SISTER NIVEDITA GOVERNMENT NURSING COLLEGE,

IGMC, SHIMLA.

PROCEDURE

ON

OXYGEN ADMINISTRATION

SUBMITTED TO SUBMITTED BY

[Link] NEGI MS. KHUSHI BRICE

{LECTURER} MSC.1ST YEAR

CHILD HEALTH NURSING ROLL NO : 06

SNGNC, IGMC, SHIMLA SNGNC, IGMC, SHIMLA

SUBMITTED ON
 INTRODUCTION

Oxygen is a colorless, odorless, tasteless gas that is essential for the body to function properly
and to survive. The air that we breathe in contains approximately 21% oxygen, and the heart
relies on oxygen to pump blood. If not enough oxygen is circulating in the blood, it is difficult
for the tissues of the heart to keep pumping. Supplemental oxygen is used to treat medic
conditions in which the tissues of body do not have enough oxygen. Oxygen is a gas, but when
administered as a supplement to normal atmospheric air, may also be considered as a
medication (or drug).

DEFINITION

• Oxygenation is the process that includes both the inspiratory and expiratory activities.
• It is defined as when patients with respiratory dysfunctions are treated with oxygen
inhalations to relieve anoxemia or hypoxemia.
• Oxygen therapy is the administration of oxygen at a concentration of pressure greater
than that found in the environmental atmosphere.

INDICATION

The most readily accepted indication for supplemental oxygenation is hypoxemia, or decreased
levels of oxygen in the blood. For the otherwise healthy patient, oxygen saturation targets are
generally at 92 to 98%. For patients with chronic hypercapnic conditions, target oxygen
saturations are generally between 88 to 92%, with oxygen administration indicated at
saturations below these levels. This value is commonly measured with pulse oximetry, but a
pulse oximeter can give falsely elevated readings in anemia, cyanide, or carbon monoxide
poisoning and is not an adequate indicator of perfusion, as seen in cases of shock.

• Cyanosis: Bluish colour of the skin, nail beds and mucus membranes, resulting from
decreased amount of O2
• Breathlessness: Caused by certain diseases such as asthma, pulmonary embolism.
• Anemia: It is the deficiency of either quality or quantity of red blood cells in blood.
• Poisoning with chemicals that alters the tissue ability to utilize oxygen.
 • Severe respiratory distress (acute asthma or pneumonia).
• Pulmonary hypertension.
• Acute myocardial infarction (heart attack)
• Shock and circulatory failure.
• Haemorrhage and air hunger.
• Patient under anesthesia.
• Patient who are critically ill
• Psychologically induced breathlessness.
• Asphyxia
• Severe trauma.

CHRONIC
• Chronic obstructive pulmonary disease (COPD)
• Cystic fibrosis
• Pulmonary fibrosis
• Sarcoidosis
ACUTE

Medical emergencies requiring high concentrations of oxygen in all cases:

• Shock
• Sepsis
• Major trauma
• Cardiac arrest and during resuscitation
• Anaphylaxis
• Carbon monoxide and cyanide poisonings
• Transfusion-related acute lung injury (TRALI)

METHODS OF DISPENSING OXYGEN

1. Piped in cylinder
2. Oxygen concentrator.
 USING OXYGEN CYLINDERS

• The oxygen cylinder is delivered with a protective cap to prevent accidental force
against the cylinder outlet.
• To release oxygen safety and at a desirable rate, a regulator is used. It consists of two
parts.
• A reduction gauge that reduces the pressure to a working level and shows the amount
of oxygen in the tank.
• A flow meter that regulates the control of oxygen in liters per minutes.

WALL OUTLET OXYGEN

• The oxygen is supplied from a central source through a pipeline.

• Only a flow meter and a humidifier are required.

CLASSIFICATION OF OXYGEN DELIVERY SYSTEMS

Low flow systems:

• Contribute partially to inspired gas patient breathes.

• Do not provide constant FiO
• Ex: nasal Cannula, simple mask, nonrebreather mask, partial rebreather mask.

High flow systems:

• Deliver specific and constant percent of oxygen independent of patient's breathing.

• Ex: venturi mask, trach collar, t- piece.
Low Flow Administration
 METHODS OF OXYGEN ADMINISTRATION

LOW FLOW SYSTEMS:

Nasal Cannula (Prongs)

• It is a disposable.
• Plastic devise with two protruding prongs for insertion into the nostrils, connected to
an oxygen source. Used for low-medium concentrations of oxygen (24-44%).

Nasal Cannula

Low flow

24-44%

• 1 L/min 24%
• 2 L/min = 28%
• 3 L/min = 32%
• 4 L/min = 36%
• 5 L/min = 40%
• 6L/min = 44%

Face mask

• The simple oxygen mask

• The partial rebreather mask
• The nonrebreather mask
• The venturi mask

The Simple Oxygen Mask

• Simple mask is made of clear, flexible, plastic or rubber that can be molded to fit the
face.
• It is held to the head with elastic bands.
• Some have a metal clip that can be bent over the bridge of the nose for a comfortable
fit.
• It delivers 35-60% oxygen.
 • A flow rate of 6-10 L/minute.
• It has vents on its sides which allow room air to leak in at many places, thereby diluting
the source oxygen.
• Often it is used when an increased delivery of oxygen is needed for short periods (i.e,
less than 12 hours).

The Partial Rebreather Mask

• The mask is have with a reservoir bag must remain inflated during both inspiration
and expiration.
• It collection of the first parts of the patients' exhaled air.
• used to deliver oxygen concentrations up to 80%.
• It is The oxygen flow rate must be maintained at a minimum of 6 L/min to ensure
that the patient does not rebreathe large amounts of exhaled air.
• The remaining exhaled air exits through vents.

The Nonrebreather Mask

• This mask provides the highest concentration of oxygen (95-100%) at a flow rate
6-15 L/min.
• It is similar to the partial rebreather mask except one-way valves prevent
conservation of exhaled air,
• The bag is an oxygen reservoir
• When the patient exhales air the one-way valve closes and all of the expired air is
deposited into the atmosphere, not the reservoir bag.

HIGH FLOW SYSTEM

Venturi Mask

• It is high flow concentration of oxygen.

• Oxygen from 40% to 50%.
• At liters flow of 4-15 L/min.
• The maak is so constructed that there is a constant flow of room air blended with a fixed
concentration of oxygen.
• It is designed with wide-bore tubing and various colour coded jet adapters
• Each colour code corresponds to a precise.
 • Oxygen concentration and a specific liter flow.

The venturi system:

• Room air dilutes the oxygen entering the tubing to a certain concentration.
• The amount of air drawn in is determined by the size of the orifice (jet adapter).

Tracheostomy Collar/Mask

• Inserted directed into trachea

• It is indicated for chronic O2 therapy need.
• O2 flow rate 8-10 1.
• Provides accurate FIO
• Provides good humidity.
• Comfortable, more efficient
• Less expensive

T- piece

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

• Provides accurate FiO₂.
• Provides good humidity.

HAZARDS OF OXYGEN ADMINISTRATION

• Infection.
• Combustion.
 • Drying of the mucus membranes.
• O, toxicity.
• Atelectasis.
• Retrolental fibroplasias.
• Asphyxia.

ARTICLES
A tray containing:

• Nasal catheter/Cannula/O₂ mask.

• A bowl with water.
• Gauze pieces (wet and dry).
• No smoking indication.
• Swab sticks and normal saline.
• Kidney tray
• Paper bag

STEPS OF PROCEDURE
Preprocedural Steps

• Check the name and other identification of patient.

• Check the diagnosis and need for oxygen.
• Check the doctors order for initiation of the therapy.
• Check the doctors order for specific positioning of the patient.
• Check the patients vital signs.
• Arrange the articles and select the most appropriate and comfortable oxygen delivery
device.

Intraprocedural Steps

• Wash hands.
• Clean the Cannula/catheter mask firstly with wet gauze then with dry gauze.
• Attach the Cannula/catheter mask to O, tubing and humidified O, source adjusted to
prescribe flow rate.
• Check the flow of O, by dipping the tip of Cannula into bowl of water.
 • Place tips of Cannula into patient's nares, if mask is applied snuggly to face.
• Check Cannula/equipment every 8 hour.
• Keep humidification jar filled at all times.
• observe the patients nares and superior surface of both ears and skin.
• Observe Check the O, flow rate.
• Record procedure in the nurses record.
• Inspect the patient for relief of symptoms associated with hypoxia.

Postprocedural Steps

• Stay with the patient.

• Keep the patient warm and comfortable.
• Evaluate the patient progress by observing the vital signs.
• Watch the patient for any deteriorating symptoms after the removal of O₂ inhalation.
• Record date and time.
• Take all the articles to utility room.
• Clean nasal catheter with wet and dry gauze piece and replace them back
 CONCLUSION

Oxygen therapy is an integral part of the treatment of critically ill patients. Maintenance of
adequate oxygen delivery to vital organs often requires the administration of supplemental
oxygen, sometimes at high concentrations. Although oxygen therapy is lifesaving, it may be
associated with deleterious effects when administered for prolonged periods at high
concentrations. Here, we review the recent advances in our understanding of the molecular
responses to hypoxia and high levels of oxygen and review the current guidelines for oxygen
therapy in critically ill patients.
 BIBLIOGRAPHY

• Ghai sandhya “a textbook of clinical nursing procedure” published by CBS publishers,

1st edition, page no. 150- 154.

Net references

• [Link]
• [Link]
Administration