ASSIGNMENT ON

OXYGEN ADMINISTRRATION (NASAL

CATHETER, MASK, OXYGEN HOOD& CPAP)

OXYGEN ADMINISTRATION

DEFINITION
 Administration of oxygen is a process of providing the oxygen supply to

child for the treatment of low concentrations of oxygen in the blood. Children

with respiratory dysfunctions are treated with oxygen inhalation to relieve

hypoxia. The oxygen administration treats the effects of oxygen deficiency but

it does not correct the underlying disease.

DESCRIPTION

■ Used for hypoxemia resulting from a respiratory or cardiac emergency

or an increase in metabolic function

■ In respiratory emergency, enables reduction of ventilatory effort by

boosting alveolar oxygen levels

■ In a cardiac emergency, helps to meet the increased myocardial

workload as the heart tries to compensate for hypoxemia

■ When metabolic demand is high, supplies the body with enough

oxygen to meet its cellular needs

■ Usually required for a child who has a partial pressure of arterial

oxygen less than 60 mm Hg or an oxygen saturation range of 89% to 92%

■ Useful in the patient with a reduced blood oxygen carrying capacity

(such as with carbon monoxide poisoning or sickle cell crisis)

■ Effectiveness determined by arterial blood gas (ABG) analysis,

oximetry monitoring, and clinical examinations

mechanical ventilation or via an anesthesia bag and mask; for a child

breathing on his own, delivered via nasal cannula, an oxygen hood or

tent, or mask

■ Most appropriate method of administration dependent on such factors

as disease, physical condition, and age

PURPOSE

1. To manage the condition of hypoxia

2. To maintain the oxygen tension in blood plasma

3. To increase the oxy hemoglobin in red blood cells

4. To maintain the ability of cells to carry the normal metabolic function

5. To reduce the risk of complications

EQUIPMENT

Oxygen source (wall unit, cylinder, liquid tank, or concentrator)

◆ flowmeter

◆ adapter, if using a wall unit, or a pressure-reduction gauge, if using a

cylinder

◆ sterile humidity bottle and adapters

◆ “Oxygen Precaution” signs

◆ appropriate oxygen delivery system (nasal cannula, simple mask,

partial rebreather mask, or nonrebreather mask for low-flow and variable

oxygen concentrations, Venturi mask, aerosol mask)

◆ T tube

◆ tracheostomy collar

◆ tent or oxygen hood for high-flow and specific oxygen concentrations

◆ small-diameter and large-diameter connection tubing

◆ flashlight (for nasal cannula)

◆ water-soluble lubricant

◆ gauze pads

◆ tape (for oxygen masks)

◆ jet adapter for Venturi mask (if adding humidity)

◆ oxygen analyzer (optional)

COMMON INDICATIONS

1. Cyanosis

2. Breathlessness or labored breathing

4. Disease such as pulmonary edema, pneumonia and chest trauma etc

5. Environment with low oxygen concentration

6. Poisoning with chemicals that change the tissue ability to utilize

oxygen

7. Hemorrhage

8. Shock and circulatory failure

9. Children who are under anesthesia

10. Asphyxia

METHODS OF OXYGEN ADMINISTRATION

Administration of oxygen by nasal catheter

1. This is very common method of oxygen administration in hospital

settings.

2. A catheter is inserted into the nostril reaching up to the vulva and is

held in place by adhesive tapes.

3. The catheter does not interfere with children’s freedom to eat, talk and

move on bed.
 4. The catheter should be removed every 8 hourly and new one should be

introduced.

5. Amount of oxygen should be 4 liters per minute.

Administration of oxygen by mask

1. By this method, child’s nose and mouth should be covered by oxygen

mask.

2. The size of mask may vary and should be removed every four hours

and wipe the face.

3. The flow of oxygen should be about 2-3 liters per minute for young

children and 1-2 liters per minute for infants.

Administration of oxygen by tent method

1. This method consists of a canopy that covers the patient fully or

partially.

2. It is made up of plastic or fiber, transparent and prevents absorption of

oxygen.

3. The lower part of canopy should be tucked under the bed to prevent

escape of oxygen.

Continuous positive airway pressure (CPAP)

upper airway obstruction (blockage) during sleep.

 It involves delivering normal air to your child's airway at a set pressure,

which keeps the airway open and prevents airway obstruction.

 CPAP is most commonly used in newborns with breathing difficulties,

but is also used to treat severe obstructive sleep apnoea (OSA) and other

airway disorders. This fact sheet focuses on its use as a treatment for

OSA.

 The air is given to your child through a mask attached to an electrically

powered machine called a CPAP driver.

 The mask may cover the whole face, the nose and mouth or just the nose,

or it might simply consist of prongs into the nostrils.

 It is held in place by a little cap (headgear) or straps.

APPLICATION OF OXYGEN

• Nasal canula (23-40%)

• Hood (80 – 90%) infants, (21-50%) older

• Simple face mask (35-60%)

• Non-rebreather mask (80-100%)

• High flow (10-12 l/min)

• Reservoir of oxygen
 • Tight-fitting to face

• Valves to prevent entrainment of room air

COMPLICATIONS OF OXYGEN ADMINISTRATION

1. Infection

2. Dryness of mucous membrane of respiratory tract.

3. Combustion (fire)

4. Oxygen toxicity

5. Atelectasis

6. Oxygen induced apnoea

7. Asphyxia

8. Retrolental fibroplasia.

ESSENTIAL STEPS

■ A respiratory therapist usually sets up, maintains, and manages the

equipment, but you should have a working knowledge of the oxygen system

being used.

■ Oxygen is a drug and should be administered only in the prescribed

dosage.
 ■ Confirm the child’s identity using two patient identifiers according to

facility policy

■ Check the oxygen outlet port to verify flow.

■ Pinch the tubing near the prongs to ensure that an audible alarm will

sound if the oxygen flow stops.

■ Assess the child’s condition; verify open airway.

■ Explain the procedure to the child and his parents.

■ Perform a safety check of the patient’s room to be sure it’s safe for

oxygen use.

■ Whenever possible, replace electric devices with nonelectric ones.

ALERT For a child in an oxygen tent, remove all toys that may produce a spark.

Oxygen supports combustion, and the smallest spark can cause a fire.

■ Place an “Oxygen Precaution” sign over the child’s bed and on the door

to his room.

■ Fit the oxygen delivery device to the child.

■ Monitor his response to oxygen therapy.

■ Check his ABG values during initial adjustments of oxygen flow.

■ When stable, use pulse oximetry instead.

■ Check the child frequently for signs of hypoxia.

■ Wipe moisture from the child’s face and mask.

■ Watch for signs of oxygen toxicity.

■ Remind the child to cough and deep-breathe frequently.

■ Measure ABG values repeatedly to determine whether high oxygen

concentrations are still necessary.

NURSING CONSIDERATIONS

■ Monitor or measure ABG values 20 to 30 minutes after adjusting the

oxygen flow.

■ Monitor the child for adverse response to a change in oxygen flow.

■ Evaluate the child and his family’s ability and motivation to administer

oxygen therapy at home.

■ Teach the child and his family about the proper use and care of

equipment and supplies.

■ Document the date and time of oxygen administration, type of delivery

device, oxygen flow rate, vital signs, lung sounds, skin color, respiratory effort,

and any teaching performed