Fundamentals of Oxygen Safety and Management in Health Care Facilities
Presented by Bryan Beatty
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Oxygen is a commonly used therapy for patients suffering from hypoxemia. Because it is considered a therapy, a specific order needs to be in place to legally and effectively use it. This course will provide an overview of oxygen safety and management in a health care facility. Understanding the type of respiratory failure (type I or II) that is to be treated is essential. This course will address the evaluation of the patient needing oxygen therapy, how to determine the correct method of delivery, the benefits and risks of administering oxygen therapy, and finally the ongoing care of the patient receiving oxygen therapy. This course is also directed toward those practicing in long-term care, rehabilitation, and acute care facilities. It reaches across many disciplines and would be appropriate for nurses, occupational therapists, physical therapists, respiratory therapists, social workers, and speech-language pathologists.
Meet your instructor
Bryan Beatty
Bryan Beatty, RRT, CPFT is the clinical program manager at the University of Louisville, Pulmonary Division. He is a clinical researcher and a respiratory therapist, managing a full-service pulmonary function lab and occupational health program. He has been involved in research and education for 35 years. He has been a…
Chapters & learning objectives
1. Respiratory Failure Type I and II
Respiratory failure can be classified into two categories. Type I, hypoxemic respiratory failure, is characterized by arterial oxygen tension (Pa02) less than 60 mmHg, with a normal to low carbon dioxide (PaC02) value. This type of failure is the most common and is often seen in patients with cardiogenic or noncardiogenic pulmonary edema, pulmonary hemorrhage, or pneumonia. Type II, defined as a PaC02 greater than 50 mm Hg and a Pa02 less than 60 mmHg, characterizes hypercapnic respiratory failure. This type of respiratory failure is more common in patients with COPD, neuromuscular disease, and drug overdose. Delivery devices and patient monitoring will be discussed.
2. Comprehensive Assessment of Patients Receiving Oxygen Therapy
Patients receiving oxygen therapy should be monitored for cardiac, pulmonary, and neurologic status. In most cases, pulse oximetry will provide adequate information to determine patient’s response to therapy. Ensure the patient is alert, aware of surroundings, and breathing comfortably. Reinforcing the need to keep the oxygen device on is key for patient safety.
3. Oxygen Sources and Safety Issues in a Facility
Most facilities have oxygen piped into the facility from a large external liquid oxygen system, making it easy to use an oxygen flowmeter to administer the correct flow to your patient. Some facilities may still use oxygen tanks, or in some cases, oxygen concentrators. The pressure and flow available will dictate which delivery system can be used. In this chapter, the benefits, safety, and problems associated with oxygen therapy will be addressed.
4. Oxygen Delivery Devices
This chapter will discuss three standard delivery devices: low-flow, high-flow, and reservoir. The type of respiratory failure will dictate which system will help relieve the patient’s hypoxemia. Type II failure raises the biggest concerns due to C02 retention. Variable- and fixed-flow devices are available, but as the health care provider you must be sure to choose and monitor the correct device.
