oxygen inhalation

OXYGEN

INHALATION

Dr. Jayesh Patidarwww.drjayeshpatidar.blogspot.com

1

DEFINITION

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Administration of oxygen is a process of

providing the 02 supply to child for the

treatment of low concentration of 02 in the

blood. Children with respiratory dysfunctions

are treated with oxygen inhalation to relieve

anoxaemia or hypoxaemia (deficiency of oxygen

in the blood). The normal amount of oxygen in

the arterial blood should be in the range of 80 to

100 mm of Hg. If it falls below 60 mm of Hg;

irreversible physiologic effects may occur. The

oxygen administration treats the effects of

oxygen deficiency but it does not correct the

underlying causes9/17/2014

3www.drjayeshpatidar.blogspot.com

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PURPOSESOF

OXYGEN INHALATION

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•To manage the condition of hypoxia

•To -maintain the oxygen tension in blood plasma

•To increase the oxy hemoglobin in red blood cells

•To maintain the ability of cells to carry out the normal metabolic function

•To reduce the risk of complications9/17/20146


COMMON INDICATIONS

FOROXYGEN

ADMINISTRATION

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Cyanosis: Bluish discoloration of skin,

nail buds, mucus membranes, resulting

from a decreased amount of oxygen in the

hemoglobin of the blood.

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Breathlessness or labored breathing: By some

diseases such as - emphysema, pulmonary

embolism, coronary thrombosis etc.

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Anemia

Diseases such as - pulmonary edema,

pneumonia, chest trauma etc

Environment with low oxygen content e.g.

high attitudes

Poisoning with chemicals that alter the

tissues ability to utilize oxygen e.g.

cyanide poisoning

Hemorrhage9/17/2014


ARTICLES NEEDED

FOR OXYGEN

ADMINISTRATION

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Oxygen source - 02 cylinder, central

supply

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Oxygen instrument according to methods

like – oxygen mask, oxygen hood, nasal

prongs, nasal catheter, oxygen tent or

canopy

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Humidifier

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Flow meter

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Gauze pieces

Adhesive tape

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‘No smoking' signs

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Spinner to open the main valve of oxygen

cylinder

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Bowel with water to check the patency of

the tube

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METHODSOF

OXYGENADMINISTRATION

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Oxygen administration depends upon

the condition of child, age, concentration

desired, facilities available and the

preference of the doctor. Oxygen

administration can be given continuously or

intermittently. It depends on the

requirement of the child. It is given in 40 to

60 percent concentration. There are

following methods of oxygen administration

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ADMINISTRATION OF 02 BY NASAL CATHETER

This is very common method of 02 administrations in hospital settings. A catheter is inserted into the nostril reaching up to the uvula and is held in place by adhesive tapes

This catheter does not interfere with the Childs freedom to eat, to talk and to move on the bed. Catheter no. 4 to 6 is used and it should be 7.5 to 10 cm inserted in the naso pharynx. The catheter should be removed every 8 hourly, and new catheter should be inserted by using other nostril alternatively. Catheter method is used for the older children. The amount of oxygen should be 4 liter per minute 9/17/2014


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ADMINISTRATION OF OXYGEN BY THE MASK

Today, there are various face masks available that cover the Childs mouth and nose for 02 administration. The mask size should be according to the child's size. It should be properly fitted and if it does not fit properly, 02 will be lost from the mask. It should be removed after every four hours and-wine the face. The masks are advantageous for those patients who are unable to breathe through nose. The flow of oxygen should be about 2-3 litre for young children and 1-2 litre/minute for the infants.

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ADMINISTRATION OF OXYGEN BY THE TENT METHOD

The oxygen tent method consists of a canopy over the patients bed, that cover the patient fully or partially. Oxygen tent is made up of plastic material, transparent and prevent absorption of oxygen. The lower part of the canopy is tucked under the bed to prevent the escape of oxygen. There are certain advantages and disadvantages for using a oxygen tent method.

Oxygen tent provides the environment for the patient with controlled oxygen concentration, temperature regulation and humidity control.

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PROCEDURES

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Assemble the 02 headbox

Place the headbox properly covering

head, face and neck.

Seal the opening of headbox around neck

to minimize 02 leaking

Attach thermometer probe to head box via

aperture or use disposable thermometer

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Adjust 02 and air flow rates to achieve

prescribed oxygen concentration the

total flow should be between 6 and 8

liters per minute to prevent

accumulation of carbon dioxide in the

head box.

Place sensor of oxygen analyzer into

headbox alongside infant's nose (within 8

cm) to check oxygen concentration in

headbox

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NURSING

PRINCIPLES

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Monitor oxygen concentration hourly

Check frequently for loose connections in the

circut

Ensure position of oxygen analyzer sensor is

close to infant's nose and not in mainstream of

the oxygen hose

Maintain the infant's head inside the headbox

Fill humidifier to appropriate level with

distilled water PRN

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G. Maintain inspired gas temperature as

indicated below

Weight in kg 0.5 1 2 3 4

Temperature=C 35-37 34-36 33-35 31-34 30-33

All procedures through open incubator doors or

with infant partially out of the incubator should

be carried out with the infant in headbox or with

a mask connected to gas supply, and close to the

infant's nose.

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DISADVANTAGES

•It creates a feeling of isolation.•It requires high volume of oxygen which is not easily available.•When tent is opened, there is loss of 02 concentrations•It has more chances of fire.•It requires more time and cleanliness to maintain a tent.

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COMPLICATIONS OF

0XYGEN ADMINISTRATIONS

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Infection: By using the contaminated

equipments, the causative organisms can be

present in such places as tracheotomy or

endotracheal tubes, catheters, humidifying

water and masks etc.

Drying of mucus membrane of the respiratory

tract: It can occur when oxygen is

administered without sufficient humidity. It

can cause irritation and drying of the mucus

membrane.

Combustion (fire) : 02 itself does not burn, but

it supports combustion.9/17/2014


Oxygen toxicity: Symptoms of toxicity includes

tracheal irritation and cough.

Atelectasis: Collapse of alveoli develops as a

result of increased oxygen concentration in the

inspired air. This is due to elimination of

nitrogen.

Oxygen induced apnoea: The carbon dioxide is

washed off completely from the blood by a high

concentration of oxygen. The respiratory center

is not stimulated sufficiently.

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Asphyxia: Patient who receives 02 by

masks and close tents must be protected

from asphyxia.

Retrolental fibroplasia: The hazards of

oxygen may affect the eyes. It is noted in

premature infants who have a high

concentration of oxygen inhalation.

Some others are - Bronchopulmonary,

dysplasia, respiratory depression, seizure

disorders and epilepsy.9/17/2014


IMPORTANTINSTRUCTIONS

FOR OXYGEN

INHALATION

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Oxygen should be prescribed in specific

dose. It acts as a drug and cause oxygen

toxicity.

Always use humidifier and regulator.

All the articles should 'be cleaned and use

the disposable nasal catheter and change the

nasal

catheter every 8 hourly.

Lubricate the nasal catheter before inserting.

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Control valve of cylinder should be adjusted only

when catheter is out of nose. or during

oxygenation, do not alter the valve.

Discontinue of oxygen should be gradually.

Leave a calling signal or bell near the patient

while going away from the patient.

Keep in close observation conditions, which can

interfere with the flow of oxygen from the source

to the patient.

Keep ready one cylinder to prevent the

deprivation of oxygen. 9/17/201441


Give oxygen in low concentration to the

premature babies to prevent the.

retrolental fibroplasia.

Continuously monitoring of patient to find

out the oxygen toxicity symptoms.

Empty cylinder should mark "empty" and

keep separately from full cylinders.

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While oxygen administration, paste

the "No Smoking" signs, near the

patient bed or on the door.

Proper recording and reporting

should be followed

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Thank

You

oxygen inhalation

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