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%

Last modified: Wednesday, 10 March 2021, 1:02 PM