Oxygen Therapy
Oxygen is an essential element for sustaining life, as it is required by every cell in the body to carry out vital functions. In a state of optimal health, the human body efficiently extracts oxygen from the air, which typically consists of 21% oxygen, to meet its metabolic needs and maintain homeostasis. However, certain health conditions or environmental factors may disrupt this equilibrium, leading to a need for supplemental oxygen therapy prescribed by a physician.
Conditions Requiring Oxygen Therapy: Various medical conditions may necessitate the use of supplemental oxygen therapy to ensure adequate oxygenation of tissues and organs. These conditions include:
Respiratory System Disorders: Conditions such as chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and pulmonary fibrosis can impair lung function, leading to decreased oxygen levels in the blood.
Cardiovascular Ailments: Heart failure, coronary artery disease, and other cardiovascular disorders may result in inadequate oxygen delivery to tissues due to reduced cardiac output or impaired circulation.
Reduced Red Blood Cell Count: Anemia, which is characterized by a low red blood cell count or reduced hemoglobin levels, can limit the blood’s ability to carry oxygen to tissues.
Nervous System Disorders, Injuries, and Medications: Conditions affecting the central nervous system, such as spinal cord injuries, neuromuscular disorders, or the use of certain medications, may disrupt the body’s ability to regulate breathing and oxygenation.
Effects of Aging on Lung Function: Age-related changes in lung structure and function, such as decreased elasticity of lung tissue and reduced respiratory muscle strength, can impair oxygen exchange in older adults.
Level of Physical Activity: Intense physical exertion or high-altitude activities can increase oxygen demand, requiring supplemental oxygen to maintain adequate oxygenation.
Elevation in Body Temperature and Pain: Fever, inflammation, and pain can elevate metabolic demands and oxygen consumption, necessitating increased oxygen delivery to tissues.
Role of Home Health Aides (HHAs): While HHAs are not responsible for managing or administering oxygen therapy, they play a crucial role in supporting clients who require supplemental oxygen. HHAs must be aware of and adhere to safety protocols associated with oxygen use to ensure the well-being of their clients.
This includes:
Understanding Oxygen Equipment: HHAs should be familiar with the types of oxygen delivery devices used by their clients, such as oxygen concentrators, compressed gas cylinders, and liquid oxygen systems.
Monitoring Oxygen Supplies: HHAs may assist clients in monitoring their oxygen supplies, ensuring that they have an adequate stock of oxygen cylinders or refills to avoid interruptions in therapy.
Observing Signs of Oxygen Deficiency: HHAs should be vigilant for signs of inadequate oxygenation in their clients, such as shortness of breath, cyanosis (blue discoloration of the skin), confusion, or increased respiratory rate.
Safety Precautions: HHAs must follow safety guidelines when handling oxygen equipment to prevent fire hazards and ensure proper ventilation in areas where oxygen is being used.
Emergency Response: In the event of an oxygen-related emergency, such as equipment malfunction or a client experiencing respiratory distress, HHAs should know how to respond quickly and seek assistance from healthcare professionals.
Oxygen Safety
Despite its non-flammable nature, oxygen serves as a potent catalyst that sustains combustion and accelerates burning, necessitating careful handling to mitigate fire risks during oxygen therapy. To ensure the safety of clients undergoing oxygen therapy, adherence to specific guidelines is paramount:
Prohibition of Combustion: All forms of combustion, including smoking, the use of lighters, matches, candles, or any open flame, must be strictly prohibited in or around areas where oxygen therapy is administered. Visitors should be informed that smoking paraphernalia is not allowed in the client’s room or residence to minimize fire hazards.
Avoidance of Electrical Appliances: To prevent the risk of electrical fires, refrain from using electric razors, hair dryers, heating pads, or other electrical appliances in the presence of oxygen. If necessary, ensure that client-owned electrical devices have a functional three-prong grounded plug to reduce the risk of electrical hazards.
Avoidance of Flammable Substances: Flammable substances such as aerosol sprays, Vaseline, petroleum jelly, rubbing alcohol, nail polish, or oil-based lubricants should not be used in proximity to oxygen therapy. These substances can ignite spontaneously or create a flammable atmosphere when exposed to oxygen, posing a significant fire risk.
Selection of Clothing Materials: Synthetic or woolen garments should be avoided when dressing the client, as these materials can generate static electricity, increasing the risk of ignition in the presence of oxygen. Instead, opt for clothing made of cotton or other non-static materials to minimize fire hazards.
By adhering to these safety guidelines, home health aides can help ensure the safe administration of oxygen therapy and minimize the risk of fire-related incidents in the home care setting. Additionally, regular education and training on oxygen safety protocols are essential to reinforce awareness and promote safe practices among caregivers and clients receiving oxygen therapy.
Oxygen Flow Management
When a physician prescribes oxygen therapy, they designate a specific oxygen flow rate, measured in liters per minute, ranging typically from two to 15 liters per minute.
While home health aides (HHAs) are not authorized to adjust the flow rate, they play a crucial role in ensuring the safe and effective administration of oxygen therapy by:
Confirming Flow Rate Accuracy: HHAs must verify that the flow meter indicates the correct flow rate as specified in the client’s care plan. This involves checking the settings on the oxygen delivery device and ensuring that it matches the prescribed flow rate.
Monitoring Oxygen Supply: It is essential to ensure that the oxygen tank or source is not depleted and has an adequate supply to meet the client’s oxygen needs. HHAs should monitor the oxygen levels regularly and notify the agency or supervising nurse if the supply is running low or if there are any concerns regarding oxygen availability.
Observing Respiratory Status: HHAs should vigilantly observe the client for any signs of abnormal breathing, respiratory distress, or changes in lip or nail bed coloration, which may indicate inadequate oxygenation. Prompt reporting of such observations to the agency or healthcare provider is crucial for timely intervention and management.
Nasal Cannula and Face Masks
The choice between a nasal cannula and a face mask for oxygen delivery depends on the prescribed oxygen flow rate and the client’s individual needs.
Here’s an overview of each:
a) Nasal Cannula: This device consists of plastic tubing with two nasal prongs designed to fit securely into the client’s nostrils. The tubing is looped behind the ears to keep the cannula in place. Nasal cannulas allow clients to eat, drink, and communicate comfortably while receiving oxygen. However, improper positioning or excessive pressure from the elastic band can cause skin irritation, requiring careful monitoring by HHAs.
b) Face Mask: Face masks cover the client’s nose and mouth and are secured with straps that loop around the ears and head. Plastic tubing connects the mask to the oxygen source. While face masks provide a higher concentration of oxygen and may be necessary for clients requiring higher flow rates, they can pose challenges such as muffled speech and discomfort.
Clients should remove the mask during meals or drinks, and HHAs should address any concerns or discomfort promptly.
Precautions for Nasal Cannulas and Face Masks:
Tubing Positioning: HHAs should ensure that the tubing is not obstructed and remains unobstructed, free from kinks or pinches, to maintain an uninterrupted oxygen supply.
Correct Positioning: Proper placement of the nasal cannula or face mask is essential to prevent discomfort and skin irritation. HHAs should regularly check and adjust the positioning as needed.
Moisture Maintenance: HHAs can help maintain moisture on the client’s lips and mouth by using a non-petroleum-based lubricant, preventing dryness and discomfort associated with oxygen therapy.