Oxygen Therapy

Dr/Basma Atta
 Out lines
1-Introduction.

2-Definition of Oxygen Therapy.

3-Indication of oxygen therapy.

3-Purpose of Oxygen Therapy.

4- Methods of Oxygen Administration.

5-Procedure of Oxygen Therapy.

 Introduction

v Oxygen is required for the functioning and

survival of all body tissues and deprivation
for more than a few minutes is fatal.

v Without oxygen the brain can begin to die

within 4 to 6 minutes.
v Hypoxemia resulting from apnea or
inadequate ventilation occurs rapidly
in children than in adult because of:

1. children’s higher metabolic rate

2. increased oxygen consumption
 Definition of Oxygen Therapy

Oxygen therapy is the administration of oxygen at

concentrations greater than that in room air to treat or
prevent hypoxemia.
Hypoxemia: Low arterial oxygen concentration
(in the blood)
Hypoxia: Low oxygen level at the tissues.
Hypoxemia resulting in hypoxia.
Indication of oxygen therapy

 Respiratory disorder.
- Cyanosis
-Tachypnea
- Hypoxemia

 Cardiac disorder.
-Chest pain
-Tachycardia
-Arrhythmias

 Neurological deficits.
-Coma
 Purpose of Oxygen Therapy

• Relieve hypoxemi a an d maint ain

a dequate oxygenation of tissue s an d vital
organs.
• Reduce the work of breathing.
• To maintain targeted SpO2 levels.
Source of oxygen

Wall outlet Cylinder

Methods of oxygen Administration

Nasal cannula.
Disposable facemask.
Oxygen hood.
Non rebreather mask .
Oxygen tent.
Type of O2 delivery device selected
depends on:
Age and size of the child.
Oxygen requirements/therapeutic
goals.
Patient tolerance to selected method.
Safety is great concern in administering
oxygen.
 Nasal cannula

Plastic device with two protruding prongs for

insertion into the nostrils, connected to an
oxygen source.
It is a disposable.
Available in 3 different sizes: neonatal,
pediatrics and adult .
Delivered relatively low concentrations of
Oxygen (24-44%) at flow rate of (2 L to 5 L/M).
Nasal cannula
 Nasal cannula

Advantages:
Inexpensive.
Well tolerated, comfortable.
Easy to eat, drink.
Used with humidity.

Disadvantages:
May cause irritation to the nasal and
pharyngeal mucosa.
 The simple Oxygen Mask

vSimple mask is made of clear, flexible, plastic or

rubber that can be molded to fit the face.
v It is held to the head with elastic bands.
vSome have a metal clip that can be bent over the
bridge of the nose for a comfortable fit.
v It delivers concentrations of Oxygen (35% to
60%) at flow rate of 6 to 10 liters per minute.
The simple Oxygen mask
 The simple Oxygen Mask
Advantages:
• Can provide increased delivery of oxygen for short
period of time.

Disadvantages:
• Difficult to keep mask in position over nose and mouth.
• Potential for skin breakdown (pressure, moisture).
• Uncomfortable for pt while eating or talking.
 Oxygen Hood
A hood is a plastic dome or box with warm, moist
oxygen inside. The hood is placed over the baby's
head.
Can be placed on infants in cribs, radiant
warmers or incubators.
An oxygen hood is used to provide maximum
oxygenation for neonates and infants.
oxygen hood
 Oxygen Hood
Oxygen is warmed and humidified, which can
l e ad to fogging and limit s vi sibility.
Size of hood limits use to younger than age 1 year.
Well tolerated by infants.
Allows easy access to chest, trunk, and
extremities.
Delivers 80-90% oxygen at flow rate of 10- 15
liter per minute.
 Oxygen Tents

• An oxygen tent consists of a canopy placed

over the head and shoulders , or over the entire
body of a patient to provide oxygen at a higher
level than normal.
• Delivers 30-50% oxygen at flow rate of 4-8
liter per minute.
Oxygen Tents
Non re-breather mask
 This mask provides the highest concentration
of oxygen (95-100%) at a flow rate 6-15
L/min.
Minimum 5 LPM for infant/child, 1 0 L P M f o r
teens.
 Simple Oxygen Mask
Action Rational
Explain to the child and family about O2
therapies.
Assemble equipment and select the
correct size mask to ensure a tight fit.
Wash hand.

Set the child in good position (semi

fowler’s position).

Check the cylinder for any leakage for

the safety of the patient.
 Procedure cont,

Action Rational
Attach the mask to the humidified oxygen
source and adjust the flow rate to the
prescribed level
Then place the mask over the child’s face
and adjust the nose clip and strap. Check
the oxygen flow
Wash hand.
 Nasal Cannula
Action Rational
Determine current vital signs, level of
consciousness and child’s blood gases.
Show the nasal cannula to the child or to his mother
and explain the procedure.
Make sure the humidifier is filled to the
appropriate mark.
Attach the connecting tube from the nasal cannula
to the humidifier outlet.
 Procedure cont,
Action Rational
Set flow rate at prescribed liters/minute.

The loop of cannula can be enlarged to slip

easily over the child’s ears. Place the prongs in
the nares and tighten the loop. If child is active ,
tape cannula to sides of face to maintain proper
position

Wash hand.
 Oxygen Hood

Action Rational
Disinfect the oxygen hood and revise the
written order.

Warmed humidified oxygen is supplied

through a plastic container that over the
infant`s head.
Open the hood or remove the baby
from it as infrequently as possible.
 Oxygen Tent
Action Rational
When using O2 tents the nurse has to monitor the
child’s temperature frequently to prevent
hypothermia and be sure to keep the child in dry
clothing.
Be certain to check that the sides and the end of the
tent are securely tucked to prevent oxygen leakage.

If humidified oxygen is used, the resulting mist

limits both visual observation of the child and the
child’s ability to see out.
Post procedure
Record in the nurse’s notes:-
1. Date.
2. Time of starting and finishing O2 therapy.
3. Type of oxygen administration, system used.
4. The percentage of oxygen delivered and the flow rate.
5. The child’s vital signs, skin color, respiratory effort and lung
sounds.
6. The child’s response to the procedure and any teaching done
with the child or family.
Complications of Oxygen
therapy
1. Oxygen toxicity (Symptoms may include disorientation, breathing
problems, and visual changes such as cataract formation)

2. Depression of ventilation (Risk of respiratory depression)

in some patients with COPD if high concentrations of

oxygen administered (CO2 retains).

3. Retinopathy of Prematurity.
4. Fire hazard.
 Oxygen safety
Oxygen is not a flammable gas but it does support combustion
(rapid burning).

 Do not smoke in the vicinity of oxygen equipment.

 Turn off oxygen immediately when not in use.

 Oxygen cylinders should be secured safely to avoid injury.

 Do not store oxygen cylinders in hot places.

 Keep the oxygen equipment out of reach of children.