OXYGEN
INHALATION
DEFINITION
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 causes
PURPOSES
OF
OXYGEN
INHALATION
•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 complications
COMMON
INDICATIONS
FOR
OXYGEN
ADMINISTRATION
Cyanosis: Bluish discoloration of skin,
nail buds, mucus membranes, resulting
from a decreased amount of oxygen in the
hemoglobin of the blood.
Breathlessness or labored breathing: By some
diseases such as - emphysema, pulmonary
embolism, coronary thrombosis etc.
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
Hemorrhage
ARTICLES
NEEDED
FOR
OXYGEN
ADMINISTRATION
Oxygen source - 02 cylinder, central
supply
Oxygen instrument according to methods
like – oxygen mask, oxygen hood, nasal
prongs, nasal catheter, oxygen tent or
canopy
Humidifier
Flow meter
Gauze pieces
Adhesive tape
‘No smoking' signs
Spinner to open the main valve of oxygen
cylinder
Bowel with water to check the patency of
the tube
METHODS
OF
OXYGEN
ADMINISTRATION
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
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
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.
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.
PROCEDURES
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
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
NURSING
PRINCIPLES
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
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.
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.
COMPLICATIONS
OF
0XYGEN
ADMINISTRATIONS
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.
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.
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.
IMPORTANT
INSTRUCTIONS
FOR
OXYGEN
INHALATION
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.
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.
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.
While oxygen administration, paste
the "No Smoking" signs, near the
patient bed or on the door.
Proper recording and reporting
should be followed