1.   WASH HANDS

2.   OBTAIN APPROPRIATE EQUIPMENT

       A. 02 FLOW METER

       B.  HUMIDITY OR NEBULIZER

       C.  STERILE WATER

       D.  02 CONNECT TUBE IF NEEDED

       E.  02 ADMIN. DEVICE

             1) NASAL CANNULA

             2) SIMPLE MASK

             3) PRB

             4) NRB

             5) VENTI MASK

             6) HEAD BOX

             7) CROUPETTE

             8) ISOLETTE

             9)  NO SMOKING SIGN

3.  ASSEMBLE EQUIPMENT

4.  IDENTIFY THE PATIENT USING ARM BAND

5.  EXPLAIN PROCEDURE TO PT, EX BENEFITS OF TX, ILICIT COOPERATION

6.  APPLY DEVICE TO PAT AS APPROPRIATE, ADJUST DEVICE TO ACCEPTALBE COMFORT LEVEL FOR PATIENT

7.  ADJUST CONCENTRATION OF FLOW RATE AS ORDERED BY PHYSICAN

8.  CONFIRM DELIVERY OF 02 CONCENTRATION W/O2 ANALYZER

9.  CLEAN UP THE PT'S AREA

10.  ENSURE PT'S COMFORT AND SAFETY

11.  WASH HANDS

12 DOCUMENT IN THE PT'S CHART THE DATE, TIME, O2 DEVICE APPLIED, FLOW ARATE OR 02 CONCENTRATION THE PT'S CONDITION

CLASSIFICATION OF HYPOXEMIA

HYPEROXEMIA     >1OO mmHg

NORMAL                80-100 mmHg

MILD HYPOXEMIA    60-79  mmHg

MODERATE ""          40-59  mmHg

SEVERE ""               <40mmHg

PaO2 NORMALLY DECREASES WITH AGE FOR EVERY YEAR OVER 60, SUBTRACT 1 mmHg FROM NORMAL RANGE

ADULT VITALS

RR=                        12-18 BR/MIN

HR=                        60-100 BPM

TACHYCARDIA IS       >100 BPM

BRADYCARDIA IS       <60 BPM

BP   SYSTOLIC 90-140             DIASTOLIC 60/90

NORMAL                     120/80

HYPER TENSION        >140/90

HYPO TENSIVE          <95/60

NORMAL ABG LEVEL

PH               7.40

PaO2            80-100  mmHg

PaCO2          40  mmHg

SAO2            95%

HCO3-mEq/l   24 mEq/l

GOALS FOR O2 THERAPY

TREAT HYPOXEMA -  ABG SHOWING PaO2 OF <60mmHg OR SPO2 OF 90%< REQUIRE O2 UNLESS CARDIAC CHILD

↓ WOB O2 CONSUMPTION IS HIGH/ DSYPNEA  = O2 APPLICATION WILL EASE WOB LESSEN RISK OF RESP FATIGUE AND FAILURE

↓MYOCADIAL WORK  PROVIDING O2 WILL HELP THE HEART TO SLOW DOWN AND HELP PROVIDE O2 TO THE PERIPHERAL TISSUES; ↓CYANOSIS, DIAPHORESIS AND CARDIAC WORK