UNCONTROLLED WHEN PRINTED
Indications
  • To provide supplementary oxygen to patients who show clinical signs of low oxygen levels.
Contraindications
Contraindications
Patient Factors & Considerations
  • N / A
COVID-19 / Febrile Respiratory Illness
  • Crews are advised to limit the use of oxygen in patients with influenza like symptoms wherever possible to avoid aerosolisation.
  • Crews are advised to tolerate lower SpO2 than usual in patients with ILI; ≥ 88% is acceptable. Note: It may not be possible to improve SpO2 to an acceptable level within the oxygenation guideline described above.
  • Recommendations:
    • Nasal prongs: 1-4 litres per minute, ideally with surgical mask over the top where possible
    • Therapy mask: Maximum 10 litres per minute
    • Non-rebreather/high concentration mask: Maximum 15 litres per minute
  • Crews treating patients who are on home BiPAP/CPAP or with a tracheostomy should don full PPE requirements for aerosol generating procedures (AGP’s) if the presentation is an infective respiratory illness. See PPE requirements.
  • Always turn the oxygen off first, then remove the nasal prongs/mask from the patient.
Procedure
  • All relevant infection control methods to be utilised.
  • Prepare equipment required:
    • Nasal cannula / therapy mask / non-rebreather mask
    • Oxygen
    • Oxygen tubing
    • Explain the procedure to the patient.
  • Select appropriate size and type of face mask required, either nasal cannula[1], the therapy mask[2] or the non-rebreathing mask[3].

Nasal Cannula

  • Connect the face mask to the oxygen cylinder.
  • Set flow rate at 1 to 4 litres per minute.
  • Apply the nasal cannula to the patient's nose first; if the nasal prongs are curved, these should face posteriorly to the patient.
  • Looping the tubing around the patients ears and bring it to the front of the patients chest.
  • Move the slider up the tubes to adjust the fit. The nasal cannula should sit snugly under the chin with enough room to fit two fingers between the tubes and the patients chin.
  • Refer to oxygen protocol

Therapy Mask

  • Connect the face mask to the oxygen cylinder.
  • Set flow rate at 5 to 8 litres per minute.
  • Fit the face mask to the patient’s face and adjust the mask to comfort with elastic straps and nasal metal strip.
  • Refer to oxygen protocol

Non-Rebreathing Mask

  • Connect the face mask to the oxygen cylinder.
  • Set flow rate at 10 to 15 litres per minute.
  • Ensure the reservoir bag is fully inflated.
  • Fit the face mask to the patient’s face and adjust the mask to comfort with elastic straps and nasal metal strip.
  • Refer to oxygen protocol

1. Nasal Cannula
oxygen-nasalcannula

2. Therapy Mask
Therapy Mask

3. Non-rebreather Mask
Non-rebreather Mask

Success
  • Constantly monitor the patient to ensure that the oxygen is having the desired effect, e.g. respiratory effort and SpO2 reading.
Discontinue
  • N / A
Additional Information
  • Claustrophobia.
  • Drying effect on the mouth.
  • Remove the mask from the patient’s face prior to turning off the oxygen supply.

References
Oxygen Administration. (2014). Expert in My Pocket. http://expertinmypocket.com.au/oxygen-administration/ 

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