Oxygen inhalation
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OXYGEN
INHALATION
Dr. Jayesh Patidarwww.drjayeshpatidar.blogspot.com
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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
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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
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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
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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
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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
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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
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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