Oxygen 

Some of your clients may have oxygen; it is the caregiver’s responsibility to care for the oxygen!!

Oxygen

  • 21% of the air we breathe is Oxygen.
  • 78 % is Nitrogen.
  • There are 3 Oxygen Delivery Systems for the Home.
  • Pressurized:  Comes in a tank; Purest form of O2.
  • Oxygen Concentrator:  Pulls air in, filters through machine; 96% O2.
  • Liquid Oxygen:  Stainless Steel drum. Call if office if in home
  • Oxygen therapy SUPPLEMENTS breathing.
  • Usually, a Dr.’s order for a client with lung disease is 2 LPM.
  • O2 is a prescription drug. It requires a Dr.’s order along with a liter flow.
  • The best way to know O2 is flowing out is by holding the nasal cannula to your ear.
  • Oxygen is odorless, tasteless, and colorless. However, we can FEEL & HEAR it.
  • When you are in a client’s home, it is very important that you know the client’s liter flow.
  • Sometimes you may find that a client has turned up the liter flow.  It is very important that you keep the liter flow at the correct prescribed flow rate.
  • Our goal is compliance.  We need to follow the Dr’s orders.  If a client refuses, call the office and speak to a nurse.
  • When a client has a low oxygen saturation level, it is called hypoxia.  It is important to assess your client continually for signs and symptoms of hypoxia.
  • Signs and Symptoms include:

Cyanosis (Bluish coloring of the lips and nail beds)

Confusion/ Dizziness

Headache

Rapid or labored respirations

Lethargy/ Fatigue

Tingling of the extremities

  • ALWAYS KEEP OXYGEN AWAY FROM HEAT.
  • Direct contact of Oxygen with heat or an open flame will cause a fire.
  • The cannula is the plastic part at the end of the tubing that delivers the oxygen into the nares.
  • The cannula is curved. When administering O2, be sure that the curve is downward.
  • The tubing goes up behind the ear and below the chin. When a client is sleeping, slide the lariat up to secure the tubing.
  • The cannula should be soft. Over time the cannula gets hard and can cause soreness to the client. Replace the old cannula with a new one

Every portable O2 tank has a gauge. The gauge will tell you how much longer the tank will last.

  • Portable O2 tanks all last a certain amount of time. If you’re going to be leaving the home with your client, always make sure you know how much time you have and if needed take an extra O2 tank with you.
  • To turn on/off, always use the center stem. When turning off make sure the needle is on empty.
  • Never turn off from the flow meter.
  • If the tank is empty, the regulator twists off and you can put it on the next tank.
  • If you can hear and feel the oxygen flowing, it’s ready to administer.

CONCENTRATOR

  • The concentrator is equally as effective since the O2 is supplementary.
  • If the power goes out, the concentrator will not work. If the client is in distress, put on the pressurized oxygen and figure out how much time you have.
  • Call the Oxygen Company and notify them of how much time you have left and that you need O2 ASAP. Protect the patient and make sure they’re safe.
  • The concentrator pulls air in and filters through the machine. You can hear the compressor and a clicking sound from the charging sieve beds.
  • There is a water bottle that humidifies the air. The humidifier should only be half filled.  Don’t ever fill it to the max. Water will splash into the tubing and it is very uncomfortable for the client.
  • Always use bottled distilled water. DO NOT USE WATER FROM TAP.
  • The filter will get dirty so it should be cleaned once a week with soap and water.
  • The water bottle will get slimy and it needs to be washed twice a week. Wash with regular dish soap and water.
  • Oxygen coming out of the concentrator is warmer than room temperature.
  • Warm air in the tubing that is laying on a cool floor causes condensation and collects water in the tubing. If you will see droplets collecting over time, disconnect and shake out excess.

NEBULIZER

  • Nebulization works by pumping air through the medication cup.  Medication is poured into the nebulizer cup, drawn up though a hole and slammed into a lid which causes it to become a vapor or mist.
  • The vapor is breathed in by the client and could cause them to cough.  If the client is on oxygen, keep it running during nebulizer treatment.
  • Be sure to hold the nebulizer upright. If the nebulizer drops, the medication will spill out. Rinse the nebulizer after every treatment and place on a paper towel to dry. Treat with the vinegar solution every day or as directed. The nebulizer cup is usually replaced every two weeks.
  • The medication is usually pre-poured.  You are “assisting” with self- administrative meds.

Some Important Things you need to be checking in the homes with Oxygen

  1. What company is the o2 supplied from? Is there a sticker with their name and number on the concentrator?
  2. What is the clients liter flow set at?
  3. The cannula is on correctly, nasal prongs facing downward
  4. O2 is flowing out of the nasal cannula properly; you can hear and feel it?
  5. Is the alarm on the o2 concentrator working correctly?
  6. Is the concentrator plugged in?
  7. When was the filter cleaned with soap and water? (should be done once a week)
  8. When was the humidification canister cleaned (vinegar and water solution) and refilled half way with distilled water? (Clean 2 times a week)
  9. Is o2 kept away from heat sources?
  10. O2 tubing changed once a week
  11. How many portable o2 tanks are in the home?
  12. Is the key present?
  13. What is the psi on the current tank you are using?
  14. Is there an extra black washer if old one is worn out and needs to be changed?
  15. When you are done using the portable tank, did you remember to lock the tank?
  16. Does your client have any signs of hypoxia?

-Cyanosis (Bluish coloring of the face and nail beds)

-confusion/dizziness

-headache

-rapid or labored breathing

-lethargy/fatigue

-tingling of the extremities

When in doubt call the agency with any questions.