Guide to Oxygen Delivery System

Guide to Oxygen Delivery System

By Brenda Swant BSN, RN

Low-Flow Oxygen Systems: The FiO2 in low flow systems (items 1-4) will vary depending on the oxygen delivery device and the patient’s respiratory/oxygenation needs.

Important Respiratory Numbers

                                                            Phone                         Pager

                               Adult                        6-6322                        1-7815

                                               Pediatric                     6-6320                        1-7816

Device/Where Obtained	Liter Flow (LPM	O2 Concentration (FiO2)	Advantages	Disadvantages	Administration Guidelines
1. Nasal Cannula	1-6 1=25% 2=29% 3=33% 4=37% 5=41% 6=45%	22-45%	-effective for low oxygen concentrations.	-will not deliver oxygen concentrations higher than 40% -dry mucous membranes	Maximum flow is 5-6 LPM. Change to another O2 device if patient requires >5 LPM. -humidify for liter flows >4 LPM -use on patient’s with adequate tidal volume and normal vital signs
2. Simple Mask	6-10	25-60%	-delivers oxygen concentrations up to 60%	-tight seal is required for higher oxygen concentrations: hot and confining impractical long-term	A minimum of 6 LPM is required for all masks to flush expired carbon dioxide and prevent rebreathing of CO2. Do not use humid ifier and fit firmly. -use for severe asthma, pneumonia, trauma, or severe sepsis
3. Partial non-rebreather	8-12	35-60%	-flaps stay open -valves allow expired CO2 to leave the mask	-requires a tight seal -impractical for long-term	Reservoir bag must remain inflated at all times Do not use humidifier bottle -if bag collapses, increase flow rate until inflated -ensure free expansion, no  twisting or kinks
4. Non-Rebreather	10-15	80-95%	-delivers the highest possible oxygen concentration without intubation -short-term therapy	-requires a tight seal -impractical for long-term	Reservoir bag must remain inflated at all times Do not use humidifier bottle -if bag collapses, increase flow rate until inflated -ensure free expansion, no  twisting or kinks

High-Flow Oxygen Systems:  These devices (items 5-6) meet or exceed the patient’s minute volume or inspiratory demands. They deliver fixed concentration of oxygen, regardless of the inspiratory flow or breathing pattern.

Table 1 Guide to colors of Venturi valves
Venturi valve	Flow rate	Oxygen delivered
color	(l/min)	(%)
Blue	2	24
White	4	28
Yellow	6	35
Red	8	40
Green	12	60
Treatment with oxygen	60% or/>101 rebreathing	90-94

Device/Where Obtained	Liter Flow (LPM)	O2 Concentration (FiO2)	Advantages	Disadvantages	Administration Guidelines
5. Venturi Mask	Varies Mixes a specific volume of air and oxygen	24-60% FiO2 is determined by the color of the venture device as stated above	-delivers highly accurate oxygen concentration for the same amount of air always enters.	-requires a tight seal -intake ports can be blocked	Accurate O2 concentration depends on oxygen liter flow and color of attached venture device. Always use the clear plastic collar, to guarantee the oxygen concentration delivered. Do not use a humidifier bottle Use on COPD patients
6. Aerosol/Large volume Nebulizers Trach	10-15	28-100%	-administers large volumes of mist -indicated for thick secretions	-condensation may collect in the trach. Collar or tubing.	-Observe for signs of overhydration, pulmonary edema, crackles. -connected to a wide corrugated tubing that receives oxygen from a jet nebulizer.