Oxygen therapy

Authors: Rednenko V.V.

Editor: Rednenko V.V.

Equipment for the practical skill:

• one of the oxygen sources
  • hospital central oxygen pipeline

• • portable oxygen inhaler with oxygen cylinder

• • oxygen concentrator

• oxygen humidifier

• flowmeter or pressure reducer with oxygen speed regulator

• oxygen connecting tube

• mask or nasal catheter
• standard nasal catheter (nasal cannula)

• • simple mask (for oxygen of fixed concentration)

• • variable oxygen concentration mask (with venturi valves)

• • reservoir bag mask

• distilled sterile water

Clinical situation:

• You are the doctor on duty at the district hospital. A patient with 87% oxygen saturation was admitted. Give the patient oxygen therapy. The nasal passages are free.

Order of the skill performance:

Preparatory stage:

• inform the patient about oxygen therapy
• obtain verbal consent to the procedure (if conscious)
• make hygienic hand antisepsis
• put on clean gloves

Maine stage:

• prepare the oxygen therapy device 
• pour distilled water heated to 30 ° C into the oxygen humidifier to the set level
• connect the oxygen humidifier to the oxygen source through the oxygen supply port (directly or through a connecting tube)
• connect the connecting tube to the oxygen outlet port of the oxygen humidifier
• attach the selected mask or nasal catheter to the connecting tube
  • nasal catheter is designed to supply oxygen-air mixture with an oxygen concentration of 25-60%
  • simple mask - 40-60%
  • mask with variable concentration of oxygen supply - 28%, 31%, 35%, 40%, 60%
  • mask with reservoir bag - up to 100%
• turn on the oxygen supply regulator (open the valve)
• make sure oxygen is supplied (bubbles appear in the humidifier)
• adjust the oxygen flow rate using a flowmeter or reducer (typically 2 to 15 l / min) to provide the required oxygen concentration in the inhaled mixture (optimal concentration 40-60%)
  • when using a nasal catheter - an oxygen flow of 1 L/min provides an oxygen concentration in the respiratory mixture of 24%, and an increase in the flow for each next 1 L/min (in the range of 2-8 L/min) increases the concentration by another 4%
  • when using a simple mask - at a flow of 5-8 L/min (5-6 L/min - 40%, 6-7 L/min - 50%, 7-8 L/min - 60%); do not use a flow <5 L/min given the risk of re-inhalation of exhaled CO2 and increased resistance during inhalation
  • when using a mask with variable oxygen concentration, use the manufacturer's recommendations
• put on the patient a mask or mark the cannulas in the nasal passages, fix them on the head

Last stage:

• monitor the effectiveness of oxygen therapy - pulse oximetry
• adjust the oxygen supply rate to obtain SрO2 94–98%