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Oxygen Therapy Importance, Types, indications, procedure, complications and devices.

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Importance of oxygen

A human can survive without food for 1 to 2 weeks, without water 1 to 2 days, but can not survive without oxygen even for a few hours. Brain cell starts dieting after 4 to 6 min.

Presence of oxygen

  • Composition of atmospheric air.78/21/01
  • Oxygen used in medical needs is colourless and non-combustible.
  • The oxygen used in medicine has a concentration of 100%

When oxygen is needed

There are varieties of medical needs when a humane requires Oxygen.

  • Heart Failure/ Heart Attack
  • Respiratory Deficiency
  • Bleeding
  • Complications in Childbirth
  • Poisoning
  • Hypoxia

Hazards associated with oxygen use

  • FIRE: Avoid smoking or use of flame near o/cylinder
  • EXPLOSION: Avoid the use of oil/grease around the cylinder
  • VALVE DAMAGE: Dropping of the cylinder can make it a projectile

Medical hazard associated

  • After administrating oxygen 20 to 30 sec following medical hazards can be occur
  • Dryness of mucous membranes
  • Humidity
  • Can cause blindness
  • Capillaries start contracting
  • It can alter blood PH value in certain cases

Symptoms of hypoxia

  • Cyanosis
  • Inadequate rise and fall of the chest
  • Afforded breathing
  • Loss of blood

Oxygen delivery system devices.

  • Oxygen cylinder with valve
  • Low-pressure regulator
  • Flowmeter
  • Appropriate oxygen delivery device

Oxygen cylinder with valve

Oxygen cylinder with valve

Oxygen cylinder used in the field is made of seamless steel or lightweight alloy and filled with pressurized oxygen. It is found in green or grey or black colour.

  • It should be inspected daily and pressure tested annually due to the high pressure.
  • Valve: it controls the flow of oxygen and turns the bottle on or off. A typical valve may not work in a different type of cylinder.

Most common cylinder types

All foreign Cylinder D – 350 litres

Cylinder E – 625 litres

Cylinder M – 3,000 litres

In the Indian scenario

  • The black colour with white neck cylinders is used in the Hospital. Having a capacity of 600 litres and 1320 litres. Also used 200 Ltrs, 710 litres, and 1410 litres.

Low-pressure regulators and flow meter

  • Regulators reduce the high pressure (2000 psi) from the cylinder and decrease it to between 40 and 70 psi. Flow meters control the flow of oxygen, which is usually administered between 2 to 20 litres per minute.

Precaution when giving oxygen

  • The pressure in a full cylinder is between 2000 and 2200 psi. It should be reduced to 40-70 psi before administering.
  • Appropriate delivery by using flow meter and regulator. They are usually connected as one piece.
  • Keep cylinder on the stand or laying on the floor.
  • Do not keep a hand on the valve.

Accessories for ventilation

  • Oropharyngeal airway
  • Cpr mask
  • Bag valve mask

Oropharyngeal airway

  • Select proper size
  • Open the patient’s mouth
  • Insert upside down
  • Advance adjunct gently
  • Turn 180 degree
  • Advance until flanges rest
  • On teeth


The pocket face mask is designed to aid the rescuer when providing ventilation during CPR. It is made of soft plastic with or without oxygen inlet. Its use avoids direct contact with the patient’sMouth and decreases the chances of contamination.

Bag valve mask

Use of oropharyngeal airway

  • Select proper size
  • Open patient’s mouth
  • Insert the adjunct upside-down
  • Advance the adjunct gently until you encounter a slight resistance
  • Turn the airway 180 degree
  • Advance the adjunct until the flanges rest on the patient’s teeth, then secure it with tape

Adjunct equipment for oxygen administration

  • Nasal cannula
  • Non-rebreather mask

Nasal cannula

  • It has two stems for the patient’s nostrils
  • Mostly used in Hospital set up
  • Most patient tolerates it well
  • Used to administer low concentration of O2
  • Rate 1-6 lpm ( 24-44% concentration O2)
  • Cause nasal mucous membrane to dry
  • Appropriate for patients who cannot tolerate a mask

Non-rebreather mask

  • Flow rate 12-15 lpm
  • Concentration 80-90 % O2
  • It contains enough O2 so it does not deflate by more than 1/3rd when the patient inhales.


  • Non-breakable jar of water attached to the flow meter. Provide moisture to the dry oxygen.
  • Must be cleaned. Can be a breeding ground for algae, harmful bacteria, and fungal organism.

Mechanical Suction

  • Maintain A/W at all time
  • Solid objects as food, teeth etc always not be removed by suction, may use alternate
  • Suction be performed rapidly to avoid FM moving into lungs

Suction equipment

  • Suction devices use negative pressure. Manual or electrically, powered, air or oxygen powered
  • Must have a wide bore, thick walls, non-kincking tubing to fit a suction catheter
  • Several disposable catheters should be available, made of either rigid or flexible plastic
  • Unbreakable collection container with water for rinsing and cleaning
  • Enough vacuum power and flow to be effective.

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