparks or static electricity which start a fireNever use flammable liquids such as nail polish

remover, adhesive tape remover, vaseline or electrical equipment such as blow dryers, shavers, fans radio or TV and even call bells before checking with the RN

Oxygen SafetySmoking is not allowed in the room Learn how to turn off Oxygen in

case of emergencyRespond to all alarms and strange

noises immediatelyRaise the head of the bed to ease

breathing