Oxygen Therapy
Linda Winn, RN, MSN Ed., BA Ed.
OxygenMedication
Requires MD orderSide Effects
Highly combustible gasClearOdorless
Set-up is part of initial room check
Indications for O2 therapy
GoalPrevent or relieve hypoxia
Keep SaO2 > 90%
Reduce work of breathingRoom Air / FIO2 = 21%
Used with hypoxia due to:Respiratory DisordersCardiovascular disordersCentral nervous system disorders
Safety PrecautionsO2 sign posted
No smoking or flames
Electrical equipment grounded
Check tank level before transport
No oil-based lubricants / lotions
Delivery DevicesNasal CannulaMasks
Simple facePartial rebreathingNon-rebreathingVenturi (Venti Mask)
TracheostomyCollar
VentilatorFlow MeterHumidification
Oxygen Safety
Nasal CannulaAdvantages
Safe, simple, tolerated wellAllows eating and drinkingCan humidify
DisadvantagesEasily dislodged
Check regularlySkin breakdown
Check regularly
O2 Concentrations1L/min = 24%2L/min = 28%3L/min = 32%
Simple Face MaskRA enters via side holes
AdvantagesHumidified
DisadvantagesImprecise FIO2High FIO2 needed to prevent rebreathing CO2
Concentrations5-6L/min = 40%6-7L/min = 50%>7L/min = 60%
Partial Rebreather MaskUsed for short-term high O2 concentrations
Must keep bag partially inflated at all times
AdvantagesLightweightEasy to use
DisadvantagesMust fit snuglyCannot use high humidificationNot for use with COPDUncomfortable
Non-rebreather MaskUse
Valve prevents air from flowing back into bag
Last step, usually, before intubation
AdvantagesHigh O2 concentrationsAccurate
DisadvantagesCan’t use high humidityuncomfortable
Venturi MaskVenti-mask
High flowAdjustable
AdvantagesVery preciseMask of choice for
COPD
Disadvantagesuncomfortable
O2 and COPDHistorically…
Never give O2 >2L/min to COPD pts.
However…
“There has been concern regarding the dangers of administering O2 to COPD pts and reducing their drive
to breath.”
“This has been a pervasive myth but is not a serious threat.”
“In fact, not providing adequate O2 to these patients is much more detrimental.”
Lewis, p. 643 (7th ed.)
Oropharngeal SuctioningOral cavity onlyClean technique, wear glovesInsert catheter into mouth, then apply suctionEncourage coughing to assist removal of secretionsClear catheter with waterStore in clean, dry area for reuseAssess before and after to evaluate effectiveness
Yankauer suction catheter