S C P M COLLEGE OF NURSING AND PARAMEDICAL SCIENCES, GONDA

ASSIGNMENT ON

“Oxygen therapy”

SUBJECT: PAEDIATRIC NURSING

SUBMITTED TO: SUBMITTED BY:

……………………. Pushpanki Varun

HOD M.sc Nursing(1st year)

Dept. Of child health nursing

SUBMITTED ON:
 OXYGEN THERAPY

Oxygen, a gas found in the air we breathe, is necessary for human life. Some people with
breathing disorders can’t get enough oxygen naturally. They may need supplemental oxygen, or
oxygen therapy. People who receive oxygen therapy often see improved energy levels and sleep,
and better quality of life.

Who needs oxygen therapy-

Oxygen therapy is prescribed for people who can’t get enough oxygen on their own. This is often
because of lung conditions that prevents the lungs from absorbing oxygen, including:

 chronic obstructive pulmonary disease (COPD)

 pneumonia

 asthma

 bronchopulmonary dysplasia, underdeveloped lungs in newborns

 heart failure

 cystic fibrosis

 sleep apnea

 lung disease

 trauma to the respiratory system

To determine whether a person will benefit from oxygen therapy, doctors test the amount of
oxygen in their arterial blood. Another way to check is using a pulse oximeter that indirectly
measures oxygen levels, or saturation, without requiring a blood sample. The pulse oximeter
clips onto a person’s body part, like a finger. Low levels mean that a person may be a good
candidate for supplemental oxygen.
Normal levels of arterial blood oxygen are between 75 and 100 mmHg (millimeters of mercury).
An oxygen level of 60 mmHg or lower indicates the need for supplemental oxygen. Too much
oxygen can be dangerous as well, and can damage the cells in your lungs. Your oxygen level
should not go above 110 mmHg.

Some people need oxygen therapy all the time, while others need it only occasionally or in
certain situations. Some oxygen therapy is done at a doctor’s office, and other times people have
an oxygen supply in their homes, or a portable oxygen system.

Symptoms of low oxygen-

When you aren’t getting enough oxygen, you’ll experience a host of symptoms, including:

 rapid breathing

 shortness of breath

 fast heart rate

 coughing or wheezing

 sweating

 confusion

 changes in the color of your skin

If you experience any of these symptoms, seek immediate medical attention.

Procedure steps flow chart-
Oxygen delivery systems

Oxygen delivery systems are categorised into low-flow and high-flow systems. Low-flow
systems provide lower oxygen flow than the actual inspiratory flow (∼30 L·min−1). When the
patient inspires, the oxygen is diluted with room air, and the degree of dilution depends on the
inspiratory flows. Therefore, these oxygen delivery systems do not allow for accurate calculation
of the inspiratory oxygen fraction (FIO2). High-flow oxygen delivery systems provide higher
oxygen flows and the FIO2 is stable and is not affected by the patient's type of breathing.

Low-flow oxygen delivery systems

Nasal cannula

A nasal cannula is the most common oxygen delivery system, used for mild hypoxia. It delivers
oxygen into the nasopharyngeal space and can be set to deliver between 1 and 6 L·min −1 (24–
40% ). increases by approximately 4% with each litre of oxygen per minute. Nasal cannulae are
widely used in domiciliary oxygen devices. An oxygen flow >6 L·min −1 should be avoided as it
can dry the nasal mucosa and can disturb sleeping patterns. A nasal cannula is convenient as the
patient can talk and eat while receiving oxygen, and it is easy to use. However, it can be easily
dislodged and is not as effective in patients with deviated septum or polyps.

Simple face mask

A simple face mask can be set to deliver between 5 and 10 L·min −1 (35–55% FIO2) and is
indicated when a moderate amount of oxygen is needed. It fits over the patient's mouth and nose,
and has side exhalation ports through which the patient exhales carbon dioxide. Humidified air
may be added if the oxygen concentrations are causing nasal mucosa dryness. The mask's
efficiency relies on how well it fits. Eating and drinking can be difficult with the mask on and it
can be confining for some patients, who may feel claustrophobic with the mask on.

Non-rebreather mask

A non-rebreather mask is a low-flow device with high 2. It uses a reservoir bag (∼1000 mL) to
deliver a higher concentration of oxygen. A one-way valve between the mask and the reservoir
bag prevents the patient from inhaling expired air. It can be set to deliver between 10 and 15
L·min−1 (80–95% oxygen). Oxygen flow <10 L·min−1 can cause the bag to completely collapse
during inspiration. FIO2 depends on the patient's pattern of breathing. This mask is useful in
severely hypoxic patients who are ventilating well, but it carries the risk of carbon dioxide
retention and aspiration in case of vomiting.
Transtracheal oxygen catheter

Transtracheal oxygen catheters (TTOCs) can be effective in palliating breathlessness and

hypoxaemia. The TTOC delivers oxygen directly into the trachea and it is inserted
percutaneously into the trachea using Seldinger technique. However, TTOC placement has not
gained widespread popularity as only a few physicians are trained to insert the TTOC or manage
patients with it, and there is also a widespread reservation towards performing this invasive
procedure on hypoxaemic, elderly, frail patients.

High-flow oxygen delivery systems

Rebreather mask

Unlike the non-rebreather mask, there is no one-way valve between the rebreather mask and the
reservoir bag and the inspired oxygen and expired air are collected in the reservoir bag.

Venturi mask

A Venturi mask is a high-flow device that allows precise measurement of delivered. It consists of
a bottle of sterile water, corrugated tubing, air/oxygen ratio nebuliser system, a drainage bag, and
a mask (e.g. aerosol face mask, tracheostomy mask, T-piece, a face tent). The oxygen flow
exceeds the patient's peak expiratory flow. Therefore, it is unlikely for the patient to breathe in
air from the room. A Venturi mask utilises different sized ports to change the delivered (24–
50%) . The oxygen flow are clearly stated on the bottom of each port.it does not dry mucous
membranes, but it is confining for some patients, and it interferes with talking and eating. It is
particularly useful in COPD patients, where precise oxygen delivery is crucial .

High-flow nasal cannula

A high-flow nasal cannula consists of a flow generator, an air-oxygen blender, a humidifier and a
nasal cannula. The flow generator can provide gas flow up to 60 L·min −1, and the blender
escalates FIO2 up to 100% while the humidifier saturates the gas mixture (at 31–37°C). The
heated humidified oxygen is delivered to a wide-bore nasal prong. The flow rate and FIO2 can be
independently titrated based on the patient's flow and FIO2 requirements. Overall, high flows and
humidification improve functional residual capacity and mucociliary clearance of secretions, and
thereby they reduce the work of breathing .

Oxygen hood

An oxygen hood is a plastic dome or box with warmed and humidified oxygen inside. The
oxygen hood is used for babies who can breathe on their own but still need extra oxygen.
Oxygen tent
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. Some devices cover only a part of
the face. Oxygen tents are sometimes confused with altitude tents as used by athletes and those
looking to acclimatize to a higher altitude, but those contain a reduced oxygen content.
This form of treatment is often prescribed in conditions where people have difficulty in
breathing. An oxygen tent can be used in either a hospital setting or outside a health-care facility,
and can be recommended for short- or long-term therapy.
Typically the tent is made of transparent plastic material. It can envelop the patient’s bed with
the end sections held in place by a mattress to ensure that the tent is airtight. The enclosure often
has a side opening with a zipper.

What are the different types of oxygen therapies?

There are a number of different types of oxygen therapies that can be used. These include:

 oxygen gas

 liquid oxygen

 oxygen concentrators

 hyperbaric oxygen therapy

Oxygen gas
Oxygen gas can be stored in a portable tank. These are called compressed gas systems. A larger
stationary concentrator is used within the home, and a smaller oxygen tank can be taken to use
outside the home. The smaller tanks might be used along with oxygen-conserving devices so that
the oxygen supply lasts longer. The oxygen is delivered in pulses, not continuously.

Liquid oxygen

Liquid oxygen also can be stored in a portable tank. Liquid oxygen is more highly concentrated,
so more oxygen can fit in a smaller tank. This is helpful for people who are very active, but it
will evaporate if it isn’t used in a timely manner. These tanks are refillable.

Both liquid oxygen and oxygen gas are available for home delivery in many locations.

Oxygen concentrators

Oxygen concentrators are less portable than the other options. An oxygen concentrator is a
device that takes oxygen from the room, concentrates it for therapeutic use, and removes other
naturally occurring gases. The benefits of concentrators are that they are less expensive and don’t
require filling like tanks. Portable versions are available. However, most models are too large to
be truly portable.

Oxygen is distributed from the tank through a tube. It enters the lungs through nasal tubes, a face
mask, or a tube inserted directly into the person’s windpipe.

Hyperbaric oxygen therapy

Hyperbaric oxygen therapy is unlike the other methods of oxygen therapy. People will breathe in
pure oxygen in a pressurized room or chamber. In the hyperbaric chambers, the air pressure is
increased to three or four times the normal air pressure levels. This increases the amount of
oxygen delivered to the body’s tissue. This type of oxygen delivery is often used to treat wounds,
serious infections, or bubbles of air in your blood vessels. Hyperbaric therapy should be carried
out carefully so that blood oxygen levels don’t become too high.

Delivery methods

The most common delivery method is the nasal cannula, which consists of a tube that runs
through both nostrils. Other delivery methods include:

 the nonrebreather mask

 the incubator (for infants)

 continuous positive airway pressure (CPAP)

Benefits of oxygen therapy-

Oxygen therapy can be extremely beneficial for those who frequently experience low oxygen
levels, regardless of the reason. If needed, regularly utilizing oxygen therapy can allow people to
be more active and mobile by decreasing shortness of breath. It also can significantly improve
quality of life, and in many cases extend life expectancy.

Oxygen therapy can also reduce symptoms such as:

 headaches

 irritability

 fatigue

 swollen ankles

Oxygen therapy can help the growth and development of children who have chronic lung
conditions. It can also lessen symptoms such as headaches caused by low oxygen levels, and
behavioral changes or problems.

Guidelines for using oxygen therapy-

Your doctor will write you a prescription to begin oxygen therapy. They’ll tell you how to use it
and how often you should use it. This will include the flow rate, or how much oxygen you’ll
need per minute. It is essential that you follow all of your doctor’s specific instructions. If you
don’t think the oxygen therapy is working for you, see them before making any changes.

Some people only need oxygen during certain activities, like exercising or sleeping. Other people
need oxygen constantly. Most types of oxygen therapy come with portable oxygen tanks so you
can leave home with them if necessary.

Do not use drugs or alcohol while taking oxygen therapy, as they can slow your breathing. When
discussing oxygen therapy with your doctor, make them aware of any other prescription
medications you may be taking.

Safety considerations for oxygen therapy-

Even though oxygen is not a flammable gas, it’s also necessary for combustion. Fires in areas
with excessive oxygen are likely to burn more quickly. Be cautious with oxygen tanks around
open flames and heaters, and be sure to store oxygen tanks safely.

Safety tips

 Do not smoke or have open flames in the room where a person is using oxygen.

 Place more fire alarms throughout the home to help prevent serious complications.

 When cooking, keep oxygen away from the stove, oven, and any grease.

 To avoid tripping over the oxygen tank or tubing, tape the tube to the back of your shirt.

 Only store oxygen in an area where air moves freely around the tank. Do not store it in a
trunk or a small closet.

Outlook for people who use oxygen therapy-

Many people who need supplemental oxygen live normal, active lives. In many cases, the
oxygen therapy helps make activity easier, increases stamina, and decreases shortness of breath.
In some cases, oxygen therapy can increase life expectancy.

Even people who need ongoing therapy due to chronic conditions can live normal lives. Once a
person learns to manage the oxygen equipment, the therapy doesn’t have to limit their routine.

Oxygen therapy in infants

Babies with heart or lung problems may need to breathe increased amounts of oxygen to get
normal levels of oxygen in their blood. Oxygen therapy provides babies with extra oxygen.

Information

Oxygen is a gas that the cells in your body need to work properly. The air we breathe normally
contains 21% oxygen. We can receive up to 100% oxygen.

How is oxygen delivered

There are several ways to deliver oxygen to a baby. Which method is used depends on how much
oxygen is needed and whether the baby needs a breathing machine. The baby must be able to
breathe without assistance to use the first three types of oxygen therapy described below.

An oxygen hood or “head box” is used for babies who can breathe on their own but still need
extra oxygen. A hood is a plastic dome or box with warm, moist oxygen inside. The hood is
placed over the baby's head.

A thin, soft, plastic tube called a nasal cannula may be used instead of a hood. This tube has soft
prongs that gently fit into the baby's nose. Oxygen flows through the tube.

Another method is a nasal CPAP system. CPAP stands for continuous positive airway pressure.
It is used for babies who need more help than they can get from an oxygen hood or nasal
cannula, but do not need a machine to breathe for them. A CPAP machine delivers oxygen
through tubes with soft nasal prongs. The air is under higher pressure, which helps the airways
and lungs stay open (inflate).
Finally, a breathing machine, or ventilator, may be needed to deliver increased oxygen and
breathe for the baby. A ventilator can give CPAP alone with nasal prongs, but can also deliver
breaths to the baby if the baby is too weak, tired, or sick to breathe. In this case, the oxygen
flows through a tube placed down the baby's windpipe.
Risk of oxygen

Too much or too little oxygen can be harmful. If the cells in the body get too little oxygen,
energy production decreases. With too little energy, cells may not work well and may die. Your
baby may not grow properly. Many of the developing organs, including the brain and heart, may
be injured.

Too much oxygen can also cause injury. Breathing too much oxygen can damage the lung. For
babies who are born very prematurely, too much oxygen in the blood may also lead to problems
in the brain and eye. Babies with certain heart conditions may also need lower levels of oxygen
in the blood.

Your baby's health care providers will closely monitor and try to balance how much oxygen your
baby needs. If you have questions about the risks and benefits of oxygen for your baby, discuss
these with your baby's provider.

The risk of oxygen delivery system

Infants receiving oxygen by hood may get cold if the temperature of the oxygen is not warm
enough.

Some nasal cannulas use cool, dry oxygen. At higher flow rates, this can irritate the inner nose,
causing cracked skin, bleeding, or mucus plugs in the nose. This can increase the risk for
infection.

Similar problems can occur with nasal CPAP devices. Also, some CPAP devices use wide nasal
prongs that can change the shape of the nose.

Mechanical ventilators have a number of risks as well. Your baby's providers will closely
monitor and try to balance the risks and benefits of your baby's breathing support. If you have
questions, discuss these with your baby's provider.

Alternative Names
Hypoxia - oxygen therapy in infants; Chronic lung disease - oxygen therapy in infants; BPD -
oxygen therapy in infants; Bronchopulmonary dysplasia - oxygen therapy in infants

Images
 Oxygen hood
 Lungs - infant
 Bibliography-

1 ) https://www.healthline.com/health/oxygen-therapy

2) https://medlineplus.gov/ency/imagepages/19869.htm

3) https://en.wikipedia.org/wiki/Oxygen_tent

4) https://breathe.ersjournals.com/content/15/3/e108