OXYGEN ADMINISTRATION

Introduction:

A continuous supply of oxygen is essential for all the cells of the body.
Oxygen is necessary to control anoremia, which may be caused due to lack of
oxygen in the inspired air, depressed respiratory centre or indiquate gaseous at
the lung level.

Definition:

Method by which oxygen is supplemented at higher percentage than what

is available is atmospheric air.
Or
 Oxygen (O2) is administered as a corrective treatment for conditions
resulting in hypoxia (low level of Oxygen in the cells.)

Purposes:

 To increase the oxygen tension in blood plasma.

 To re-store oxy-hemoglobin in RBC.
 To decrease the work of breathing.
 To improve hypoxemia & hypoxia.
 To decrese myocardial work.

Indications:
 Hypoxia
 Cynosis
 Hammorhage & air hunger
 Anemia
 Asphyxia
 Shock & circulatory failure
 Tachycardia or tachyphoea.
 Poisoning with chemicals.

Method of oxygen administration:

 Nasal cannula or nasal catheter

 Mask method
 Simple mask
 Venture mask
 Partial re-breathing mask
 Non re-breathing mask
 Face tent
 T-bars & tracheotomy masks
 Oxygen tent
  Closed incubator or isolates
 Oxygen hood

1. Nasal cannula or nasal catheter:

 These are short tube inserted into the naso-pharynx. It is removed every
8 hours & new catheter is used in other nostrils alternatively.

Amount maintained according to age:

 For infants 1 Litre per min

  For toddlers 2 Litre per min
 For preschoolers 4 Litre per min

Pocedure:
Sr. No. Nursing action Rationale
1 Determine current vital signs level Provide baseline for future
of consciousness & most recent assessment.
ABG.
2 Make sure the humidifier iss filled Humidification may not be
to the appropriate mark. ordered if the flow rate is greater
than or equal to 4 litre per min.

3 Place the tip of the cannula in the Inspect skin behind ears
patient’s nose & adjust straps periodically for irritation or
around ears for smug comfortable breakdown.
fit.
4 Avoiding use of petroleum gelly to I may clog openings of cannula.
lubricate areas.

Advantages:

1. Safe & simple, comfortable & easily tolerated.

2. They do not interfere with feeding.
3. Allow movements.

Disadvantages:

1. Cannot deliver concentration higher than 45%.

2. Invasive procedure
3. Headache or dry mucosa.

2. Mask Method:

Types of mask:
(A) Simple mask:

 O2 entry at the bottom of the mask.

 Exits through large holes on the sides
 Allow inspired O2 concentration of upto 40-60%.
(B) Venturi mask:

 O2 enters by way of a jet at a high velocity.

 Mask output ranges from approximately 97 litre/min to approximately
33 litre/min.
(C) Partial Re brething masks:

 It has an inflatable bag that stores 100% oxygen.

 On inspiration, the pt. inhales from the mask & bag.
 On expiration the bag refills with oxygen.
(D)Non Re-breathing marks:
 It has one way valve between the bag & mask to prevent the exhaled air
from entering the bag, on inspiration.
Sr. No. Nursing Action Rationale
1 Use a mask that is capable of Venture mask deliver low to
delivering the desired CO2 moderate concentration of
concentration oxygen.
2 Place the mask over the child's Make sure mask is adjusted
mouth and nose. properly over the mouth and
nose.
3 Remove the O2 mass at hourly Make the patient feel more
intervals, wash the face & Dry. comfortable.

4 Do not use mask for comatose Such children are more likely to
infants and children. vomit.

3. Face Tent:
Sr. No. Nursing Action Rationale
1 These devices are used to Face tent combine the positive
deliver O2 to intubated PTS quantities or aerosol mask.

2 Flow of 8 to 10 hours should be Larger children will required

used to flush the systems and higher flows
provide a stable CO2
concentration

4. T-Bars and Tracheotomy mask:

 A catheter inserted into the base of the neck.

 An incision is made just below the cricoids cartilage and above the
isthmus of thyroid gland.
Sr. No. Nursing Action
1 the flow rate must be set to
minimum volume requirement
of the child and to provide a
hundred percent source of gas
Rationale
T-Bars requires a short flexible
tube on the distal end and to act
as a Reservoir and prevent room
air entrapment

5. Oxygen tent:

 This is also called the canopy.

 O2 concentration in the tent is about 30% to 50%.
 Amount of Administration would depend upon the size of the tent (4-6
L/Min).
Sr. No. Nursing Action Rationale
1 Place a Macintosh under the O2
tent

2 Flush the tent with 8 litre of

oxygen per minute

3 Pad the metal frame that This protects the child from injury.
support the canopy.

4 Maintain a tight fitting canopy. This prevent O2 leakage.

6. Closed incubator or isoletter:

 newborns weighting less than 1000 gram are placed in the incubators.
Sr. No. Nursing Action Rationale
1 The incubator is used to provide The unit is able to provide
a control environment for the environment control of
neonate. temperature, O2 humidity
2 Adjust the O2 flow to achieve Refer The table below
the desired O2 concentration.

7. Oxygen hood:

 it is a small box like chamber to fit just the head of an infant.

 Sr. No. Nursing Action Rationale
1 Warmed humidified O2 is This especially is useful when high
supplied through a plastic concentration of O2 are desired.
container that fit over the child
head.
2 continuously monitor the O2 Oxygen should be warmed to 31
concentration temperature andto 34 degrees Celsius (87.8-93.2
humidity inside the Hood Fahrenheit)
3 open the hold and remove the This prevents fluctuation of heat
baby from its and O2 which may further
deliberate the young Infant.
Precautions to be taken while administering oxygen:

1. O2 cylinder should be checked to see that it is filled

2. A child may be placed in propped up position.
3. O2 flow rate should be adjusted before insertion.
4. For most of the conditions 40-60% concentrations of O2 is given
5. The extent of time during which these children receive CO2 must be
determined accurately

Dangers of O2 therapy:

1. Atelectasis may occur if the child has an Airway obstruction.

2. Infection
3. Drying of the mucus membrane of the respiratory tract.
4. O2 Toxicity.
5. O2 induced Opnea.

BIBLIOGRAPHY

1. Gupta Piyush, Essentials of pediatric nursing, 1st edition(2004),AP Jain and co. Page no
23-31
2. Marlow Dorothy. R, Textbook of paediatric nursing; 6th edition, Saunders Elsevier,
Missouri, Page no- 315
3. Wilson. Hockenberry and Kline. Winkelstein, Nursing care of infants and children; 7th
edition, Elsevier publisher, Newdelhi, page no-240-247
4. Basavanthappa B. T, Paediatric and child health nursing; 1st edition, Altuja publishing
house, New Delhi.
5. Ghai 0. P, Essential of Paediatrics; 6th edition, CBS Publishers and distributors, New
Delhi, Page no- 137-147.