OXYGEN INHALATION Slide 2 DEFINITION Slide 3 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 Slide 4 Slide 5 PURPOSES OF
OXYGEN INHALATION Slide 6 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 Slide 7 COMMON INDICATIONS FOR OXYGEN ADMINISTRATION
Slide 8 Cyanosis: Bluish discoloration of skin, nail buds, mucus
membranes, resulting from a decreased amount of oxygen in the
hemoglobin of the blood. Slide 9 Breathlessness or labored
breathing: By some diseases such as - emphysema, pulmonary
embolism, coronary thrombosis etc. Slide 10 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 Slide 11 ARTICLES NEEDED FOR OXYGEN ADMINISTRATION Slide
12 Oxygen source - 02 cylinder, central supply Slide 13 Oxygen
instrument according to methods like oxygen mask, oxygen hood,
nasal prongs, nasal catheter, oxygen tent or canopy Slide 14
Humidifier Slide 15 Flow meter Slide 16 Gauze pieces Adhesive tape
Slide 17 No smoking' signs Slide 18 Spinner to open the main valve
of oxygen cylinder Slide 19 Bowel with water to check the patency
of the tube Slide 20 METHODS OF OXYGEN ADMINISTRATION Slide 21
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 Slide 22 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
Slide 23 Slide 24 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. Slide 25 Slide 26
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. Slide 27 Slide 28 PROCEDURES Slide 29 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 Slide 30 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 Slide 31 NURSING PRINCIPLES Slide 32
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 Slide 33 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.
Slide 34 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. Slide 35 COMPLICATIONS OF 0XYGEN ADMINISTRATIONS Slide 36
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. Slide
37 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. Slide 38 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. Slide 39
IMPORTANT INSTRUCTIONS FOR OXYGEN INHALATION Slide 40 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. Slide 41 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. Slide
42 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. Slide
43 While oxygen administration, paste the "No Smoking" signs, near
the patient bed or on the door. Proper recording and reporting
should be followed Slide 44
