Methods of and Indications for Oxygen Delivery

Modes of Oxygen Delivery:

  • Nasal Cannula

  • tracheal catheter

  • oxygen mask

 

  • be alert for skin breakdown over ears and in nares

 

Rates greater than 4L/min not often used due to drying effect on mucosa

 

 

 

Transtracheal oxygen (TTO)

 

Indication: used in cases of chronic lung disease

Mechanism: a small IV-size catheter is inserted directly into the trachea through a surgical tract in the lower neck.

 

Advantages of transtracheal Oxygenation:

 

  1. no oxygen is lost to the atmosphere during delivery into the body

  2. patients achieve adequate oxygenation at lower flow rates

  3. oxygen delivery is more efficient than the nasal cannula or mask

  4. there are fewer side side effects, such as drying of the nasal mucosa

 

Nasal Cannula

 

2 cannula protrude 1.5cm in length from the center of a disposable tube

The cannula are inserted in the nares

Oxygen is delivered in a flow rate up to 6L/min, although rates greater than 4L/min are not often used due to mucosal drying effect

 

Oxygen Masks

 

A device used to administer oxygen, humidity, or heated humidity

Shaped to fit snugly over the mouth and nose and is secured by a plastic strap

There are 2 types: high and low delivery designs

The simple face mask delivers concentrations from 30-60%

The mask is contraindicated for patients with carbon dioxide retention because the retention can worsen as increased oxygen availability affects breathing drive

 

A plastic face mask with a rebreather bag or a venturi mask can deliver higher oxygen concentrations

 

The Venturi mask can be used to deliver oxygen concentrations of 24% to 55% with oxygen flow rates of 2 to 14L/min

 

Indications of Home Oxygen Therapy

 

  • PaO2 of 55mm Hg

  • less than an SaO2 of 88%

  • less on room air at rest, exertion or with excercise

  • pulmonary hypertension

  • cor pulmonale (enlargement of the right ventricle of the heart due to disease of the lungs or of the pulmonary blood vessels)

  • erythrocytosis

  • CNS dysfunction

  • increased hypoxemia on exertion

 

Perry, A, G, Potter, P, A, Ross-Kerr, J, C and Wood, M, J. 2006. Canadian fundamentals of nursing. 3rded. Toronto: Elselvier

 

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