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Administering Oxygen (102.108)

Administering Oxygen (102.108) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Pulmonary

102.108

1
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE

TITLE: ADMINISTERING OXYGEN

Effective Date: April, 2002 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education

Reviewed October, 2003 March, 2005 November 2007 May 2010 October 2011
October 2011

PURPOSE: To provide guidelines for oxygen delivery to patients at UWMF Clinics.

POLICY: The clinical staff will utilize the following guidelines to administer oxygen.

DEFINITION: The delivery of oxygen through simple devices such as nasal cannulas or face masks can assist
patients to breathe more effectively. Oxygen should be humidified, whenever possible, to prevent dried
secretions from obstructing smaller airways.


SUPPLIES: Nasal cannula or facemask, Oxygen tubing, Humidifier (if available)
Pulse oximeter, Oxygen tank
Provider’s order, Patient’s record

PROCEDURE:

1. Check provider’s order and clarify any inconsistencies in the order.

2. Wash hands and gather equipment.

3. Introduce yourself and identify the patient: include date of birth.

4. Explain procedure and purpose of the oxygen to patient.

5. Attach oxygen tubing to humidification device (if available)

6. Choose appropriate oxygen delivery method:

Blow-by
Blowing (or wafting) oxygen past a patient's face.
This method is not used in adults, however, it can temporarily provide oxygen to infants and
toddlers who become agitated and more distressed with other methods of oxygen delivery
Usually provided with oxygen tubing, corrugated tubing, or a simple mask.
Blow by oxygen is typically held at a short distance from the child's face by a parent or other
caregiver.
Low concentrations of oxygen (<30 percent fraction of inspired oxygen) can be provided using
method.



2
Nasal Cannula
Provides oxygen through tubing with two soft prongs that are inserted into the patient’s nares.
A nasal cannula with 1-4L/min of oxygen flow delivers 25 to 40 percent oxygen depending on
patient’s respiratory rate and extent of mouth breathing.
When using a nasal cannula, ensure that the nasal prongs fit into the patient’s nose and that the
tubing is secure around the ears. Gauze pads may be used to reduce irritation on patient's ears and
scalp.

Masks- a properly-fitting mask should fit over the patient’s nose and mouth and be
secured around the head with an elastic strap.
Simple
Useful for patients who need moderate amounts of oxygen to maintain an acceptable oxygen
saturation. Can provide higher concentrations of oxygen than a nasal cannula.
A mask with 6 to 10 L/min of oxygen flow delivers 35 to 50 percent
oxygen.
Non-Rebreather Mask
A nonrebreathing mask is a mask and reservoir system modified with two valves that limit the
mixing of exhaled gases and room air with the oxygen supply
A nonrebreather mask reliably supplies the highest concentration of oxygen that can be provided to
a spontaneously breathing patient.
With oxygen flow rates of 10 to 15 L/min and a mask with a good seal, inspired oxygen
concentrations of up to 95 percent can be achieved

7. Start flow of oxygen at ordered rate.

8. The effectiveness of oxygen delivery should be monitored with pulse oximetry (refer to Pulse Oximetry
policy).

9. Documentation (in Vital Signs & Progress Notes sections of HealthLink, utilizing SmartPhrase: .npo2)
Patient education
Oxygen delivery method and liters per minute
Patient assessment prior to and after oxygen administration, i.e., improved skin color, decreased
respiratory distress, oxygen saturation (vitals section of HL)
How patient tolerated procedure

REVISED BY: Carol Decker, RN, MSN, Clinical Staff Educator
REVIEWED BY: LaVay Morrison, RN, BSN, Clinical Staff Educator
Daniel Shea, RT, Wisconsin Sleep Clinic
WRITTEN BY: Ronnie Peterson, RN, MS, Manager of Clinical Support
REFERENCES:
1. Bailey, P. (2011, February 8). Oxygen delivery systems for infants, children, and adults. UpToDate. Retrieved October 7, 2011
from http://www.uptodate.com/contents/oxygen-delivery-systems-for-infants-children-and-adults.
2. Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams & Wilkins.
3. Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
AUTHORIZATION:



Medical Director Date