1、Reasons for occurrence
(1) Oxygen inhalation device factors: low pressure of oxygen source, poor connection of oxygen inhalation tube, inaccessible oxygen inhalation tube, oxygen inhalation concentration cannot meet the needs of the condition.
(2) Patient factors: excessive secretions in the airway, blocking the airway; patient agitation, resulting in oxygen inhalation tube dislodgement; poor compliance behaviour.
After O₂ inhalation, the patient still cannot relieve the symptoms of clinical hypoxia, manifested as dyspnoea, chest tightness and shortness of breath, irritability, etc. There is no change in respiratory rate, rhythm and depth from before oxygen inhalation.
(1) Check carefully whether the oxygen inhalation device is intact before using oxygen to ensure that the pressure of the oxygen source is normal and the oxygen inhalation tube is tightly connected without air leakage. Secure the oxygen inhalation tube to the patient to avoid dislodgement and displacement and keep it open.
(2) Adjust the oxygen flow rate according to medical advice or the patient's condition and observe the effect of oxygen intake during the process.
(3) Remove respiratory secretions in a timely manner to keep the airway clear and avoid crusting of secretions to block the oxygen tube.
(4) Once ineffective oxygen inhalation is found, immediately identify the cause and take corresponding treatment measures to restore effective oxygen supply as soon as possible.
1、Reasons for occurrence
(1) Dryness in the hospital room, insufficient wetting solution in the oxygen wetting bottle, the inhaled oxygen cannot be fully wetted.
(2) Hyperventilation or excessive oxygen inhalation flow, oxygen concentration greater than 60%.
(3) Long-term oxygen inhalation.
2. Clinical manifestations
Symptoms of respiratory irritation appear: irritating dry cough, sticky sputum that is not easily coughed up, and dry discomfort in the nasal mucosa. Some patients have rhinorrhoea or blood in the sputum.
3. Prevention and treatment
(1) Maintain suitable temperature and humidity in the room and replenish the sterilized injection water in the wetting bottle in time to ensure that the inhaled oxygen is fully wetted.
(2) Adjust oxygen flow according to the condition. O₂ inhalation concentration is generally controlled at 45% or less (oxygen flow is appropriately controlled at 6L/min or less).
(3) Patients who are hyperventilating should be more hydrated, and patients who are breathing with their mouths open can have their mouths covered with wet gauze and changed regularly.
(4) For those with dry airway mucosa, ultrasonic nebulised inhalation can be given.
Prolonged inhalation of high concentration or high pressure oxygen can cause oxygen poisoning. Oxygen poisoning symptoms can occur in normal people who continue to inhale 60%~80% of oxygen for more than 24 hours, or inhale 100% of pure oxygen for 6 hours.
In general, after 6 hours of continuous inhalation of pure oxygen, patients can experience burning sensation behind the sternum, coughing, nausea and vomiting, irritability and pallor; after O₂ inhalation for more than 24 hours, lung capacity can be reduced; after 1~4 days of inhalation of pure oxygen, progressive dyspnea can appear. Individual patients may develop visual or mental impairment. The chest X-ray shows small, scattered, infiltrative patches on both sides in a symmetrical, diffuse pattern.
3、Prevention and treatment
(1) Strictly grasp the indications for oxygen administration and choose the appropriate mode of oxygen administration.
(2) Strictly control the oxygen concentration and time, adjust the oxygen flow rate according to the changes in the condition, and avoid prolonged and high flow rate oxygen administration as far as possible.
(3) Strengthen the rounds during oxygen administration and carefully observe the effect of oxygen therapy; educate patients on the safety of oxygen administration and warn them not to adjust the oxygen flow by themselves.
Instantaneous high flow and high pressure oxygen rushes into the lungs, causing lung tissue damage. This is most often seen when the oxygen flow is not adjusted before connecting the nasal cannula for oxygen inhalation, or when the nasal cannula is constantly opened during oxygen inhalation to adjust the oxygen flow.
2. Clinical presentation
Sudden choking, coughing and pneumothorax may occur in severe cases.
3、Prevention and treatment, improve lung function.
When administering oxygen to a patient, be sure to adjust the oxygen flow rate before connecting the oxygen inhalation tube to the patient's nasal cannula. If the oxygen flow rate needs to be changed during O₂ inhalation, be sure to disconnect the oxygen inhalation tube from the patient's nasal cannula before making adjustments.