Oxygen Therapy and Support Workers

• Oxygen (O2) is a tasteless, odorless, and colorless gas that is essential for life.
• Without oxygen, death will occur within minutes.
• Oxygen enters the body via the airway into the lungs.
• The airway includes the nose, mouth, breathing tube, or tracheostomy.

Support Workers and Oxygen

• Support workers often assist clients who have difficulty breathing or absorbing oxygen, these clients require supplemental oxygen through a nasal tube or face mask.
• Providing safe and effective care to these clients is a key responsibility.

Oxygen Therapy

• Oxygen therapy: administering oxygen at concentrations higher than room air.
• Oxygen is a medication, so strict rules must be followed for administration, and only qualified healthcare providers can administer it.
• A physician or nurse practitioner must prescribe oxygen therapy.
• The prescription should include the amount of oxygen, the type of device, and the therapy schedule.
• Respiratory therapists or nurses typically set up the oxygen device and lead respiratory therapies.
• Respiratory therapists are regulated professionals who evaluate, treat, and maintain heart and lung function to help clients breathe.
• Oxygen therapy is needed constantly for some, or for relief of symptoms, like chest pain or shortness of breath.
• Clients should receive the prescribed amount of oxygen, as too much can dangerously slow their respiratory rate.
• Before assisting with any care: Ensure the task is within the scope of practice according to the province or territory.
• The task should be in the job description and the support worker must have the necessary training, know how to use the equipment, review the task with a nurse, and be supervised by a nurse or respiratory technician.

Altered Respiratory Function

• Respiratory function involves air moving in and out of the lungs, O2 and CO2 exchange in the alveoli, & blood transporting O2 to cells and removing CO2.
• Issues in these processes result in altered respiratory function.
• Clients with shortness of breath (SOB) or shortness of breath on exertion (SOBOE), experience altered respiratory function and have difficulty in breathing easily.
• Altered respiratory function can be acute or chronic.
• Clients may panic, become anxious, uncomfortable, visibly struggle to breathe, or prefer sitting up (orthopnea).
• Struggling to breathe uses more energy, and clients need more oxygen to support respiratory function.
• Observations should be immediately reported so action can be taken.
• Never adjust the oxygen level without direction from there care plan, because it may cause extreme harm.

Symptoms of Altered Respiratory Function

• Symptoms of hypoxia
• Abnormal breathing patterns
• Windedness
• Cough (note frequency and time of day)
• Dry or hacking cough
• Harsh or barking cough
• Productive (produces sputum) or nonproductive cough
• Sputum color (clear, white, yellow, green, brown, or red)
• Sputum odor (none or foul)
• Sputum consistency (thick, watery, or frothy)
• Bloody sputum
• Noisy respirations
• Wheezing
• Wet-sounding respirations
• Crowing sounds
• Chest pain location, description, and exacerbating factors
• Cyanosis affecting the skin, mucous membranes, lips, and nail beds
• Changes in vital signs
• Body position (sitting upright or leaning forward)

Respiratory Patterns

• Normal respiration rate for adults is 12 to 20 breaths per minute, infants and children have faster rates.
• Normal respirations are quiet, effortless, and regular, with uniform chest rise and fall and the medical term is eupnea.
• Tachypnea: rapid breathing which is 20+ breaths/minute; caused by fever, exercise, pain, airway obstruction, and hypoxemia.
• Bradypnea: slow breathing which is less than 12 breaths/minute; caused by drug overdoses and nervous system disorders.
• Apnea: the absence of breathing occurring in cardiac or respiratory arrest, as well as sleep apnea.
• Kussmaul respirations: deep, rapid breaths typical of diabetic acidosis.
• Hypoventilation: slow, shallow, and irregular respirations is commonly caused by lung disorders like pneumonia, obesity, airway obstruction, drugs, and nervous system or musculoskeletal disorders.
• Hyperventilation: rapid and deep respirations are commonly caused by asthma, emphysema, infection, , hypoxia, anxiety, pain, and some drugs.
• Dyspnea: difficult or painful breathing commonly caused by heart disease, exercise, and anxiety.
• Cheyne-Stokes: respirations gradually increase and decrease in rate and depth, with apnea lasting 10-20 seconds which are commonly caused by drug overdose, heart failure, renal failure, brain disorders, or near death.
• Orthopnea: shortness of breath when lying flat, relieved by sitting or standing which are commonly caused by emphysema, asthma, pneumonia, angina pectoris, and other heart and respiratory disorders.

Hypoxia

• Hypoxia: a deficiency of oxygen in the cells, resulting from abnormal respiratory function caused by illness, disease, injury, or surgery.
• Hypoxia is life-threatening as cells become damaged or die without sufficient oxygen.
• Signs and symptoms of Hypoxia: restlessness, dizziness, disorientation, confusion, behavior and personality changes, difficulty concentrating/following directions, apprehension, anxiety, fatigue, agitation, increased pulse rate, increased rate and depth of respirations, sitting position (leaning forward), cyanosis affecting the skin, mucous membranes, lips, and nail beds, and dyspnea.