What is Oxygen (O2)
•Odourless – can’t smell it.
•Colourless - can’t see it.
•Accounts for 21% of inspired air
•Can be manufactured and stored in cylinders
•Administered to hypoxic patients
•May be used to drive automatic resuscitators
Describe 02 clinder
•Ambulance Services typically carry the following cylinders:
–D Size - 340 litres @ 2000 psi.
–CD Size – 610 litres @2000 psi
–F Size - 1360 litres @ 2000 psi.
•They can be identified by their colouring – black body and white collar
•White collar and white body with lettering on the side
Oxygen Equipment - Safety
•Cylinders should be stored under cover, preferably inside, kept dry and clean and not subjected to extremes of heat or cold.
••Cylinders should not be stored near stocks of combustible materials or near sources of heat.
••Medical gases containing different gases should be stored on separate shelves. Full cylinders should be used in strict rotation.
••Medical cylinders should be stored separately from industrial and other non-medical cylinders.
•Cylinders must not be repainted, have any markings or labels removed.
••F sized cylinders and larger should be stored vertically.
••No smoking in any area where
oxygen cylinders are in use or
•Sealing or jointing compounds must never be used to cure a leak.
••NEVER use excessive force when connecting equipment to cylinders.
••Cylinder valves and any associated equipment must never be lubricated and must always be kept free from oil or grease.
•Close all valves when the cylinder is not in use, even when it appears to be empty.
••Secure cylinders as per Service Instructions so that they do not present a hazard during transit.
••Never place any part of your body over the cylinder outlet valve.
Oxygen Safety - Summary
•Simple plastic face mask (medium, vari- or duo- flow)
••This can deliver up to 60% oxygen concentration depending on the oxygen flow rate.
••The simple plastic face mask should be used with a flow rate of 6 to 8 litres per minute (or as recommended on packaging) to ensure adequate oxygenation for hypoxic patients.
••Each mask is sealed in a polythene bag to ensure sterility – don’t open until ready to use.
Oxygen Masks flow rate
• non-rebreathing mask with a reservoir bag.
•Oxygen can be provided through a non-rebreathing mask with a reservoir bag.
With an oxygen flow rate sufficient to keep the bag inflated (10 – 15 litres/min) a high concentration of oxygen can be delivered
Nasal Cannulae amount
Nasal Cannulae (2-6 litres per minute)
Therapy Face Masks
Nebulisation used for
Nebuliser masks are used to administer medication in the form of a mist inhaled into the lungs.
The new UK Ambulance Service Clinical Practice Guidelines (2013) identify near fatal asthma to be managed with positive pressure ventilation using a nebulizing T piece.
Oxygen Equipment – Use
•Position the patient and gain consent for the use of oxygen therapy.
•Turn the flow control knob anti-clockwise until the desired flow rate is achieved.
•Secure the mask to the patient’s face.
•Document the use of oxygen on the PRF / ePRF
•When you are ready to stop giving oxygen shut off the flow control knob until the litre flow is at zero.
•Do not leave a mask on a patient if no oxygen is being administered.
•Shut off the main cylinder valve by turning it clockwise.
•Significant illness and/or injury
•Critical illness requiring high levels of supplemental oxygen
•Serious illness requiring moderate levels of supplemental oxygen if the patient is hypoxaemic
•COPD and other conditions requiring controlled or low dose oxygen therapy
•Conditions for which the patient should be monitored closely but oxygen therapy is not required unless the patient is hypoxaemic
•Normally respiration is driven by the levels of CO2 in the blood
•In a person with compromised gas exchange (COPD, chronic bronchitis) the body gets used to high levels of CO2 and so no urge to breathe.
•For these individuals it is the lowered Oxygen level that triggers the urge to take a breath
•If these patients are given even moderately high levels of oxygen therapy, respiratory depression may be caused in turn leading to respiratory arrest
•Give 28% oxygen via venturi mask or patients own mask.
Oxygen Alert Card