There are two types of oxygen concentrators: stationary oxygen concentrators and portable oxygen concentrators. The percentage of oxygen delivery depends on the flow rate and the delivery device. The main type of oxygen deliver device are outlined below.

An oxygen section on the drug chart has been designed to assist prescription and administration. Oxygen should be prescribed by a doctor in the designated section of the hospital prescription card and the appropriate target saturation should be circled on the chart. Administering oxygen (Appendix b) The frequency of observations depends on how high the NEWS is (the higher the score, the more frequently it is measured). If the patient is not critically unwell, consider increasing oxygen by increments (e.g. from 3L via nasal cannulae to a white Venturi mask – FiO 2 28% at 4L/min)Since oxygen is a drug, it must be prescribed on a drug chart (paper or electronic). Most drug charts have a section for oxygen prescribing. Flow rate (oxygen flow rate is set on the O2 wall tap) is shown on mask along with the % O2 delivery. Each colour must be used with a given flow rate (written on the mask) to give the correct oxygen percentage. Reservoir mask at 15L/min if initial SpO 2 below 85%, otherwise nasal cannulae or simple face mask. Once patient has adequate and stable saturation on minimal oxygen dose, consider discontinuation of oxygen therapy.

Oxygen saturations of less than 90%, with or without oxygen, laboured breathing or respiratory rate, or change in CEWS score outwith the expected range for the child should be reported immediately to the medical team. If the diagnosis is unknown, patients over 50 years of age who are long-term smokers with a history of chronic breathlessness on minor exertion such as walking on level ground and no other known cause of breathlessness should be treated as having suspected COPD for the purposes of this guideline. Record arterial oxygen saturation measured by pulse oximetry (SpO 2) and consider blood gas assessment in patients with unexplained confusion and agitation as this may be presenting feature of hypoaxaemia and/or hypercapnia (cyanosis is a difficult physical sign to record confidently, especially in poor light or with an anaemic or plethoric patient).

HIERARCHY OF EVIDENCE AND GRADING OF RECOMMENDATIONS

If a patient’s oxygen saturations do not reach their target within 3-5 minutes of administering oxygen, the flow rate/FiO 2 (if using a Venturi mask) should be increased. 2 If hypoxaemic, the initial oxygen therapy is nasal cannulae at 2–6L/min or simple face mask at 5–10L/min unless saturation is below 85% (use reservoir mask) or if at risk from hypercapnia (see below). E6. In cases of carbon monoxide poisoning, an apparently ‘normal’ oximetry reading may be produced by carboxyhaemoglobin, so aim at an oxygen saturation of 100% and use a reservoir mask at 15 L/min irrespective of the oximeter reading and PaO 2 (grade D). To identify if oxygen therapy is maintaining the target saturation or if an increase or decrease in oxygen therapy is required

For the mask to work effectively, the reservoir bag needs to be filled before the mask is fitted to the patient. To fill the reservoir bag, obstruct the valve with your finger until the bag is filled with oxygen. Calculate the P/F ratio instead of the old-fashioned way of calculating an adequate PaO 2 for a patient on supplemental oxygen (subtracting 10 from the FiO 2). Give highest possible inspired oxygen concentration during CPR until spontaneous circulation has been restored. The median baseline oxygen saturation in healthy term infants is 97- 98% in the first year of life(5) Oxygen can be delivered via a tracheostomy mask (4-15L/min) or Swedish nose (0.125-4L/min). Consider child’s individual needs.Roca, O., Riera, J., Torres, F., & Masclans, J. R. (2010). High-flow oxygen therapy in acute respiratory failure. Respiratory Care, 55(4), 408-413. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/20406507/ If you already own a portable oxygen concentrator, Medicare does help pay for supplies and for the delivery of oxygen. Does Insurance Cover Portable Oxygen Concentrators? Oxygen should be regarded as a drug and should be prescribed. BTS National guidelines (2008). British National Formulary (2008). Oxygen is a treatment for hypoxaemia, not breathlessness. Oxygen has not been proven to have any consistent effect on the sensation of breathlessness in non-hypoxaemic patients. Works in cases of tiredness, stress, tension. In physical sports activities to increase endurance, performance and promote recovery.