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Nursing

Oxygen Therapy

The goal of oxygen therapy is to relieve hypoxemia, decrease work of breathing and to reduce myocardial stress. Oxygen is considered a medication and is therefore administered in the lowest possible concentration to produce the most acceptable oxygenation without causing toxicity. When delivering oxygen, the caregiver must ensure that it is properly humidified to prevent drying and irritation of the respiratory tract and to facilitate secretion removal.

Oxygen Delivery Devices

Simple Mask

For acute situations and very short-term use

O2 flow MUST be set to a minimum of 10L/m to facilitate clearance of CO2

Nasal Cannula

Offers low FiO2 concentration For extended periods of time Less precise Maximum O2 flow should be 2L/m for newborns and infants Maximum O2 flow for older children should be 4L/m

Include humidity for O2 flow >1L/m

Nebulized Low Flow O2 Mask

For continuous O2 therapy

Used to deliver humidified O2up to 60%

Set Oxygen flow at 10-15L/m

Use dial at the nebulizer connection to the sterile water bottle to set prescribed oxygen dose

Use an oxygen analyzer to ensure accurate oxygen delivery

High Flow Nebulized O2 Mask

Used for patients who require O2 delivery at >60% to maintain adequate oxygenation. Note: The RRT should be called for the assessment of the patient and setup of this device

Set O2 flow to >15Lpm (e.g. wide open)

Set prescribed O2 dose on the dial

Use an oxygen analyzer to ensure accurate oxygen delivery

Oxygen Hood

Fits over an infant’s head and neck

Set O2 flow at 10-15Lpm

Set prescribed O2 dose using dial

Use an oxygen analyzer to ensure accuracy

 

Trach Mask/Collar

Set O2 flow at 10-15Lpm

Set prescribed O2 dose using dial

Must be humidified as bypasses natural humidification provided by the mucosal layer of the upper respiratory tract

An oxygen analyzer should be used to ensure accuracy

Reference: Critical Care Nursing of Infants and Children (Second Ed.). Martha A.Q Curley & Patricia A. Moloney-Harmon. W.B Saunders Company, Toronto: 2001, pages 266-268.