OXYGENTHERAPY

GOALS

The purpose is to increase oxygen saturation

in tissues where the saturation levels are too
low due to illness or injury
OXYGEN THERAPY

• Oxygen therapy is the administration of

oxygen at concentrations greater than that
in room air to treat or prevent hypoxia.
• Oxygen delivery systems are classified as
stationary, portable, or ambulatory, and
oxygen can be administered by mask,
nasal cannula ,or teint.
 INDICATIONS

Conditions requiring oxygen therapy:

documented hypoxemia
severe respiratory distress (e.g., acute asthma or
pneumonia, pulmonary oedema, pulmonary embolism)
severe trauma
acute myocardial infarction
short-term therapy, such as post-anesthesia recovery
insufficient hemoglobin ( bleeding, anemia, carbon
monoxide intoxication )
heart failure, schock,
Hyperbaric oxygen therapy
It is providing the body with extra oxygen
• It is used in the following conditions:
gas gangrene
decompression sickness
air embolism
smoke inhalation
carbon monoxide poisoning
cerebral hypoxic event
•CONTRA-INDICATIONS

The oxygen should never be used in an explosive environment

Smoking during oxygen therapy is a fire hazard
Untreated pneumothorax

•OXYGEN SOURCES

Environment
Oxygen is processed and stored in oxygen cylinders
Liquid storage: liquid oxygen is stored in chilled tanks
Compressed gas storage: the oxygen gas is compressed in a gas cylinder
which provides convenient storage
METHOD OF OXYGEN ADMINISTRATION

Nasal cannula: offers the gas flow of 4-6L/min

Oxygen mask: the oxygen flow is maintained at
the rate of 6-10L/min when using this method of
administration.
Oxygen tent: the oxygen flow is maintained at
the rate of 6-10L/min.
GENERAL CARE OF THE CLIENT UNDER OXYGENOTHERAPY

 Care of the mouth and nose frequently and regularly.

 Verify proper connection of oxygen tube to the oxygen apparatus
 Verify if the prescribed amount of oxygen is the amount given
 The client must be advised not to change the flow of oxygen
 Maintain all adequate measures to protect explosion.
 Keep free air ways to permit the passage of air.
 If the client is unconscious, place him/her in the lateral position
 If the client is conscious, install him in fowler's position to
facilitate the thoracic expansion
GENERAL CARE OF THE CLIENT UNDER
OXYGENOTHERAPY

 Change the client position at least every two hours to avoid

bed sores.
 Provide daily hygiene in particular mouth care.
 Verify the oxygen flow and insure that it remains stationary

 Verify the content of the oxygen cylinder in order to change

it immediately when it will be empty
 Assess the clients general condition noting skin color and
vital signs client
 Record all observations on the client's file or medical record.
MONITORING OF THE CLIENT UNDER OXYGEN THERAPY

Skin appearance: Is the client cyanotic or pale? Is the client

sweating?
General signs: check blood pressure (usually high blood
pressure), check respiratory rate and check physical condition
of client.
Neuropsychiatric signs: the client may present signs of
agitation, anxiety, confusion, or unconsciousness. Agitation
may persist in case of excessive oxygen administration.
PRECAUTIONS

• Oxygen supports combustion, therefore no

open flame or products that are
combustible should be permitted when
oxygen is in use.
• Special care must be given when
administering oxygen to premature
infants, because of the danger of high
oxygen levels causing retinopathy
 DESCRIPTION

• In the hospital, O2 is supplied to each client room and is available

via an outlet in the wall.
• A flow meter attaches to the wall outlet to access the oxygen.
• Oxygen is most commonly delivered to the client via a nasal
cannula or mask attached to the tubing.
• Another delivery option is transtracheal oxygen therapy, which
involves a small flexible catheter inserted in the trachea or
windpipe through a tracheostomy tube.
• In this method, the oxygen bypasses the mouth, nose, and throat,
and a humidifier is required at flow rates of 2Lpt (1 l) per minute
and above.
OXYGEN BY MASK
• PREPARATION
• A physician's order is required for oxygen therapy except in emergency use.
• The need for supplemental oxygen is determined by inadequate oxygen
saturation, as determined by blood gas measurements, pulse oximetry, or
clinical indications.
• No special preparation of the client is required to administer oxygen therapy.
• AFTER CARE
• Once oxygen therapy is initiated, periodic assessment and documentation of
oxygen saturation levels is required.
• If the client is using a mask or a cannula, gauze can be tucked under the tubing
to prevent irritation of the cheeks or the skin behind the ears.
• Water-based lubricants can be used to relieve dryness of the lips and nostrils.
• COMPLICATIONS
In normal conditions, complications from oxygen therapy are
infrequent.
Respiratory depression, oxygen toxicity, and absorption
atelectasis are the most serious complications with overuse of
oxygen.
High pressure of oxygen can alter the bronchia and lungs
irritating the alveoli membrane leading to acute edema of the
lungs
Non humidified oxygen causes irritation of the respiratory tract
Blindnes
• Delivery equipment may present other problems.
Perforation of the nasal septum as a result of using a
nasal cannula and non–humidified oxygen has been
reported.
In addition, bacterial contamination of the nebulizer and
humidification systems can occur, potentially leading to
the spread of pneumonia.
 RESULTS

• The client demonstrates adequate oxygenation through pulse oximetry,

blood gases, and clinical observation.
• Signs and symptoms of inadequate oxygenation include cyanosis,
drowsiness, confusion, restlessness, anxiety, or slow, difficult, or
irregular breathing.
• Clients with obstructive airway disease may exhibit "aerophagia" or "air
hunger," as they work to pull air into the lungs.
• In cases of carbon monoxide inhalation, the oxygen saturation can be
falsely elevated.
 aerophagia is the medical term used to describe excessive and
repetitive air swallowing
 HEALTH CARE TEAM ROLE

• Health care team members may check and document that

oxygen therapy is being used appropriately and the oxygen
flow is as ordered.
• Physicians are responsible for ordering oxygen therapy ( flow
rate and when the client will need to use the oxygen).
• Nurses are responsible for assessing clients, ensuring that
oxygen therapy is initiated as prescribed, monitoring oxygen
delivery systems, and recommending changes in therapy.
• Respiratory therapists may assess clients, initiate and monitor
oxygen delivery systems, and recommend changes in therapy.
Specific Care of the Client Receiving Oxygen by Nasal Cannula

clean the cannula at least every 8 hours to avoid

mucus obstructing the cannula
decrease the irritation of the mucous membrane,
alternate nostril
Provide mouth care to avoid dryness
Check if the catheter is attached well (fixed)
 REFERENCES
• Hess, D. (Ed.). (2014). Nebulizers and inhalers: Advances in delivery
science and technology. CRC Press.
• Dolovich, M., & Newman, S. (Eds.). (2015). Aerosols in medicine:
Principles, diagnosis and therapy (3rd ed.). CRC Press
• Dexter, J.R., Wilkins, R.L., & Gold, P.M. (2019). Respiratory Disease: A
Case Study Approach to Patient Care. F.A. Davis Company.
• Kacmarek, R.M., Dimas, S., & Mack, C.W. (2019). Essentials of
Respiratory Care. Elsevier.