1. ADMINISTRATION OF OXYGEN
SHARON HARVEY

2. LEARNING OUTCOMES THE STUDENT SHOULD BE ABLE TO:
REVIEW THE PHYSIOLOGICAL REQUIREMENTS OF THE BODY FOR OXYGEN. IDENTIFY WHEN OXYGEN THERAPY MAY BE NEEDED FOR AN ADULT AND CHILD
DEMONSTRATE HOW OXYGEN THERAPY SHOULD BE PRESCRIBED USING A PRESCRIPTION/MEDICATION CHART

3. LEARNING OUTCOMES
DISCUSS THE SAFE AND EFFECTIVE DELIVERY OF OXYGEN THERAPY WITH PARTICULAR REFERENCE TO:
USE OF COMMON DELIVERY APPARATUS (FACEMASKS, NASAL CANNULA) FOR ADULT AND CHILD
SAFETY CONSIDERATIONS (THE CORRECT FLOW RATE, AVOIDANCE OF NAKED FLAME)
STORAGE AND DELIVERY OF OXYGEN IN CLINICAL AREAS

4. LEARNING OUTCOMES
DISCUSS THE PATIENT’S EXPERIENCE WHEN UNDERGOING OXYGEN THERAPY
IDENTIFY EFFECTIVE NURSING INTERVENTIONS TO SUPPORT THE PATIENT, E.G. ORAL HYGIENCE, ADEQUATE FLUID INTAKE, CORRECT POSITIONING TO ACHIEVE MAXIMUM VENTILATION OF LUNGS
DISCUSS THE INDICATIONS AND CONTRAINDICATIONS FOR A CHILD AND ADULT:
NASOPHARYNGEAL AND OROPHARYNGEAL SUCTIONING
LOWER AIRWAY SUCTIONING
SUCTIONING OF THE TRACHEOSTOMY

6. OXYGENATION OXYGEN – A PRESCRIBED DRUG
MUST BE WRITTEN LEGIBLY BY THE DOCTOR
PRESCRIPTION SHOULD BE DATED BY THE DOCTOR
DOCTOR MUST INDICATE DURATION OF O2 THERAPY
THE O2 % CONCENTRATION MUST BE PRESCRIBED
THE FLOW RATE MUST BE PRESCRIBED

7. INDICATION FOR OXYGEN THERAPY
ACUTE RESPIRATORY FAILURE
ACUTE MYOCARDIAL INFARCTION
CARDIAC FAILURE
SHOCK
HYPERMETABOLIC STATE INDUCED BY TRAUMA, BURNS OR SEPSIS
ANAEMIA
CYANIDE POISONING
DURING CPR
DURING ANAESTHESIA FOR SURGERY

8. OXYGEN DELIVERY SYSTEMS

9. BASIC COMPONENTS OF A OXYGEN DELIVERY SYSTEM
PIPED OR PORTABLE CYLINDER OXYGEN SUPPLY
A REDUCTION GAUGE
FLOW METER (LITRES/MIN)

10. BASIC COMPONENTS OF A OXYGEN DELIVERY SYSTEM
DISPOSABLE TUBING OF VARYING DIAMETER AND WIDTH
MECHANISM FOR DELIVERY (MASK OR CANNULA)
HUMIDIFIER (TO WARM AND MOISTEN THE O2

11. METHODS OF ADMINISTERING OXYGEN
SIMPLE SEMI-RIGID MASKS
NASAL CANNULA
FIXED PERFORMACE MASKS OR HIGH-FLOW MASKS (VENTURI)
T-PIECE CIRCUIT
PAEDIATRIC CIRCUITS - HEADBOX OR HOOD
- O2 TENT/COT
TRACHEOSTOMY MASK
MECHANICAL VENTILATION
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP)

12. HUMIDIFICATION OF OXYGEN
NORMAL AIR TRAVELLING THROUGH THE AIRWAYS IS WARMED, MOISTENED AND FILTERED BY EPITHELIAL CELLS OF THE NASOPHARYNX
THE AIR ENTERING THE TRACHEA WILL HAVE A RELATIVE HUMITY OF 90% AND A TEMPERATURE OF BETWEEN C
OXYGENATION WILL CAUSE DEHYDRATION OF THE MUCUS MEMBRANES AND PULMONARY SECRETIONS
HUMIDITY IS ESSENTIAL FOR PATIENTS WHO HAVE AN ENDOTRACHEAL OR TRACHEOSTOMY TUBE

13. HUMIDIFICATION REQUIREMENTS
HUMIDIFICATION AND TEMPERATURE SHOULD NOT BE AFFECTED BY THE FLOW RATE
SAFETY ALARMS SHOULD GUARD AGAINST OVERHEATING, OVER HYDRATION AND ELECTRIC SHOCK
NO INCREASED RESISTENCE TO RESPIRATION
WIDE BORE TUBING (ELEPHANT) SHOULD BE USED TO ALLOW SUFFICIENT FORMATION OF WATER VAPOUR

14. HEALTH AND SAFETY ISSUES WITH O2
MEDICAL GAS CYLINDERS HAVE TO CONFORM TO COLOUR CODING
CURRENTLY OXYGEN CYLINDERS ARE BLACK WITH WHITE SHOULDERS.

15. HEALTH AND SAFETY ISSUES WITH OXYGEN
OXYGEN IS COMBUSTIBLE
OIL AND GREASE AROUND CONNECTIONS SHOULD BE AVOIDED
ALCOHOL, ETHER AND INFLAMMATORY LIQUIDS SHOULD BE KEPT SEPARATE FROM O2
NO ELECTRICAL DEVICES NEAR 02 TENT
NO SMOKING
FIRE EXTINGUISHER NEEDS TO BE AVAILABLE
CARE WITH USING DEFIBRILLATOR NEAR HIGH OXYGEN CONCENTRATIONS

16. POTENTIAL PROBLEMS CO2 NARCOSIS
CO2 LEVELS IN THE BLOOD NORMALLY INFLUENCES RESPIRATION
PATIENTS WHO ARE HYPERCAPNIC CO2
E.G. CHRONIC BRONCHITIS, HAVE THEIR BRAIN CHEMORECEPTORS NO LONGER SENSITIVE TO CO2 LEVELS
INSTEAD THE HYPOXIC DRIVE BECOMES THE RESPIRATORY DRIVE I.E. O2 IS THE DRIVE FOR RESPIRATION
HIGH LEVELS OF SUPPLEMENTARY O2 MAY LEAD TO REPIRATORY DEPRESSION/UNCONSCIOUSNESS AND DEATH

17. POTENTIAL PROBLEMS OXYGEN TOXICITY
THIS FOLLOWS AFTER PROLONGED O2 THERAPY (>24 HOURS)
THERE IS DECREASING LUNG COMPLIANCE FROM HAEMORRHAGIC INTERSITIAL AND INTRA-ALVEOLAR OEDEMA
THIS ULTIMATELY LEADS TO FIBROSIS OF LUNG TISSUE
>24 HOURS AND > 50 % O2 THERAPY SHOULD BE AVOIDED

18. PRINCIPLES OF SUCTIONING
SHARON HARVEY

19. PRINCIPLES OF SUCTIONING
THREE PRIMARY SUCTIONING TECHNIQUES ARE:
OROPHARANGEAL/ NASOPHARANGEAL SUCTIONING
OROTRACHEAL AND NASOTRACHEAL SUCTIONING
SUCTIONING AN ARTIFICAL AIRWAY

20. SIGNS OF A NEED FOR SUCTIONING
RESPIRATORY RATE
CHANGE IN RESPIRATORY PATTERN
NOISY BREATHING
DIFFICULTY SUCTIONING
REDUCED OR UNEVEN AIR ENTRY
INCREASED AIRWAY PRESSURE
SURGICAL EMPHYSEMA OR OTHER NECK SWELLING
DISTRESSED PATIENT
HYPOXIA
THE ABILITY TO HEAR THE PATIENT SPEAK WHEN CUFF IS INFLATED

21. PRINCIPLES OF SUCTIONING
OROPHARYNGEAL SUCTIONING REMOVES SECRETIONS FROM THE PHARYNX VIA A CATHETER PLACED THROUGH THE MOUTH OR NOSTRILS
THIS TYPE OF SUCTIONING IS USED WHEN THE PATIENT S ABLE TO COUGH EFFECTIVELY BUT UNABLE TO CLEAR SECRETIONS BY EXPECTORATING OR SWALLOWING
PROCEDURE IS CARRIED OUT AFTER THE PATIENT HAS COUGHED

22. ASSESSMENT PRIOR TO SUCTIONING
ABNORMAL BREATHING SOUNDS
IRREGULAR RESPIRATORY PATTERN
CHANGES IN SECRETIONS
INCREASE IN COUGHING INCIDENTS
CHANGE IN PATIENT’S APPEARANCE

23. COMPLICATIONS OF SUCTIONING
TRAUMA
HYPOXIA
INFECTION

24. OROPHARYNGEAL SUCTIONING
MEASUREMENTS?
ALWAYS USE THE SMALLEST DIAMETER SUCTION CATHETER POSSIBLE TO REMOVE THE SECRETIONS
FOR ADULTS USE CATHETERS SIZE FRENCH GAUGE
FOR CHILDREN USE 8-12 CATHETER GAUGE
INSERTION DEPTH
FOR NASOPHARYNGEAL SUCTIONING:
ADULTS INSERT ABOUT 16CM
INFANTS AND YOUNG CHILDREN 4-8 CM

25. OROPHARYNGEAL SUCTIONING
CAUTION ON PATIENTS WITH:
NASOPHARYNGEAL BLEED OR CSF LEAK
ANTI COAGULANT THERAPY

26. OROPHARYNGEAL SUCTIONING PROCEDURE
REVIEW OXYGEN SATURATIONS AND BREATHING PATTERN
EVALUATE ABILITY TO COUGH
CHECK HISTORY FOR DEVIATED SEPTUM, NASAL POLYPS, NASAL OBSTRUCTION, TRAUMATIC INJURY, EPISTAXIS OR MUCOSAL SWELLING
EXPLAIN PROCEDURE
INFORM THAT SUCTIONING MAY CAUSE TRANSIENT COUGHING AND GAGGING
MINIMISE ANXIETY
POSITION PATIENT IN AN UPRIGHT POSITION TO PROMOTE LUNG EXPANSION

27. OROPHARYNGEAL SUCTIONING
TURN ON SUCTION ( MMHG)
EXCESSIVE PRESSRE MAY CAUSE TRAUMA
OCCLUDE THE END OF CONNECTING TUBE TO CHECK SUCTION PRESSURE
ASEPTIC TECHNIQUE
USE LUBRICANT IF THE CATHETER IS PASSED THROUGH NASAL PASSAGE

28. OROPHARYNGEAL SUCTION
USE YOUR DOMINANT HAND TO CONTROL THE CATHETER
USE YOUR OTHER HAND TO CONTROL SUCTION VALVE
PATIENT TO COUGH AND BREATH DEEPLY BEFORE SUCTIONING
COUGHING HELPS TO LOOSEN SECRETIONS
DEEP BREATHING HELPS TO MINIMISE HYPOXIA AND LUNG COLLAPSE

29. OROPHARYNGEAL SUCTIONING
SPECIAL CONSIDERATIONS
ALTERNATE BETWEEN NASAL PASSAGES TO MINIMISE TRAUMATIC IJURY
WHERE REPEATED SUCTIONING IS REQUIRED, A PHARYNGEAL AIRWAY WILL HELP WITH CATHETER INSERTION, REDUCE TRAUMA AND PROMOTE PATENT AIRWAY
RESPT PATIENT AFTER SUCTIONING AND OBSERVE

30. OROPHARYNGEAL SUCTIONING
COMPLICATIONS
DYSNOEA
BLOODY ASPIRATE

31. DOCUMENTATION RECORD THE DATE TIME PROCEDURE TECHNIQUE
REASON FOR SUCTIONING