Oxygen therapy
Definition of Oxygen:
Oxygen is colorless, odorless, tasteless gas that is essential for the
body to function properly and survive.
The air that human breathe contain approximately 21% oxygen.
The heart relies on oxygen to pump blood. If not enough oxygen
is circulating in the blood, it's difficult for tissues of the heart to
keep pumping.
Definition:
Is the administration of oxygen at a concentration of pressure
greater than found in the environmental atmosphere.
It is the administration of oxygen as a medical intervention for a
variety of purposes in both chronic & acute patient care.
Indications:
Acute respiratory failure.
Cardiac failure.
Acute myocardial infarction.
Shock.
Anemia .
During anesthesia for surgery.
Purpose:
Torelieve hypoxemia results from respiratory or cardiac
emergency.
To decrease respiratory effort.
To decrease work load of the heart.
Types:
1- High flow rate 2- Low flow rate
13-15L/min 1-13L/min.
60-80% 40-60%
By ambo By all methods
Sources for oxygen therapy:
Wall-outlet source Portable source
-Oxygen is supplied from central For transporting oxygen dependent
source through a pipeline.
clients, in home use.
- Only flowmeter and humidifier
are required.
Methods:
1. Simple face mask.
2. Nasal cannula.
3. Hood (head box) .
4. Oxygen tent.
Methods:
Incubator.
Ambu bag.
Venturi mask (T. tube).
1- Simple face mask
Advantages:
Available in wide variety of size.
Suitable for all ages.
Maximum flow rate 5-8L/m, it delivers
40% to 60% oxygen.
Ability to provide predictable concentration of oxygen whether
child breathes through nose or mouth.
Disadvantage:
Child may not tolerate the mask.
Not suitable for long term therapy.
The O2 concentration is depend on the security of
Eating talking disrupts oxygen delivery.
2- Nasal Cannula
Advantages:
Suitable for all ages.
Prongs allow considerable mobility.
Doesn't distort child visual field.
Flow rate 1-6L/m, it deliver 24to 44%.
Provision of constant O2 flow even while child eats or talks.
Disadvantages:
Young children often resist cannula.
May irritate nasal mucosa.
Restrain may be needed.
Difficulty of controlling O2 concentration if child breaths
through mouth.
3- Head box (hood)
Advantages: Disadvantages:
* Available at any size. * Limit access to the head.
* Maximum flow rate (10L/m). * High humidity environment.
* Facial movement isn't *Need to remove box during
restricted. feeding and *providing care to
patient.
4- Mist tent
Advantages:
Tent allows older children considerable mobility.
Maximum flow rate (10L/m).
Disadvantages:
Steady O2 concentration difficult
to maintain.
Child feel isolated.
Cool and wet tent environment.
Poor access to patient.
Equipment:
O2 source (cylinder or central piping system).
Delivery equipment.
Oxygen flow meter.
Oxygen tubing.
Humidification attachment.
No smoking sign.
Disposable gloves.
Water soluble lubricant (for catheter insertion).
Procedures of nasal cannula, mask or hood
Steps:
•Perform hand hygiene.
.
•Select proper size of cannula or mask.
•Remove all friction toys form the area and display no smoking signs.
•Connect the flow meter to either oxygen source wall unit or freestanding
tank.
•Connect the humidifier to oxygen setup.
Steps:
Following instruction for particular oxygen setup and fill reservoir with sterile water.
Attach tubing to oxygen source.
Connect the distal of oxygen tubing to delivery device (cannula, mask or hood).
Turn on flow meter to the prescribed amount.
Feel oxygen flowing through the system.
Place child in supine semi fowler's position.
For nasal cannula: For mask:
Place nasal prong inside external Place the oxygen mask over the mouth
meatus of the nares. and nose.
Instruct child to breathe through his or Tighten the straps attached to the mask
her nose. until you can easily fit one finger between
the strap and the face of the child.
notes For oxygen hood:
Connect the unit to oxygen source.
Place the hood on the crib or bed so the child's head is inside the unit.
The hood should not rest on child's neck and the child should be able to turn or her
head side to side easily.
Encourage family and other staff to limit amount of time the child is outside of hood.
Evaluation of response:
O2 saturation (SpO2) with normal by pulse oximeter.
Breathing pattern regular and normal rate.
Pink color in nail beds, lips, conjunctiva of eyes.
No confusion, disorientation, difficulty with cognition.
Complications:
Eye: Retro lental fibroplasia
Abnormal proliferation of fibrous tissue immediately behind the lens of
the eye leading to blindness due to excessive administration of oxygen.
O2 dependency.
Oxygen toxicity:
A condition resulting from harmful effect of increasing partial pressure
of oxygen
Absorption atelectasis
A condition resulting if large volume of nitrogen in the lungs is
replaced with oxygen, the oxygen may be absorbed in the blood,
reducing the volume of the alveoli which lead to alveolar collapse.
