Oxygen Therapy, Indications, procedure, precautions, different ways of oxygen delivery Presented by Ganga Tiwari (BSC. Nursing Fourth Year , TU, IOM, MNC, Kathmandu Nepal)

1. OXYGEN THERAPY
Presented by:
Ganga Tiwari
BSc Nursing 4th year, Teaching
Learning
TU, IOM, Maharagunj Nursing Campus,
Kathmandu

2. OXYGENATION
The addition of oxygen to any system,
including the human body. Oxygenation
may also refer to the process of treating
a patient with oxygen, or combining a
medication or other substances with
oxygen
2

3. 3

4. OXYGEN INHALATION
It is the method of supplying higher
concentration of O2 than O2 found in
the environment, through the different
devices.
O2 is administered whenever there is
deficiency in blood shown by cyanosis.
Normal oxygen concentration in blood
is more than 90 %.
4

5. PURPOSES
To supply oxygen in conditions when
there is interference with normal
oxygenation of blood.
To reduce respiratory distress.
To reduce effects of anoxemia.
5

6. INDICATIONS
Breathlessness.
Obstructed airway due to growth,
enlarged thyroid
Cyanosis
Cardiac failure
Respiratory distress
Shock
After severe hemorrhage 6

7. INDICATIONS..
Anemia
Patient’s under anesthesia
Asphyxia
Poisoning: carbon monoxide poisoning
Post -operative period
Insufficient o2 in the atmosphere
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8. HYPOXIA
 Hypoxia is the decreased oxygen
concentration in blood.
8

9. SIGNS AND SYMPTOMS
Restlessness
Lack of concentration
Increased fatigue
Increased rate and depth of respiration
Pallor
Clubbing of nail
Anxiety
9

10. SIGNS OF HYPOXIA
10

11. CYANOSIS
11

12. SIGNS AND SYMPTOMS OF HYPOXIA..
Decreased level of consciousness
Dizziness
 Increased pulse rate.
Elevated blood pressure.
Cyanosis
Dyspnea
12

13. SOURCES OF OXYGEN
Wall outlet
Portable cylinder
13

14. WALL OUTLET
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15. OXYGEN CYLINDER
15

16. OXYGEN DELIVERY SYSTEM
16

17. NASAL CANNULA
Thin tube with two nozzles that
protrude into the patient‘s nostrils.
Used to administer 2 to 6 liter of
oxygen delivering (24 to 45 %) of the
concentration.
 Connected to an oxygen source with
flow meter and humidifier.
Easily dislodged and causes dryness
of nasal mucosa but easier for carrying
out daily activities. 17

18. NASAL CANNULA
18

19. FACE MASKS
Particularly four types of face masks
are in use,
Simple face mask,
Partial rebreather mask,
Non rebreather mask
Venturi mask.
19

20. SIMPLE FACE MASK
Applicable for providing oxygen of 5 to 8
liter/min with the concentration
between ( 40 to 60%).
20

21. SIMPLE FACE MASK
21

22. PARTIAL REBREATHER MASK
Simple face mask with reservoir bag.
Used to administer ( 60 to 90) % of
oxygen concentration at the rate of 6
to 10 liter/ min
Reservoir bag collects the patient’s
exhaled air allowing the patient
rebreathes the 1/ 3rd part of the
expired air from the bag which permits
the oxygen conservation.
Bag must totally deflate with
inspiration to prevent carbon dioxide
build up.
22

23. PARTIAL RE BREATHER MASK
23

24. NON RE BREATHER
Two one way valves prevent the
patient from rebreathing the exhaled
air or exhaled air escapes away.
Used to deliver highest concentration
of oxygen 95 to 100% at the rate of
10- 15 lit/min.
24

25. NON RE BREATHER MASK
25

26. VENTURI MASK
Used to deliver a predetermined
concentration.
Designed to provide accurate control
of oxygen concentration such that it
does not rise high enough to cause
respiratory depression but adequate to
relieve anoxia.
It delivers varying concentration of
oxygen i.e. 24 to 60 % at 4 to 15 liter
flow.
26

27. VENTURI MASK
It has wide bore tubing and color
coded adapter that corresponds to a
prescribed oxygen concentration and
liter flow.
Oxygen flow rate according to the
color of adaptor in venturi mask is as
follow:
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28. VENTURI MASK
28

29. OXYGEN TENT
A thin plastic tent like structured,
suspended over the patient and sides
are tucked firmly under the bed
clothing of the patient.
Usually used for delivering oxygen to
the infants.
29

30. OXYGEN TENT
30

31. OXYGEN TENT
31

32. OXYGEN HOOD/ HEAD BOX
Used for infants
Plastic device which is kept over the
head of the baby.
It helps in efficient delivery of oxygen.
While placing hood over the head of
the child , the edges should not rubbed
against the child’s chin, neck, and
shoulder.
32

33. OXYGEN HOOD
33

34. OXYGEN HOOD
34

35. ARTICLES REQUIRED
O2 cylinder with flow meter connected,
regulator, humidifier with sterile
distilled water.
Cardex
Cylinder with stand
 Opening key.
Nasal cannula , O2 mask with
connective tubes
Gauze pad/ cotton balls.
35

36. HUMIDIFIER
36

37. PROCEDURE FOR OXYGEN
ADMINISTRATION
Determine need for oxygen therapy in
Patient and verify the prescription for
the therapy.
Explain procedure to the patient and
inform how to co-operate.
Wash hands.
37

38. PROCEDURE..
Set up o2 equipment and humidifier,
Attach tubing, nasal cannula and mask
to humidifier.
Check the condition for oxygen pipe
and flow meter
38

39. PROCEDURE..
Assist the patient on semi-fowlers
position if possible.
Regulate flow meter to prescribed
level. Ensure proper functioning of
humidifier.
Clean the nostrils with swab stick. If
the nostrils are blocked with secretion.
Assess the flow of oxygen in the nasal
cannula. 39

40. PROCEDURE..
Place the nasal prong in the patient’s
nostrils. Secure the cannula in place
by adjusting straps around ear.
 In case of mask fit it properly covering
the nose and mouth avoid air leakage
from the edges .fasten the elastic band
around the client’s ear.
40

41. PROCEDURE…
Check for proper flow rate every four
hour.
Ensure that ports of mask are open.
Assess client’s nostrils every 8 hours.
Sterile lubricants can be used to keep
mucous membrane moist.
Assess clients face and ear for
pressure from the mask and tubing.
Wash hands 41

42. PROCEDURE..
Document time, flow rate and
observation made on the patient.
Record the abnormal findings,
outcomes and results.
Report any abnormalities.
Observe for oxygen saturation every
hourly. (Must be more than 90%)
42

43. PRECAUTION
Never deliver more than prescribed to
prevent from oxygen toxicity.
Monitor Spo2 of the patient frequently.
Ensure that humidifier bottle is always
at least 1/3rd full with the sterile water.
43

44. PRECAUTION..
Never increase or decrease the flow of
oxygen when the cannula in the
patient’s nostrils.
Promote safety measures: inform that
smoking is not permitted in the area of
oxygen use.
Place NO SMOKING signs in the
patient’s room or door
44

45. PRECAUTION..
Patient’s visitors must be instructed
about the danger of smoking when
oxygen is used.
Always locate the fire extinguisher
close to the room.
Assess patient carefully for oxygen
toxicity.
45

46. PRECAUTION..
O2 cylinder should be stored at a low
temperature.
Oxygen therapy is potential source of
contamination so the tubing should be
changed frequently.
Oil or grease should not be used on
the regulator cylinder.
46

47. PRECAUTION..
Change the nasal cannula 8 hour or
more often.
Assess patient carefully to prevent
oxygen toxicity.
Do not use electrical appliances close
to O2.
47

48. SOME QUESTIONS??
What is oxygenation?
What is oxygen inhalation?
What are the indications of oxygen
inhalation?
What is hypoxia?
What are the signs and symptoms of
hypoxia?
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49. SOME QUESTIONS??
What are the different delivery system
of oxygen?
How can you administer oxygen to a
patient?
What are the precautions to be taken
in oxygen administration
49

50. REFERENCES
 Health learning material center. Institute of
medicine of medicine ,Tribhuwan
University.Fundamentals of nursing ( second
edition reprint ,2010). Kathmandu:Heidal Press
,Dillibazar.
 Basvanthappa,B.T.(2004). Fundamentals of
Nursing. New Delhi :Jaypee Brothers.
 Perry, A.G. and Potter, P.A. (2007).Basic
Nursing Essentials For Practice .(sixth edition):
Mosby
 Giri, M. and Sharma,P. (2013). Essential
Fundamental Of Nursing.(first
edition).Kathmandu: Medhavi Publication.
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51. REFERENCES…
 Pathak ,S.and Devkota ,R.(2011).A Textbook Of
Fundamentals of Nursing.(second
edition).Kathmandu:Vidyarthi Prakashan.
 Taylor,C.R. and Lillis,C.(2008). Fundamental Of
Nursing.(Volume1):Lippincott William and Willikins
 Skidmere ,L . Nursing Drug Reference(2009):
Mosby
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52. THANK YOU!
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