SAM COLLEGE OF NURSING,
BHOPAL (M.P.)
PROCEDURE
ON
OXYGEN THER
SUBMITTED TO:-
MS. SANI S GEORGE
H.O.D. OF MEDICAL SURGICAL
NURSING
SUBMITTED BY:-
MR. FIROJ KHAN
M.Sc. NURSING, PREVIOUS YEAR
BATCH – 2021-22
OXYGEN THERAPY
INTRODUCTION-
The goal of oxygen administration is to treat or prevent hypoxemia. Oxygen is
considered a medication and is therefore administered in the lowest possible concentration to
produce the most acceptable oxygenation without causing toxicity.
GUIDELINES:
Oxygen may be administered by use of a nasal cannula, mask, mist tents, or hoods
when the oxygen level is below normal or the demand is increased.
Oxygen therapy may be a respiratory therapist or registered nurse or any licensed
practical nurse.
The need for oxygen, the type of delivery system and the amount of oxygen
administered are determined by the physician.
Restrict use of ignition sources in child’s room when oxygen is in use.
Secure cylinders of oxygen in upright position.
During oxygen administration, the child should not wear clothing made of synthetic
fabric that can build up static electricity.
Oils and oil – based petroleum products should not be used on the child when oxygen
is in use.
EQUIPMENTS:
NASAL CANNULA OR MASK
Oxygen flow meter
Oxygen tubing
Paper tape
Humidification attachment ( if ordered )
No smoking sign
MIST TENT OR HOOD
Oxygen flow meter
Oxygen tubing, tent or hood
Humidifier and sterile water
Water absorbent material, such as chux
Extra baby blankets or bath blankets
No smoking sign
MODES OF OXYGEN DELIVERY:
Method of delivery Percentage of O2 delivery Liter flow
1. NASAL CANNULA 21% oxygen plus 3% per liter 0.5 – 6L/min
Maximum of 2L/min
for newborns and
infants
2. NASAL CATHETER
FiO2 varies with the child’s inspiratory
flow. < 3L/min
3. O2 HOOD
Can deliver FiO2 upto 100% 7 – 15 L /min
4. O2 TENT
Up to 40% - 50% FiO2 7 – 15L/min
( MIST TENT )
24% - 50% FiO2
5. VENTURI MASK
35% - 50% FiO2 3 – 15L/min
6. SIMPLE FACE
MASK
5 – 10L/min
7. PARTIAL RE –
40% - 60% FiO2
BREATHING MASK
8. NON RE- 60% - 95% FiO2 6 – 10L/min
BREATHING MASK
65% - 95% FiO2
9. BAG VALVE MASK
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10. O2 - POWERED 6 – 10L/min
DEVICE
10 – 15L/min
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OXYGEN ADMINISTRATION NASAL CANNULA OR MASK:
PROCEDURE:
STEPS RATIONALE
1. Wash hands. Gather all equipment. To prevent infection.
Select proper size of cannula or mask.
2. Remove all friction toys or open
Sparks or static electricity will ignite oxygen.
flames from the area and display “no
smoking sign”.
3. Connect the flow meter to either the
oxygen wall unit or free standing
tank. Allows for the oxygen to flow from the
source at the prescribed rate.
4. Connect the humidifier to the oxygen
setup.
Humidified air is less drying to the nares and
5. Following instructions for the to the lungs.
particular oxygen setup, fill reservior
with sterile water.
Use of sterile water prevents microbial
6. Attach tubing to the oxygen source. growth.
Check all electrical equipments in
area to ensure that it is grounded.
7. Turn on flow meter to the prescribed
amount and check to see if you feel
Allows oxygen to flow from source to the
oxygen flowing through the system.
patient.
For nasal cannula: In infants and
newborns flow shoud be limited to a
maximum of 2L/min Ensures that the child will actually be
For older children and adolescents to receiving the amount of oxygen the
be maintained at 6L/min. physician deemed necessary.
For mask: flow rates can vary from 5
to 10L/min. rebreathing of carbon
dioxide may occur if total oxygen
flow is inadequate.
8. Place the nasal prongs just inside the
external meatus of the nares. Either
loop the head attachment around the
child’s ears and tighten it under the
chin or loop it around and behind the
child’s head and tighten.
9. Instruct child to breathe through his or
her nose.
This allows the oxygen to flow in closest
proximity to the respiratory system of the
FOR MASK:
child.
10. With the elastic straps very loose,
place the oxygen mask over the head
of the child so that the oxygen tubing
travels downward and away from the
child’s head.
11. Tighten the straps attached to the
mask until you can easily fit one
finger between the strap and the face Provides the prescribed oxygen.
of the child.
TENT OR HOOD:
1. Wash hands. Gather all equipments.
This position ensures that the mask is not
2. Remove all friction toys or open placed upside down.
flames from the area and display “ no
smoking signs”.
3. line area that the hood or tent will
cover on the bed with a water
A properly secured mask will allow the
absorbent material such as chux.
prescribed amount of oxygen to flow into the
4. Connect the humidifying unit to the respiratory system. Irritation may result from
tent or hood.
tight application.
5. Following the manufacturer’s
instructions, fill the reservoir with
sterile water.
To prevent infection.
6. Connect the unit to the oxygen source.
Sparks or static electricity will ignite the
For tents: oxygen.
7. Secure the top layer of the oxygen tent
by tucking the ends under the
Humidity from oxygen delivery system will
mattress. Secure the top and sides of
the unit to the bed by tucking the cause the sheets and mattress to become
plastic under the mattress or placing
soaked with moisture in a very short time.
sheeting material over the ends of the
plastic. Place the child inside the tent.
8. Turn on the oxygen/humidifying unit
Moistened oxygen is less drying to the
to the prescribed setting. Measure
oxygen concentration close to the respiratory system.
child’s nose and mouth. Adjust
oxygen to ordered concentration.
9. As the top layer of the blankets Sterile water is less likely to grow bacteria
becomes wet, remove it, leaving the
and clog the system with minerals.
next dry blankets exposed.
10. As moisture condenses on the sides of
the unit, wipe it off periodically with a
towel.
11. Encourage family and other staff to This allows the oxygen to move from the
limit the amount of time that the unit
source to the child
open. Provide diversional activities
for the child.
For Hood:
Leaks will decrease fraction of inspired
12. Place the hood on the crib or bed so
oxygen levels.
that the child’s head will be inside the
unit. The hood should not rest on the
child’s neck, and the child should be
able to turn his or her head side to
side easily.
13. Turn on the oxygen or humidifying
unit to the prescribed setting.
Ensure that the ordered oxygen concentration
14. Encourage family and other staff to
level is available.
limit the amount time that the child is
outside of the hood.
Dry sleeping area decreases discomfort.
Status of the child can be evaluated by direct
observation.
Limiting the amount of time that the unit is
open will maximize the quality of the oxygen
therapy.
Prevents obstruction of the airway.
Ensure that the ordered oxygen concentration
level is available.
Limiting the time that the unit is open will
maximize the quality of oxygen therapy.
CHILD AND FAMILY EVALUATION:
Evaluate the child’s and family level of understanding of how and why oxygen
therapy is being used.
Discuss safety concern with the family, giving special attention to avoidance of
smoking, open flames and electrical or friction toys.
Evaluate and document the respiratory status of the child.
Document the time the oxygen, type of oxygen deliver system, setting of the flow
meter and the frequency and the length of time that the hood or tent is open.
Skin status for redness or irritation at pressure points of straps or cannula.
