Oxygen Administration

and Airway Management

EDNA WATTS, MSN, RN
REVISED MAY 2020

Concept: Gas Exchange SLOs 1, 2, 3, 4, 5, 6

 Discuss the different types
of oxygen delivery devices

Discuss different types of

Objectives airway management
devices

Demonstrate tracheostomy
suctioning and care
“The goal of Oxygen administration is to
supply the patient with adequate
oxygen to maximize the oxygen carrying
ability of the blood” (Lewis, Dirksen,
Heitkemper, & Bucher, 2017, p. 589).
 Low – Flow Delivery Devices
Oxygen concentrations will vary with patients respiratory
pattern because patient’s minute
ventilation exceeds supplemented oxygen flow

 Nasal Cannula (1 - 6 L)
*Delivering 4-6L of O2 via a nasal
cannula should have humidification
 Simple Face Mask (6 -12 L)
*Never use below 5 L
 Partial and Non-Rebreather Masks (10
– 15 L)
*Make sure bag stays inflated
High – Flow Delivery Devices
Oxygen concentrations are fixed by supplying an oxygen
concentration at a flow equaling or exceeding the
patient’s inspiratory flow demand

 High Flow Nasal Cannula

 *More comfortable than a mask

 Tracheostomy Collar
 *Can be used with a Venturi device

 Tracheostomy T Bar
 *Used to attach to ventilator and in-line suctioning

 Venturi Mask
 *Make sure air entrainment ports are not occluded
 Airway Management

Oropharyngeal
and
Nasopharyngeal
airways How do you determine which one to use?
Airway Management

Endotracheal tube (ETT)

Tracheostomy tube
Tracheostomy Equipment

 Tie strings
 Flange
 Outer cannula
 Cuff
 Balloon
 Inner cannula
 Obturator
  Obtain  Connect catheter to
suctioning/tracheostomy suction tubing (one hand
kit is designated as
contaminated)
 Assess if patient needs
suctioning  Supply 100% O2 if
indicated
 Explain procedure to
patient  Suction small amount of
sterile water to check
 Position patient in semi- suction
Fowler’s position
 With the sterile hand, insert
 Place towel on patient’s suction catheter the
Tracheostomy
chest length of the
 Adjust suction 120-150 mm tracheostomy tube
without applying suction
Suctioning 
Hg
Wash hands and put on  Apply intermittent suction
goggles and withdrawal the
suction catheter with a
 Use sterile technique to rotating motion
open suction kit
 Suction sterile water to
 Fill cup with sterile water clear suctioning tubing
 Don sterile gloves
Suctioning

 Do not instill normal saline

before suctioning

 Each pass should last less

than 10 - 15 seconds

 Allow 30 – 60 secs between

each pass

 Repeat procedure 2- 3 times

Tracheostomy care

 Wash hands and don clean gloves and goggles

 Remove soiled dressing
 Remove gloves and perform hand hygiene
 Using sterile technique open tracheostomy care kit
 Pour sterile water or NS into two compartments in sterile basin
 Don sterile gloves
 Unlock and remove inner cannula (if present)with non-dominant hand
(contaminated)
 Dispose if indicated or
 Immerse in sterile solution and clean with pipe cleaners/brush
 Rinse in sterile solution and dry with a pipe cleaner
Tracheostomy care

 Replace inner cannula

 Remove dried secretions from stoma using 4x4 gauze soaked in sterile
solution
 Clean under faceplate with cotton swabs using a circular motion
 Use dry gauze and dry stoma and flange by lightly patting
 Change ties
*one at a time and always with an assistant
 Place dressing
*never cut gauze
Questions?
Reference

 Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., & Bucher, L. (2014). Medical-
Surgical Nursing: Assessment and Management of Clinical Problems (9th
ed.). St. Louis: Elsevier.
 Potter, P., Perry, A. G., Stockert, P., 2017, Fundamentals of Nursing, 9th ed.,
St. Louis, MO, Elsevier, Inc.
 Eldridge, L., 2020, How an Endotracheal Tube Is Used Understanding the
purpose, procedure, and possible risks, VeryWellHealth, About, Inc.
 MayoClinic.org, 1998-2020, retrieved at https://www.mayoclinic.org/tests-
procedures/tracheostomy/about/pac-20384673