GROUP 1

OXYGEN
THERAPY
MEMBERS:
Cuadero Dayanan, B
Jurilla Lee
Pelomino Sinco
Learning Objectives:
● What is O2 therapy
● Purpose
● Types
● Indications
● Materials
● Administration (Infants, Children, Adults)
● Precautions
● Complications
● Nursing Responsibilities
 01.
DEFINITION
OXYGEN THERAPY
Oxygen therapy
● Administration of oxygen at concentrations
greater than room air (21%).

● Administered as a corrective treatment for

conditions resulting in hypoxia/hypoxemia.

Hypoxia - low levels of oxygen in the cells.

Hypoxemia - low oxygen levels in your blood.
 02.
PURPOSE
OXYGEN THERAPY
What is the Purpose of O2 therapy?
● Increases oxygen saturation in tissues where the saturation
levels are too low due to injury or illness.
● administered to correct the hypoxemia, relieve the
pulmonary vascular vasoconstriction, and reduce the
pulmonary hypertension.
● Serves as respiratory stimulant
● Soothe irritated mucous membranes
 03.
TYPES
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.
 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.

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.
 04.
INDICATION
OXYGEN THERAPY
● Hypoxemia/Hypoxia
● Acute Respiratory Failure
● Acute Myocardial Infarction
● Cardiac Failure
● Shock
● Anemia
● During CPR
● During anesthesia for surgery
 05.
MATERIALS
OXYGEN THERAPY
Low Flow System
Provide oxygen at flow rates that are lower than
patients' inspiratory demands; thus, when the
total ventilation exceeds the capacity of the
oxygen reservoir, room air is carried along.

ADVANTAGE
-Lightweight, comfortable, inexpensive,

Cannula continuous use with meals and activity

DISADVANTAGE
-Nasal mucosal drying, variable FiO2
 Oropharyngeal Catheter
ADVANTAGE
-Inexpensive, does not require a tracheostomy
DISADVANTAGE
-Nasal mucosal irritation; catheter should be
changed frequently to alternate nostrils

Mask, Simple
ADVANTAGE
-Simple to use, inexpensive
DISADVANTAGE
-Poor fitting, variable FiO2, must be removed to eat
Mask, Partial rebreather Mask, Non rebreather
ADVANTAGE ADVANTAGE
-Moderate O2 concentration -High O2 concentration
DISADVANTAGE DISADVANTAGE
-Warm, poor fitting, must be removed to -Poorly fitting
eat
 High Flow System
If the ventilatory demand of the patient is met completely by the
system, then it is a high-flow system. High flow oxygen therapy helps
reduce the effort your body needs to put into breathing. By decreasing
the effort of breathing and creating a small amount of positive pressure
in the upper airways, this therapy helps improve oxygen delivery.

ADVANTAGE
-Lightweight, comfortable,

Transtracheal inexpensive, continuous

use with meals and activity

catheter
DISADVANTAGE
-Nasal mucosal drying,
variable FiO2
Mask, Venturi
ADVANTAGE
-Provides low levels of
supplemental oxygen
-Precise FiO2, additional humidity
available
DISADVANTAGE
-Must be removed to eat

Mask, Aerosol
ADVANTAGE
-Good Humidity, accurate FiO2
DISADVANTAGE
-Uncomfortable for some
Tracheostomy collar
ADVANTAGE
-Good humidity, comfortable,
fairly accurate FiO2
DISADVANTAGE
-Uncomfortable for some

T-piece
ADVANTAGE
-Good humidity, fairly accurate
FiO2
DISADVANTAGE
-Heavy with tubing
Face Tent
ADVANTAGE
-Good humidity, fairly accurate
FiO2
DISADVANTAGE
-Bulky and cumbersome
ACCESSORIES
Reservoir Tubing - An Oxymizer
mustache or pendant can
increase the amount of oxygen
delivered or make the oxygen
last longer.

Humidifier Bottle - Higher oxygen

settings can be drying to the lining
of the nose. A humidifier attached
to your stationary oxygen
equipment can help prevent this
dryness.
Carrying Cases, carts -
Ambulatory oxygen tanks can
be rolled in small carts,
carried in backpacks and
sometimes even worn as a
waist pack. Portable oxygen
concentrators are rolled in
their own cases, worn in a
backpack on the back or
slung over the shoulder.

Reservoir bag - The reservoir

bag is connected to an
oxygen tank. The mask covers
both your nose and mouth.
Pulse oximeter - commonly
used portable device used to
obtain a patient’s oxygen
saturation level. Normal SpO2
is 95%-100%.

Oxygen Flow Meter - In

inpatient settings, rooms are
equipped with wall-mounted
oxygen supply outlets that are
nationally standardized in a
green color, whereas air outlets
are standardized with a yellow
color. Oxygen flow meters are
attached to the green oxygen
outlets, and then the
oxygenation device is attached
to the flow meter
Portable O2 Supply Device -
commonly used when
transporting a patient to
procedures within the hospital
or to other agencies

Bag Valve Mask (Ambu Bag) -

a handheld device used in
emergency situations for
patients who are not breathing
(respiratory arrest) or who are
not breathing adequately
(respiratory failure).
Mechanical Ventilator- a
machine attached to an
endotracheal tube to assist
or replace spontaneous
breathing. Mechanical
ventilation is termed
invasive because it requires
placement of a device
inside the trachea through
the mouth, such as an
endotracheal tube.
 06.
ADMINISTRATION
OXYGEN THERAPY
How to administer O2 therapy in infants
● medin nu flow nasal
cannula
● hydrocolloid fixation
pads
● tube connector.

● small with maximum flows of up

to 10 liters per minute
● medium with maximum flows of
up to 14 liters per minute
● large with maximum flows of up
to 23 liters per minute and
● extra large with maximum flows
of up to 27 liters per minute
there are two different
sizes of hydrocolloid
fixation pads included in
the set small and large
each pad

ensure that the prongs dont include

more than 50% of the nostrils on
color-coded markers
showing the outer
diameter of the cannula

● skin preparation
● skin should be dry and clean
hydrocolloid pad should be
at a body temperature

● take the hydrocolloid pads

● remove the protective film from
each one
● stick the pads either side on the
baby’s cheeks
● place each pad as close to the
nose as possible remove the
inner foil of each pad

● Remove the inner foil of each

pad
insert the nasal cannula
into the nose and seal the
upper adhesive foil over
the cannula by pressing
the foil over the tubes

With the medin nu flow nasal

cannula you are able to position the
tubes and the circuit individually to
suit the different the different body
position of the baby
 ● the fixation ring helps to guide
the tubes but avoid direct
contact between the fixation
ring and the patient
● Minimize skin irritation

the hydrocolloid pads can be open or

closed multiple times and therefore
don't need to be replaced after
therapy has been interrupted
You can use any other fixation
material to secure the nasal cannula
 BLENDER SYSTEM

CPAP devices with the high-flow optio

Ventilators with the high-flow option

 OXYGEN HOOD INFANT

● An oxygen hood is a rigid plastic dome

that encloses an infant's head. It
provides precise oxygen levels and
high humidity.
● The gas should not be allowed to blow
directly into the infant's face, and the
hood should not rub against the
infant's neck, chin, or shoulder.
How to administer O2 therapy in
CHILDREN and ADULTS
 OXYGEN TENT CHILDREN

● The tent consists of a rectangular, clear, plastic

canopy with outlets that connect to an oxygen
or compressed air source and to a humidifier
that moisturizes the air or oxygen.
● Because the enclosed tent becomes very
warm, some type of cooling mechanism is
provided to maintain the temperature at 20°C
to 21°C (68°F to 70°F).
● Cover the child with a gown or a cotton
blanket. Some agencies provide gowns with
hoods, or a small towel may be wrapped
around the head. The child needs protection
from chilling and from the dampness and
condensation in the tent.
● Flood the tent with oxygen by setting the flow meter at 15 L/min for about 5
minutes. Then, adjust the flow meter according to orders. Flooding the tent
quickly increases the oxygen to the desired level.

● The tent can deliver approximately 30% oxygen.

● Children may fight having a mask placed on their faces. They are often fearful
when placed in oxygen tents or hoods. These are normal responses that vary
based on experience, developmental stage, degree of threat to body image, and
attachment/abandonment issues. Providing safe toys and a beloved blanket or
pillow to hold can help, as can fostering the parent-child bond even though
separated by the plastic. Encourage parents to interact with their child around
and through the tubing and tent.
 Set up the oxygen equipment
and the humidifier.

● Attach the flow meter to the wall outlet or tank. The flow meter should
be in the off position.
● If needed, fill the humidifier bottle. (This can be done before coming to
the bedside.)
● Attach the humidifier bottle to the base of the flow meter.
● Attach the prescribed oxygen tubing and delivery device to the
humidifier.
 Turn on the oxygen at the
prescribed rate and ensure
proper functioning.

● Check that the oxygen is flowing freely through the tubing. There
should be no kinks in the tubing, and the connections should be
airtight. There should be bubbles in the humidifier as the oxygen flows
through. You should feel the oxygen at the outlets of the cannula, mask,
or tent.
● Set the oxygen at the flow rate ordered.
 Apply the appropriate oxygen
delivery device.

Cannula

● Put the cannula over the client's face, with the outlet prongs
fitting into the nares and the tubing hooked around the ears.

● If the cannula will not stay in place, tape it at the sides of the face.
● Pad the tubing and band over the ears and cheekbones as
needed.
 Apply the appropriate oxygen
delivery device.

Face Mask

● Guide the mask toward the client's face, and apply it from the
nose downward.
● Fit the mask to the contours of the client's face.

● Secure the elastic band around the client's head so that the mask
is comfortable but snug.
● Pad the band behind the ears and over bony prominences.
 Apply the appropriate oxygen
delivery device.

Face Tent

● Place the tent over the client's face, and secure the ties around the
head
 Assess the client regularly.

● Assess the client's vital signs, level of anxiety, color, and ease of
respirations, and provide support while the client adjusts to the
device. Some clients may complain of claustrophobia.
● Assess the client in 15 to 30 minutes, depending on the client's
condition, and regularly thereafter.
● Assess the client regularly for clinical signs of hypoxia, tachycardia,
confusion, dyspnea, restlessness, and cyanosis. Review oxygen
saturation or arterial blood gas results if they are available.
 Assess the client regularly.

Nasal Cannula

● Assess the client's nares for encrustations and irritation. Apply a

water-soluble lubricant as required to soothe the mucous
membranes.
● Assess the top of the client's ears for any signs of irritation from
the cannula tubing. If present, padding with a gauze pad may
help relieve the discomfort.

Face Mask or Tent

● Inspect the facial skin frequently for dampness or chafing, and dry
and treat it as needed.
 Inspect the equipment on a
regular basis.

● Check the liter flow and the level of water in the humidifier in 30
minutes and whenever providing care to the client.
● Be sure that water is not collecting in dependent loops of the
tubing.
● Make sure that safety precautions are being followed.

Document findings in the client record using forms or checklists

supplemented by narrative notes when appropriate.
 07.
PRECAUTIONS
OXYGEN THERAPY
Precautions
● Oxygen must be used as your
doctor ordered it. Too much or
too little can be harmful.
● Do not change the oxygen flow
rate on your own—this can lead
to serious side effects. If you feel
you are not getting enough
oxygen, contact your physician
and notify your home care
supplier.
Precautions
● When a cylinder is almost
empty, close the valve and mark
the cylinder as empty. Do not
store full and empty cylinders
together.
● If you have been prescribed
oxygen 24 hours a day you may
need a back-up oxygen cylinder.
Discuss with your doctor
whether this is the case for you.
Precautions
● Keep the oxygen at least 3
metres from any open flame or
heat source, such as candles or
a gas stove, or from anything
that could cause a spark.
● As the oxygen concentrator
becomes hot when in use, locate
it in a well-ventilated area, away
from curtains or drapes.
Precautions
● For home oxygen use or when
the facility permits smoking,
teach family members and
roommates to smoke only
outside or in provided smoking
rooms away from the client.
● Place cautionary signs reading
“No Smoking: Oxygen in use” on
the clients door, at the foot or
head of the bed, and on the
oxygen equipment.
Precautions
● Instruct the client and visitors
about the hazard of smoking
with oxygen use.
● Make sure that electric devices
(such as razors, hearing aids,
radios, televisions, and hearing
pads) are in good working order
to prevent the occurrence of
short-circuit sparks.
Precautions
● Avoids materials that generate
static electricity, such as woolen
blankets and synthetic fabrics.
Cotton blankets should be used ,
and client and caregivers should
be advised to wear cotton
fabrics.
● Avoid the use of volatile,
flammable materials such as
oils, greases, alcohol, ether, and
acetone(e.g. nail polish
remover), near clients receiving
oxygen.
Precautions

● Ground electric monitoring

equipment, suction machines
and portable diagnostic
machines.
● Make known the location of the
fire extinguishers, and make
sure personnel are trained in
their use.
Precautions
● Keep the oxygen system away
from aerosol cans or sprays,
including air fresheners or hair
spray. These products are very
flammable.
● Always store your oxygen
equipment in a well-ventilated
area.
● An oxygen cylinder must be
secured at all times; put it in a
cart or lay it down flat.
 08.
COMPLICATIONS
OXYGEN THERAPY
OXYGEN
TOXICITY
Occurrence Cause S&S
Oxygen toxicity may Overproduction of ● Substernal
occur when too high oxygen free radicals, discomfort
a concentration of which are byproducts ● Paresthesias
oxygen (greater than of cell metabolism. If ● Dyspnea
50%) is administered oxygen toxicity is ● Restlessness
for an extended untreated, these ● Fatigue
period (longer than radicals can severely ● Malaise
48 hours). damage or kill cells. ● Progressive
respiratory
difficulty
● Alveolar infiltrates
evident on chest
x-rays
SUPPRESSION OF
VENTILATION
Occurrence Cause Effects
In patients with Administration of a Decrease in alveolar
COPD, the stimulus high concentration ventilation can cause a
for respiration is a of oxygen removes progressive increase in
the respiratory drive arterial carbon dioxide
decrease in blood pressure (PaCO2),
oxygen rather than that has been
ultimately leading to the
an elevation in created largely by
patient’s death from
the patient’s chronic
carbon dioxide carbon dioxide narcosis
low oxygen tension. and acidosis.
levels.
OTHER
COMPLICATIONS
Danger of Prone to Hyperbaric
Fire bacteria oxygen toxicity
It is important to The nurse should Long term
post “no smoking” change the tubing hyperbaric O2
signs when oxygen according to therapy can lead to
is in use. infection control
policy and the type
pulmonary, optic
of oxygen delivery and central nervous
equipment. system toxicity
OTHER
COMPLICATIONS
Absorption Retinopathy of
atelectasis prematurity (ROP)
Given only pure Usually occur in low
oxygen results in the birth weight, very
collapse of the premature infant. That
dependent part of the is why in preterm
lungs as it quickly infants, 50-80 mmHg
taken up from the PaO2 is recommended
alveoli. It is also a risk in infants receiving
in general anaesthesia oxygen.
induction
 “This is a quote, words full of
wisdom that someone
important said and can make
the reader get inspired.”

—Someone Famous
 09.
NURSING
RESPONSIBILITIES
OXYGEN THERAPY
 BEFORE
● With all oxygen delivery systems, turn the oxygen on before
applying the mask.
● Explain procedure to the patient and gain consent where possible. In
patients who are acutely sick, this may not be possible and clinicians
should act in the patient’s best interests
● Gain the client’s cooperation. Inform the client of the therapeutic uses of
oxygen before bringing equipment into the room. Reassure the client and
family
● Place the oxygen mask on the patient’s face, adjusting the nose clip
and elastic straps to ensure a close fit
● Ensure pulse oximetry is available to monitor
response to oxygen therapy
● Document baseline observations including
saturations, respiratory rate, blood pressure and
pulse
● Check that there is a prescription for oxygen with a
stated target saturation range (except in peri-arrest
situation)
● Instruct the client not to change the position of the
mask, cannula, or any of the equipment after it is in
place.
● Make sure the tubing is patent at all times and that the
equipment is working properly
 DURING
● Continue to monitor oxygen saturations at least four times a day. Always record
saturations at rest and document FiO2 in situ at the time
● Help the patient to stay in an upright position to maximise ventilation unless
contraindicated by underlying clinical problems, for example, spinal or skeletal
trauma
● Observe potential pressure areas, particularly behind the ears, from nasal cannula
tubing or mask elastic and ensure skin is protected and pressure is relieved by
altering the position of the tubing or using padding
● Refer for respiratory physiotherapy if patients have difficulty clearing thick secretions
 DURING

● Consider discontinuing oxygen therapy once the patient has stable saturations
(at least two consecutive recordings) within their target range on low-dose
oxygen.

● Closely monitor the patient’s respiratory response to oxygen administration

via physical assessment, pulse oximetry, and/or arterial blood gases.

● Record how effectively the patient performs the therapy.

 AFTER
● Be aware of, and understand, local oxygen policy/guidelines
● Demonstrate a basic understanding of oxygen physiology, normal and abnormal
values
● Be able to discuss the indications for oxygen and the potential risks
● Demonstrate an ability to use oxygen equipment safely, including an awareness
of fire risks and cylinder use
● Demonstrate an ability to use a pulse oximeter to determine oxygen saturations
● Demonstrate accurate monitoring and recording of oxygen therapy
● Be able to recognise changes in a patient’s respiratory status
● Understand how to use oxygen in emergency situations, for example, cardiac
arrest
 AFTER
● Demonstrate an understanding of target range prescriptions and applications to
different patient groups
● Demonstrate an ability to assess suitability of delivery devices for individual
patients and recognise when a change of device is needed
● Be able to correctly identify and set up a range of oxygen-delivery devices
● Understand how to select appropriate oxygen/driving gas for nebulised therapy
● Demonstrate accurate recording of adjustments to the oxygen dose and the
patient’s response
● Recognise the need for escalation of treatment/medical review and further
assessment
 Sources
- www.nursingtimes.net
-https://www.healthline.com/health/oxygen-thera
py#benefits
-http://what-when-how.com/nursing/oxygen-thera
py-and-respiratory-care-adult-care-nursing-part-1
-2/
-https://www.slideshare.net/sivanandareddy52/ox
ygen-therapy-48527928
-https://www.physio-pedia.com/Oxygen_Therapy
-https://wtcs.pressbooks.pub/nursingskills/chapter
/11-3-oxygenation-equipment/