Administration of oxygen

Administration of oxygen - Oxygen (O2) is administered as a corrective treatment for conditions resulting in hypoxia (low level of oxygen in the blood). Oxygen is classed as a medication and must be prescribed by a doctor and administered correctly to prevent over- or under-oxygenation.

Remember oxygen is NOT flammable, but it does aid combustion. Patients and visitors should therefore be educated about the increased risk of fire and the precautions necessary to reduce this risk when supplementary oxygen is in use (see ‘General considerations’ below).

Oxygen must only be administered at the rate and percentage prescribed, as over-oxygenation can be dangerous for some individuals, particularly those with chronic lung disease who are retaining carbon dioxide, and infants, where there is also a risk of retinopathy.

Equipment:

The equipment required consists of a mask or nasal cannula that enables the administration of the prescribed dose (percentage) (see Table 1.1); connection tubing; flow meter; wall or cylinder oxygen supply (oxygen cylinders are black with a white collar); and a humidifier with sterile water if required. The procedures and rationales are given below.

Procedure	Rationale
Explain procedure, addressing health and safety precautions, and ensure adequate understanding	To promote client co-operation and safety
Wash hands following correct procedure	To prevent cross-infection
Assemble equipment – For rates of 40% and over, humidification (moistening of the oxygen prior to it reaching the client) is essential	To prevent dehydration of mucous membranes
Set flow meter to prescribed rate, e.g. 2 litres per minute	To prevent over/under-oxygenation. NB It may be necessary to monitor the client’s oxygen saturation rate (O2Sat) to ensure this, particularly clients with chronic lung disease, where there is a risk of apnoea, and babies, where the O2Sat rate should not be allowed to rise above 99% as there is a significant risk of brain damage
Assist client to position mask (if mouth breathing) or nasal cannula correctly, ensuring a comfortable but not too tight a fit	To facilitate optimum administration, promote patient comfort and reduce the potential for pressure sores
Clients undergoing prolonged oxygen therapy will require monitoring of mucosa and frequent mouth/nasal care (minimum 2 hourly, see Chapter 3)	To reduce the risk of dehydration and promote patient comfort
Encourage client to relieve the pressure of the mask or cannula from the face, nares and ears hourly as appropriate	To reduce the potential for pressure sores
Continue to monitor the client and promptly report any change in condition	To ensure compliance and to optimize treatment
Update nursing care plan	To ensure consistency in care delivery