Oxygen Delivery Systems: Types, Flow Rates, and Nursing Considerations" "Oxygen Therapy Guide: Devices, FiO₂ Chart & Nursing Care" "Types of Oxygen Delivery Systems & Their Uses in Healthcare" "Oxygen Masks & Cannulas: Flow Rates, FiO₂ & Nursing Management"

Oxygen Delivery Systems 🫁

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🌬️ What is an Oxygen Delivery System?

An oxygen delivery system provides supplemental oxygen to patients who have hypoxia (low oxygen levels in blood). Oxygen therapy is crucial for patients with respiratory distress, chronic lung diseases (e.g., COPD), post-surgical recovery, and emergency care.

🛑 Indications for Oxygen Therapy:

•  Hypoxia: SpO₂ < 90%

•  Respiratory distress or failure

•  Acute & chronic lung diseases (e.g., COPD, pneumonia, ARDS)

•  Post-surgical recovery (to prevent hypoxemia)

•  Carbon monoxide poisoning

⚠️ Precautions:

• Oxygen toxicity: Prolonged high concentrations can damage lung tissue.

• CO₂ retention in COPD patients: High oxygen levels can suppress their drive to breathe.

• Fire hazard: Oxygen supports combustion; keep away from flames or sparks.

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🔹 Types of Oxygen Delivery Systems

Oxygen delivery devices are classified into:
1️⃣ Low-Flow Systems (Variable Performance)
2️⃣ High-Flow Systems (Fixed Performance)

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1️⃣ Low-Flow Oxygen Delivery Systems

🔹 Provide only part of the total inspired air.
🔹 The actual oxygen concentration (FiO₂) varies depending on the patient’s breathing pattern.

💨 Nasal Cannula (NC)

• Flow Rate: 1-6 L/min

• FiO₂: 24-44%

• Uses:
  ✔ Mild hypoxia
  ✔ COPD patients (low flow preferred)
  ✔ Post-operative oxygen therapy

• Advantages:
  ✅ Comfortable, allows talking & eating
  ✅ Easy to use

• Disadvantages:
  ❌ Can cause nasal dryness & irritation
  ❌ Not suitable for high oxygen needs

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💨 Simple Face Mask

• Flow Rate: 5-10 L/min

• FiO₂: 40-60%

• Uses:
  ✔ Moderate hypoxia
  ✔ Post-surgical patients requiring more oxygen than nasal cannula

• Advantages:
  ✅ Provides higher FiO₂ than nasal cannula

• Disadvantages:
  ❌ Uncomfortable, must be removed for eating & talking
  ❌ Requires minimum flow of 5 L/min to avoid CO₂ buildup

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💨 Partial Rebreather Mask

• Flow Rate: 6-10 L/min

• FiO₂: 40-70%

• Uses:
  ✔ Patients needing moderate-to-high oxygen

• Features:
  🔹 Has a reservoir bag that partially conserves exhaled oxygen-rich air

• Disadvantages:
  ❌ Not suitable for long-term use
  ❌ Can cause discomfort

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💨 Partial Rebreather Mask

• Flow Rate: 10-15 L/min

• FiO₂: 60-90%

• Uses:
  ✔ Severe hypoxia (e.g., shock, trauma, CO poisoning)
  ✔ Pre-intubation oxygenation

• Features:
  🔹 One-way valve prevents CO₂ rebreathing
  🔹 Delivers near 100% oxygen when properly fitted

• Disadvantages:
  ❌ Not for long-term use
  ❌ Tight fit can be uncomfortable

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2️⃣ High-Flow Oxygen Delivery Systems

🔹 Provides a precise & consistent oxygen concentration (FiO₂), independent of the patient’s breathing pattern.

💨 Venturi Mask (Air-Entraining Mask)

• Flow Rate: 2-15 L/min

• FiO₂: 24-60% (depends on color-coded adapters)

• Uses:
  ✔ COPD patients (precise oxygen delivery without CO₂ retention)
  ✔ Patients needing controlled oxygen therapy

• Advantages:
  ✅ Provides accurate oxygen concentration
  ✅ Prevents CO₂ buildup (ideal for COPD)

• Disadvantages:
  ❌ Bulky & uncomfortable
  ❌ Noisy

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💨 High-Flow Nasal Cannula (HFNC)

• Flow Rate: Up to 60 L/min

• FiO₂: Up to 100%

• Uses:
  ✔ Acute respiratory failure (ARDS, COVID-19, pneumonia)
  ✔ Patients who need high FiO₂ but are not intubated

• Advantages:
  ✅ Heated & humidified oxygen (prevents dryness)
  ✅ Improves oxygenation & reduces breathing effort

• Disadvantages:
  ❌ Requires specialized equipment

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🛠 Nursing & Paramedic Considerations

✅ Monitor oxygen saturation (SpO₂):

• Normal: 94-98%

• COPD Patients: 88-92% (to prevent CO₂ retention)
  ✅ Humidify oxygen for flows above 4 L/min (prevents dryness).
  ✅ Monitor for oxygen toxicity (signs: dry cough, chest pain).
  ✅ Ensure proper fit & seal (especially for masks & NRMs).
  ✅ Watch for skin breakdown (common with prolonged mask use).

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💡 Quick FiO₂ Reference Table

Device	Flow Rate (L/min)	FiO₂ (%)	Usage
Nasal Cannula	1-6	24-44%	Mild hypoxia
Simple Face Mask	5-10	40-60%	Moderate hypoxia
Partial Rebreather Mask	6-10	40-70%	Moderate-to-severe hypoxia
Non-Rebreather Mask	10-15	60-90%	Severe hypoxia, emergencies
Venturi Mask	2-15	24-60%	COPD, controlled FiO₂
High-Flow Nasal Cannula (HFNC)	Up to 60	100%	Acute respiratory failure

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🚑 Pro Tips for Oxygen Therapy

✔️ Start with the lowest effective oxygen concentration.
✔️ Use Venturi masks in COPD patients to avoid CO₂ retention.
✔️ Switch to BiPAP/CPAP if NRMs are insufficient.
✔️ Check for leaks in masks & tubing.
✔️ Be cautious of oxygen toxicity (signs: restlessness, chest pain, confusion).

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📌 Summary:

• Oxygen therapy saves lives but must be used wisely.

• Choose the right device based on the patient’s condition.

• Monitor SpO₂ regularly & titrate oxygen accordingly.

• Avoid excessive oxygen in COPD patients to prevent CO₂ retention.

💙 Stay informed, stay safe, and save lives! 🚑🩺

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