Skill Page - Oxygen Therapy

13 DEC 2014

Oxygen therapy

Jofin, EMS Student

OBJECTIVES:
- Define the oxygen therapy
- Types of  oxygen therapy
- Purpose of using the oxygen therapy
- List Complication of oxygen therapy

OXYGEN THERAPY

Definition:
Oxygen is a colorless, odorless, tasteless gas that is essential for the body to function properly and to survive.

MEANING OF O₂ THERAPY
Oxygen therapy is the administration of oxygen at a concentration of pressure greater than that found in the environmental atmosphere
The air that we breathe contain approximately 21% oxygen
Supplemental oxygen is used to treat medical conditions in which the tissues of the body do not have enough oxygen.
 
PURPOSE -
- Oxygen therapy is a key treatment in respiratory care.
- The purpose is to increase oxygen saturation in tissues where the saturation levels are too low due to illness or injury.

OXYGEN THERAPY IS USED TO TREAT    
Example in case :-
- Documented hypoxemia
- Severe respiratory distress (acute asthma or pneumonia)
- Severe trauma
- Chronic obstructive pulmonary disease (COPD, including chronic bronchitis, emphysema, and chronic asthma)
- Pulmonary hypertension
- Acute myocardial infarction (heart attack)
- Short-term therapy, such as post-anesthesia recovery
- Oxygen may also be used to treat chronic lung disease patients during exercise .

SOURCES OF OXYGEN:
1. Cylinder                    
2. Wall outlets

1- USING OXYGEN CYLINDERS -
- The oxygen cylinder is delivered with a protective cap to prevent accidental force against the cylinder outlet.
- To release oxygen safety and at a desirable rate, a regulator is used. It consists of two parts.

PREPARATION -
- A physician's order is required for oxygen therapy, except in emergency use.
- Clinical observations.
- Oxygen supplemental is determined by inadequate oxygen saturation.
- Pulse Oximetry

PULSE OXIMETRY

CAUTIONS FOR OXYGEN THERAPY -
- Oxygen toxicity – can occur with FIO2 > 50% longer than 48 hrs
- Suppression of ventilation – will lead to increased CO2 and carbon dioxide narcosis
- Danger of fire
- Infection

Methods of Oxygen Administration -
CLASSIFICATION OF OXYGEN DELIVERY SYSTEMS
Low flow systems
- contribute partially to inspired gas client breathes
- do not provide constant FIO2
- Ex:  nasal cannula, simple mask , non-re breather mask , Partial rebreather mask
High flow systems
- deliver specific and constant percent of oxygen independent of client’s breathing
- Ex: Venturi mask,, trach collar, T-piece

METHODS OF OXYGEN ADMINISTRATION
1- Nasal cannula

 

NASAL CANNULA (PRONGS):
- It is a disposable.
- plastic devise with two protruding prongs for insertion into the nostrils, connected to an oxygen source.
- Used for low-medium concentrations of Oxygen   (24-44%).

FACE MASK -
- The simple Oxygen mask
- The non rebreather mask:
- The venturi mask

THE SIMPLE OXYGEN MASK
- Simple mask is made of clear, flexible , plastic or rubber that can be molded to fit the face.
- It is held to the head with elastic bands.
- Some have a metal clip that can be bent over the bridge of the nose for a comfortable fit.

THE SIMPLE OXYGEN MASK -
- It delivers 35% to 60% oxygen .
- A flow rate of 6 to 10 liters per minute.
- It has vents on its sides which allow room air to leak in at many places, thereby diluting the source oxygen.
- Often it is used when an increased delivery of oxygen is needed for short periods
   (i.e., less than 12 hours).

THE NON REBREATHER MASK -
This mask provides the highest concentration of
oxygen (95-100%) at a flow rate6-15 L/min.
except two one-way valves prevent conservation of exhaled air.
The bag is an oxygen reservoir

 

THE NON REBREATHER MASK    -
- When the patient exhales air.
- The one-way valve closes and all of the expired air is deposited into the atmosphere, not the reservoir bag.
- In this way, the patient is not rebreathing any of the expired gas.

 

VENTURI MASK -
- It is high flow concentration of oxygen.
- Oxygen from 40 - 50%
- At liters flow of 4 to 15 L/min.
- The mask is so constructed that there is a constant flow of room air blended with a fixed concentration of oxygen

THE VENTURI MASK - is designed with wide- bore tubing and various color - coded jet adapters.
Each color code corresponds to a precise
oxygen concentration and a specific liter flow
The venturi system,
Room air dilutes the oxygen entering the tubing to a certain concentration
The amount of air drawn in is determined by the size of the orifice (jet adapter).

TRACHEOSTOMY COLLAR/ MASK -
- Inserted directed into trachea
- Is indicated for chronic o2
- therapy need
- O2 flow rate 8 to 10L
- Provides accurate FIO2
- Provides good humidity.
- Comfortable ,more efficient
- Less expensive

T-PIECE -
- Used on end of ET tube when weaning from ventilator
- Provides accurate FIO2
- Provides good humidity

SIDE EFFECT  & COMPLICATION OF OXYGEN THERAPY  -
- Oxygen toxicity
- Retrolental fibroplasia
- Absorption atelectasis

OXYGEN TOXICITY -
It is a condition in which ventilator failure
- occurs due to inspiration of a high concentration of oxygen for a prolonged period of time.
- Oxygen concentration greater than 50% over 24 to 48 hours can cause pathological changes in the lungs.

Signs and symptoms of oxygen toxicity:
• Non-productive cough.
• Nausea and vomiting.
• Substernal chest pain.
• Fatigue.
• Nasal stuffiness.
• Headache.
• Sore throat.
• Hypoventilation.
• Nasal congestion.
• Dyspnea.
• Inspiration pain.

EVALUATION:
- Breathing pattern regular and at normal rate.
- Pink color in nail beds, lips, conjunctiva of eyes.
- No confusion, disorientation, difficulty with  cognition.
- Arterial oxygen concentration or hemoglobin
- Oxygen saturation within normal limits.

DOCUMENTATION:
- Date and time oxygen started.
- Method of delivery.
- Oxygen concentration and flow rate.
- Patient observation.
- Add oronasal care to the nursing care plan