Oxygen therapy Objectives: • Understand the reasons for requiring oxygen therapy. • Be able to set up oxygen equipment.
Oxygen therapy Oxygen is required for the functioning and survival of all body tissues and deprivation for more than a few minutes is fatal.
Oxygen therapy • In immediately life threatening situations oxygen should be administered. • Local policies will reflect when oxygen that has not been prescribed may be administered and by whom.
Oxygen therapy When to use oxygen therapy? • Hypoxaemia. • Acute hypotension. • Breathing inadequacy. • Trauma. • Acute illness. • CO poisoning. • Severe anaemia. • During the peri-operative period.
Oxygen therapy To ensure safe and effective treatment remember: • Oxygen is a prescription drug. • Prescriptions should include – • Flow rate. • Delivery system. • Duration. • Instructions for monitoring.
Oxygen therapy Oxygen delivery methods: • All systems require. • Oxygen supply. • Flow meter. • Oxygen tubing. • Delivery device. • (Humidifier).
Oxygen therapy Delivery devices: • Non-rebreathing mask. • Simple facemask. • Nasal cannulae (nasal prongs/speculae). • Venturi mask.
Oxygen therapy Non-rebreathing mask • Allows the delivery of high concentrations of oxygen (85% at 15 litres/min). • Has a reservoir bag to entrain oxygen. • One way valves prevent room and expired air from diluting the oxygen concentration. • A tight seal is essential. • Reservoir bag must be seen to expand freely.
Oxygen therapy Simple facemask • Easy to use. • Allows administration of variable concentration dependant on flow of fresh gas up to 40%. • Requires a good fit.
Oxygen therapy Nasal cannulae • Easy to use. • Well tolerated. • Comfortable for long periods. • Patient can eat and talk easily. • Possible to deliver oxygen concentrations of 24-40% at flow rates of 1-6 litres/min. • Flow rates in excess of 4 litres/min might cause discomfort and drying of mucous membranes and are best avoided.
Oxygen therapy Venturi mask • Mixes a specific volume of air and oxygen. • Useful for accurately delivering low concentrations of oxygen. • Valves are colour coded and flow rate required to deliver a fixed concentration is shown on each valve. • Can deliver oxygen concentrations between 24-60%.
Oxygen therapy Humidification • Is recommended if more than 4 litres/min is delivered. • Helps prevent drying of mucous membranes. • Helps prevent the formation of tenacious sputum.
Oxygen therapy Oxygen concentrations will be affected with all delivery systems if not fitted correctly or tubing becomes kinked and ports obstructed.
Oxygen therapy • Information to patient. • Support and reassurance. • Confidence and compliance.
Dangers of oxygen therapy • Ignition hazard. • Risk of respiratory depression in some patients with COPD if high concentrations of oxygen administered (CO2 retainers).
Oxygen Therapy Summary • Oxygen therapy can be life saving therapy. • Treat like any other drug. • Be familiar with the principles of oxygen delivery and different devices