11.2: Basic Concepts of Oxygenation (2024)

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Ernstmeyer & Christman (Eds.)
Chippewa Valley Technical College via OpenRN

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When assessing a patient’s oxygenation status, it is important for the nurse to have an understanding of the underlying structures of the respiratory system to best understand their assessment findings. Visit the “Respiratory Assessment” chapter for more information about the structures of the respiratory system.

Note

For more information about common respiratory conditions and medications used to treat them, visit the “Respiratory” chapter in Open RN Nursing Pharmacology.

Video Review for Oxygenation Basics

View the TED-Ed Oxygen’s Journey video on YouTube^{^[1]}

Breathing Mechanics^{^[2]}

Gas Exchange^{^[3]}

Carbon Dioxide Transport^{^[4]}

Assessing Oxygenation Status

A patient’s oxygenation status is routinely assessed using pulse oximetry, referred to as SpO2. SpO2 is an estimated oxygenation level based on the saturation of hemoglobin measured by a pulse oximeter. Because the majority of oxygen carried in the blood is attached to hemoglobin within the red blood cell, SpO2 estimates how much hemoglobin is “saturated” with oxygen. The target range of SpO2 for an adult is 94-98%.^[5] For patients with chronic respiratory conditions, such as COPD, the target range for SpO2 is often lower at 88% to 92%. Although SpO2 is an efficient, noninvasive method to assess a patient’s oxygenation status, it is an estimate and not always accurate. For example, if a patient is severely anemic and has a decreased level of hemoglobin in the blood, the SpO2 reading is affected. Decreased peripheral circulation can also cause a misleading low SpO2 level.

A more specific measurement of oxygen and carbon dioxide in the blood is obtained through an arterial blood gas (ABG). ABG results are often obtained for patients who have deteriorating or unstable respiratory status requiring urgent and emergency treatment. An ABG is a blood sample that is typically drawn from the radial artery by a respiratory therapist, emergency or critical care nurse, or health care provider. ABG results evaluate oxygen, carbon dioxide, pH, and bicarbonate levels. The partial pressure of oxygen in the blood is referred to as PaO2. The normal PaO2 level of a healthy adult is 80 to 100 mmHg. The PaO2 reading is more accurate than a SpO2 reading because it is not affected by hemoglobin levels. The PaCO2 level is the partial pressure of carbon dioxide in the blood. The normal PaCO2 level of a healthy adult is 35-45 mmHg. The normal range of pH level for arterial blood is 7.35-7.45, and the normal range for the bicarbonate (HCO3) level is 22-26. The SaO2 level is also obtained, which is the calculated arterial oxygen saturation level. See Table \(\PageIndex{1}\) for a summary of normal ranges of ABG values.^{^[6]}

Table \(\PageIndex{1}\): Normal Ranges of ABG Values
Value	Description	Normal Range
pH	Acid-base balance of blood	7.35-7.45
PaO2	Partial pressure of oxygen	80-100 mmHg
PaCO2	Partial pressure of carbon dioxide	35-45 mmHg
HCO3	Bicarbonate level	22-26 mEq/L
SaO2	Calculated oxygen saturation	95-100%

Hypoxia and Hypercapnia

Hypoxia is defined as a reduced level of tissue oxygenation. Hypoxia has many causes, ranging from respiratory and cardiac conditions to anemia. Hypoxemia is a specific type of hypoxia that is defined as decreased partial pressure of oxygen in the blood (PaO2), measured by an arterial blood gas (ABG).

Early signs of hypoxia are anxiety, confusion, and restlessness. As hypoxia worsens, the patient’s level of consciousness and vital signs will worsen, with increased respiratory rate and heart rate and decreased pulse oximetry readings. Late signs of hypoxia include bluish discoloration of the skin and mucous membranes called cyanosis. Cyanosis is most easily seen around the lips and in the oral mucosa. A sign of chronic hypoxia is clubbing, a gradual enlargement of the fingertips (see Figure \(\PageIndex{1}\)^{^[7]}). See Table \(\PageIndex{2}\) for symptoms and signs of hypoxia.^{^[8]}

Hypercapnia is an elevated level of carbon dioxide in the blood. This level is measured by the PaCO2 level in an ABG test and is indicated when the PaCO2 level is higher than 45. Hypercapnia is typically caused by hypoventilation or areas of the alveoli that are ventilated but not perfused. In a state of hypercapnia or hypoventilation, there is an accumulation of carbon dioxide in the blood. The increased carbon dioxide causes the pH of the blood to drop, leading to a state of respiratory acidosis. You can read more about respiratory acidosis in the “Fluids and Electrolytes” chapter of the Open RN Nursing Fundamentals book. Patients with hypercapnia can present with tachycardia, dyspnea, flushed skin, confusion, headaches, and dizziness. If the hypercapnia develops gradually over time, such as in a patient with chronic obstructive pulmonary disease (COPD), symptoms may be mild or may not be present at all. Hypercapnia is managed by addressing its underlying cause. A noninvasive positive pressure device such as a BiPAP may provide support to patients who are having trouble breathing normally, but if this is not sufficient, intubation may be required.^{^[9]}

Table \(\PageIndex{2}\): Symptoms and Signs of Hypoxia
Signs & Symptoms	Description
Restlessness	Patient may become increasingly fidgety, move about the bed, demonstrate signs of anxiety and agitation. Restlessness is an early sign of hypoxia.
Tachycardia	An elevated heart rate (above 100 beats per minute in adults) can be an early sign of hypoxia.
Tachypnea	An increased respiration rate (above 20 breaths per minute in adults) is an indication of respiratory distress.
Shortness of breath (Dyspnea)	Shortness of breath is a subjective symptom of not getting enough air. Depending on severity, dyspnea causes increased levels of anxiety.
Oxygen saturation level (SpO2)	Oxygen saturation levels should be above 94% for an adult without an underlying respiratory condition.
Use of accessory muscles	Use of neck or intercostal muscles when breathing is an indication of respiratory distress.
Noisy breathing	Audible noises with breathing are an indication of respiratory conditions. Assess lung sounds with a stethoscope for adventitious sounds such as wheezing, rales, or crackles. Secretions can plug the airway, thereby decreasing the amount of oxygen available for gas exchange in the lungs.
Flaring of nostrils or pursed lip breathing	Flaring is a sign of hypoxia, especially in infants. Pursed-lip breathing is a technique often used in patients with COPD. This breathing technique increases the amount of carbon dioxide exhaled so that more oxygen can be inhaled.
Position of patient	Patients in respiratory distress may sit up or lean over by resting arms on their legs to enhance lung expansion. Patients who are hypoxic may not be able to lie flat in bed.
Ability of patient to speak in full sentences	Patients in respiratory distress may be unable to speak in full sentences or may need to catch their breath between sentences.
Skin color (Cyanosis)	Changes in skin color to bluish or gray are a late sign of hypoxia.
Confusion or loss of consciousness (LOC)	This is a worsening sign of hypoxia.
Clubbing	Clubbing, a gradual enlargement of the fingertips, is a sign of chronic hypoxia.

Treating Hypoxia

Acute hypoxia is a medical emergency and should be treated promptly with oxygen therapy. Failure to initiate oxygen therapy when needed can result in serious harm or death of the patient. Although oxygen is considered a medication that requires a prescription, oxygen therapy may be initiated without a physician’s order in emergency situations as part of the nurse’s response to the “ABCs,” a common abbreviation for airway, breathing, and circulation. Most agencies have a protocol in place that allows nurses to apply oxygen in emergency situations. After applying oxygen as needed, the nurse then contacts the provider, respiratory therapist, or rapid response team, depending on the severity of hypoxia. Devices such high flow oxymasks, CPAP, BiPAP, or mechanical ventilation may be initiated by the respiratory therapist or provider to deliver higher amounts of inspired oxygen. Various types of oxygenation devices are further explained in the “Oxygenation Equipment” section.

Prescription orders for oxygen therapy will include two measurements of oxygen to be delivered – the oxygen flow rate and the fraction of inspired oxygen (FiO2). The oxygen flow rate is the number dialed up on the oxygen flow meter between 1 L/minute and 15 L/minute. Fio2 is the concentration of oxygen the patient inhales. Room air contains 21% oxygen concentration, so the FiO2 for supplementary oxygen therapy will range from 21% to 100% concentration.

In addition to administering oxygen therapy, there are several other interventions the nurse should consider implementing to a hypoxic patient. Additional interventions used to treat hypoxia in conjunction with oxygen therapy are outlined in Table \(\PageIndex{3}\).^{^[10]}

Table \(\PageIndex{3}\): Interventions to Manage Hypoxia
Interventions	Additional Information
Raise the Head of the Bed	Raising the head of the bed to high Fowler’s position promotes effective chest expansion and diaphragmatic descent, maximizes inhalation, and decreases the work of breathing. Patients with COPD who are short of breath may gain relief by sitting upright or leaning over a bedside table while in bed.
Encourage Enhanced Breathing and Coughing Techniques	Enhanced breathing and coughing techniques such as using pursed-lip breathing, coughing and deep breathing, huffing technique, incentive spirometry, and flutter valves may assist patients to clear their airway while maintaining their oxygen levels. See the following “Enhanced Breathing and Coughing Techniques” section for additional information regarding these techniques.
Manage Oxygen Therapy and Equipment	If the patient is already on supplemental oxygen, ensure the equipment is turned on, set at the required flow rate, correctly positioned on the patient, and properly connected to an oxygen supply source. If a portable tank is being used, check the oxygen level in the tank. Ensure the connecting oxygen tubing is not kinked, which could obstruct the flow of oxygen. Feel for the flow of oxygen from the exit ports on the oxygen equipment. In hospitals where medical air and oxygen are used, ensure the patient is connected to the oxygen flow port. Hospitals in America follow the national standard that oxygen flow ports are green and air outlets are yellow.
Assess the Need for Respiratory Medications	Pharmacological management is essential for patients with respiratory disease such as asthma, COPD, or severe allergic response. Bronchodilators effectively relax smooth muscles and open airways. Glucocorticoids relieve inflammation and also assist in opening air passages. Mucolytics decrease the thickness of pulmonary secretions so that they can be expectorated more easily.
Provide Oral Suctioning if Needed	Some patients may have a weakened cough that inhibits their ability to clear secretions from the mouth and throat. Patients with muscle disorders or those who have experienced a cerebral vascular accident (CVA) are at risk for aspiration pneumonia, which is caused by the accidental inhalation of material from the mouth or stomach. Provide oral suction if the patient is unable to clear secretions from the mouth and pharynx. See the chapter on “Tracheostomy Care and Suctioning” for additional details on suctioning.
Provide Pain Relief If Needed	Provide adequate pain relief if the patient is reporting pain. Pain increases anxiety and may inhibit the patient’s ability to take in full breaths.
Consider the Side Effects of Pain Medications	A common side effect of pain medication is sedation and respiratory depression. For more information about interventions to manage respiratory depression, see the “Oxygenation” chapter in the Open RN Nursing Fundamentals textbook.
Consider Other Devices to Enhance Clearance of Secretions	Chest physiotherapy and specialized devices assist with secretion clearance, such as handheld flutter valves or vests that inflate and vibrate the chest wall. Consider requesting a consultation with a respiratory therapist based on the patient’s situation.
Plan Frequent Rest Periods Between Activities	Patients experiencing hypoxia often feel short of breath and fatigue easily. Allow the patient to rest frequently, and space out interventions to decrease oxygen demand in patients whose reserves are likely limited.
Consider Other Potential Causes of Dyspnea	If a patient’s level of dyspnea is worsening, assess for other underlying causes in addition to the primary diagnosis. Are there other respiratory, cardiovascular, or hematological conditions such as anemia occurring? Start by reviewing the patient’s most recent hemoglobin and hematocrit lab results. Completing a thorough assessment may reveal abnormalities in these systems to report to the health care provider.
Consider Obstructive Sleep Apnea	Patients with obstructive sleep apnea (OSA) are often not previously diagnosed prior to hospitalization. The nurse may notice the patient snores, has pauses in breathing while snoring, or awakens not feeling rested. These signs may indicate the patient is unable to maintain an open airway while sleeping, resulting in periods of apnea and hypoxia. If these apneic periods are noticed but have not been previously documented, the nurse should report these findings to the health care provider for further testing and follow-up. Testing consists of using continuous pulse oximetry while the patient is sleeping to determine if the patient is hypoxic during these episodes and if a CPAP device should be prescribed. See the box below for additional information regarding OSA.
Anxiety	Anxiety often accompanies the feeling of dyspnea and can worsen it. Anxiety in patients with COPD is chronically undertreated. It is important for the nurse to address the feelings of anxiety and dyspnea. Anxiety can be relieved by teaching enhanced breathing and coughing techniques, encouraging relaxation techniques, or administering antianxiety medications.

Note

Obstructive Sleep Apnea (OSA) is the most common type of sleep apnea. See Figure \(\PageIndex{2}\)^{^[11]} for an illustration of OSA. As soft tissue falls to the back of the throat, it impedes the passage of air (blue arrows) through the trachea and is characterized by repeated episodes of complete or partial obstructions of the upper airway during sleep. The episodes of breathing cessations are called “apneas,” meaning “without breath.” Despite the effort to breathe, apneas are associated with a reduction in blood oxygen saturation due to the obstruction of the airway. Treatment for OSA often includes the use of a CPAP device.

Enhanced Breathing and Coughing Techniques

In addition to oxygen therapy and the interventions listed in Table \(\PageIndex{3}\) to implement for a patient experiencing dyspnea and hypoxia, there are several techniques a nurse can teach a patient to use to enhance their breathing and coughing. These techniques include pursed-lip breathing, incentive spirometry, coughing and deep breathing, and the huffing technique.

Pursed-Lip Breathing

Pursed-lip breathing is a technique that allows people to control their oxygenation and ventilation. The technique requires a person to inspire through the nose and exhale through the mouth at a slow controlled flow. See Figure \(\PageIndex{3}\)^{^[12]} for an illustration of pursed-lip breathing. This type of exhalation gives the person a puckered or pursed appearance. By prolonging the expiratory phase of respiration, a small amount of positive end-expiratory pressure (PEEP) is created in the airways that helps to keep them open so that more air can be exhaled, thus reducing air trapping that occurs in some conditions such as COPD. Pursed-lip breathing often relieves the feeling of shortness of breath, decreases the work of breathing, and improves gas exchange. People also regain a sense of control over their breathing while simultaneously increasing their relaxation.^{^[13]}

Note

View the COPD Foundation’s YouTube video to learn more about pursed-lip breathing:
Breathing Techniques^{^[14]}

Incentive Spirometry

An incentive spirometer is a medical device often prescribed after surgery to prevent and treat atelectasis. Atelectasis occurs when alveoli become deflated or filled with fluid and can lead to pneumonia. See Figure \(\PageIndex{4}\)^{^[15]} for an image of a patient using an incentive spirometer. While sitting upright, the patient should breathe in slowly and deeply through the tubing with the goal of raising the piston to a specified level. The patient should attempt to hold their breath for 5 seconds, or as long as tolerated, and then rest for a few seconds. This technique should be repeated by the patient 10 times every hour while awake.^{^[16]}The nurse may delegate this intervention to unlicensed assistive personnel, but the frequency in which it is completed and the volume achieved should be documented and monitored by the nurse.

Coughing and Deep Breathing

Teaching the coughing and deep breathing technique is similar to incentive spirometry but no device is required. The patient is encouraged to take deep, slow breaths and then exhale slowly. After each set of breaths, the patient should cough. This technique is repeated 3 to 5 times every hour.

Huffing Technique

The huffing technique is helpful for patients who have difficulty coughing. Teach the patient to inhale with a medium-sized breath and then make a sound like “Ha” to push the air out quickly with the mouth slightly open.

Vibratory PEP Therapy

Vibratory Positive Expiratory Pressure (PEP) therapy uses handheld devices such as “flutter valves” or “Acapella” devices for patients who need assistance in clearing mucus from their airways. These devices (see Figure \(\PageIndex{5}\)^{^[17])}require a prescription and are used in collaboration with a respiratory therapist or advanced health care provider. To use Vibratory PEP therapy, the patient should sit up, take a deep breath, and blow into the device. A flutter valve within the device creates vibrations that help break up the mucus so the patient can cough it up and spit it out. Additionally, a small amount of positive end-expiratory pressure (PEEP) is created in the airways that helps to keep them open so that more air can be exhaled.

Note

Visit NHS University Hospitals Plymouth Physiotherapy’s “Acapella” video on YouTube to review using a flutter valve device^{^[18]}

TED-Ed. (2017, April 13). Oxygen’s surprisingly complex journey through your body - Edna Butler. [Video]. YouTube. All rights reserved. https://youtu.be/GVU_zANtroE ↵
Forciea, B. (2015, May 12). Anatomy and physiology: Respiratory system: Breathing mechanics (v2.0). [Video]. YouTube. All rights reserved. Video used with permission. https://youtu.be/X-J5Xgg3l6s↵
Forciea, B. (2015, May 12). Respiratory system: Gas exchange (v2.0). [Video]. YouTube. All rights reserved. Video used with permission. https://youtu.be/uVWko7_v7MM↵
Forciea, B. (2015, May 12). Respiratory system: C02 transport (v2.0). [Video]. YouTube. All rights reserved. Video used with permission. https://youtu.be/BmrvqZoxHYI ↵
Hill, B., & Annesley, S. H. (2020). Monitoring respiratory rate in adults. British Journal of Nursing, 29(1), 12–16. https://doi.org/10.12968/bjon.2020.29.1.12↵
This work is a derivative of Clinical Procedures for Safer Patient Care by British Columbia Institute of Technology and is licensed under CC BY 4.0↵
“Acopaquia.jpg” by Desherinka is licensed under CC BY-SA 4.0↵
This work is a derivative of Clinical Procedures for Safer Patient Care by British Columbia Institute of Technology and is licensed under CC BY 4.0↵
This work is a derivative of StatPearls by Patel, Miao, Yetiskul, and Majmundar and is licensed under CC BY 4.0↵
This work is a derivative of Clinical Procedures for Safer Patient Care by British Columbia Institute of Technology and is licensed under CC BY 4.0↵
“Obstruction ventilation apnée sommeil.svg” by Habib M’henni is in the Public Domain↵
This work is derivative of "aid611002-v4-728px-Live-With-Chronic-Obstructive-Pulmonary-Disease-Step-8.jpg" by unknown and is licensed under CC BY-NC-SA 3.0. Access for free at https://www.wikihow.com/Live-With-Chronic-Obstructive-Pulmonary-Disease. ↵
This work is a derivative of StatPearls by Nguyen and Duong and is licensed under CC BY 4.0↵
COPD Foundation. (2020, April 17). Breathing techniques. [Video]. YouTube. All rights reserved. https://youtu.be/ZJPJjZRHmy8↵
“Incentive Spirometer.pngsommeil.svg” by BruceBlaus is licensed under CC BY-SA 4.0↵
Cleveland Clinic. (2018, May 2). Incentive spirometer. https://my.clevelandclinic.org/health/articles/4302-incentive-spirometer↵
"Flutter Valve Breathing Device 3I3A0982.jpg" by Deanna Hoyord, Chippewa Valley Technical College is licensed under CC BY 4.0↵
NHS University Hospitals Plymouth Physiotherapy. (2015, May 12). Acapella. [Video]. YouTube. All rights reserved. https://youtu.be/XOvonQVCE6Y↵

11.2: Basic Concepts of Oxygenation (2024)

FAQs

What to do if o2 SAT is low nursing? ›

If the SpO₂ level is below 94%, the nurse should assume the patient is hypoxic until proven otherwise, and therefore they may require supplemental oxygen administration. » Nurses should be aware of the factors that might affect SpO₂ readings, including anaemia, peripheral vasoconstriction, dark skin tone and skin ...

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What are the basic concepts of oxygenation? ›

Oxygenation is the process of supplying oxygen to the body's cells. Ventilation is the process of exchanging oxygen and carbon dioxide, which is essentially breathing.

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What is the normal range of oxygen flow meter? ›

A range of flow meters are available at RCH, 0-1 LPM, 0-2.5 LPM, 0-15 LPM.

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What are the 4 components of oxygenation? ›

The four parameters commonly used to assess a patient's oxygen status are calculated oxygen saturation, oxyhemoglobin, Spo2, and Po2.

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What is a dangerously low oxygen level? ›

People should contact a health care provider if their oxygen saturation readings drop below 92%, as it may be a sign of hypoxia, a condition in which not enough oxygen reaches the body's tissues. If blood oxygen saturation levels fall to 88% or lower, seek immediate medical attention, says Dr. Lutchmansingh.

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What are the 3 major determinants of oxygenation status? ›

Heart rate, contractility, and ventricular-wall tension are the three factors that determine myocardial oxygen demand. An increase in any of these variables requires the body to adapt to sustain adequate oxygen supply to the heart.

What are the 3 major processes involved in oxygenation? ›

Three processes are essential for the transfer of oxygen from the outside air to the blood flowing through the lungs: ventilation, diffusion, and perfusion.

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What are the three types of oxygenation? ›

The three types of oxygen systems currently available are:

Compressed gas systems.
Portable oxygen concentrators (POCs)
Liquid oxygen systems.

What is better high-flow or low flow oxygen? ›

Low-flow systems often are more comfortable, but the ability to deliver a precise oxygen concentration in various respiratory breathing patterns is limited. A high-flow system can deliver very accurate oxygen concentrations, but is often uncomfortable and obtrusive.

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What is ideal oxygen flow? ›

Flow meter should be set to deliver O₂ at 6 to 10 L/min. Used to provide moderate oxygen concentrations. Efficiency depends on how well mask fits and the patient's respiratory demands.

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What is good oxygen flow? ›

For most people, a normal pulse oximeter reading for your oxygen saturation level is between 95% and 100%.

What does level 4 oxygen mean? ›

Stage 4 of IPF requires advance oxygen needs, which means needing high-flow oxygen or when a lightweight, portable delivery system is unable to meet a person with IPFs needs.

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How do you increase oxygen saturation? ›

How to Increase Your Blood Oxygen Level

Stand or sit up straight. Rather than lying down, which may put pressure on your lungs and make it harder to breathe.
Cough. If you have a cold or the flu, difficulty breathing can decrease oxygen saturation in your blood. ...
Go outside. ...
Drink lots of water. ...
Take slow, deep breaths.

Nov 17, 2021

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Which part of the body is responsible for oxygenation? ›

The lungs are the respiratory organs responsible for the exchange of gasses between the bloodstream and the atmosphere.

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What is the lowest oxygen level to live? ›

Paragraph (d)(2)(iii) of the Respiratory Protection Standard considers any atmosphere with an oxygen level below 19.5 percent to be oxygen-deficient and immediately dangerous to life or health.

How long can you survive with low oxygen levels? ›

Most people will die within 10 minutes of total oxygen deprivation. Those in poor health often die much sooner. Some people may suffer other medical catastrophes, such as a heart attack, in response to oxygen deprivation.

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What is normal oxygen level by age? ›

Blood Oxygen Levels by Age Using a Pulse Oximetry Chart

Conditions	By Age	SpO2
Normal	Adults & Children	95% to 100%
Normal	>70 years old	about 95%
Brain is affected	Adults & Children	80% to 85%
Cyanosis	Adults & Children	Below 67%

Dec 21, 2022

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What is the most common cause of low blood oxygen? ›

Breathing that's too slow or shallow to meet the lungs' need for oxygen. Either not enough blood flow to the lungs or not enough oxygen to the lungs. Trouble with oxygen getting into the bloodstream and the waste gas carbon dioxide getting out. A problem with the way blood flows in the heart.

How can you tell if your oxygen level is dropping? ›

Oxygen levels may be low if someone feels short of breath, is breathing faster than usual, or feels too sick to do their usual daily activities, even if a pulse oximeter says their oxygen levels are normal. Call a doctor or another health care provider right away if you have these symptoms.

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Does low oxygen make you tired? ›

When your body is low on oxygen, you feel tired. Fatigue comes more quickly when your lungs can't properly inhale and exhale air. This sets up an unpleasant cycle. When you're left feeling lethargic because of a lack of oxygen, you're less likely to engage in physical activity.

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How do you check oxygenation status? ›

A pulse oximeter can measure oxygen saturation. It is a noninvasive device placed over a person's finger. It measures light wavelengths to determine the ratio of the current levels of oxygenated hemoglobin to deoxygenated hemoglobin. The use of pulse oximetry has become a standard of care in medicine.

What is the simplest way to quickly assess his oxygenation status? ›

Because the majority of oxygen transported in the blood is attached to hemoglobin, a patient's oxygenation status is easily assessed using pulse oximetry, referred to as SpO2.

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What are the 3 issues a client might present with which require oxygen therapy? ›

A severe asthma attack.
Cystic fibrosis.
Sleep apnea.

May 5, 2023

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What factors affect oxygenation? ›

Several factors influence the binding of oxygen to hemoglobin: temperature, pH, P_CO₂ and 2,3 diphosphoglycerate (2,3 DPG).

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What are the phases of oxygenation? ›

Three processes are essential for the transfer of oxygen from the outside air to the blood flowing through the lungs: ventilation, diffusion, and perfusion.

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What four factors affect oxygenation and ventilation? ›

Factors Affecting Oxygenation. Four factors influence adequacy of circulation, ventilation, perfusion, and transport of respiratory gases to the tissues: (1) physiological, (2) developmental, (3) lifestyle, and (4) environmental.

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What are the two major types of oxygen systems? ›

Oxygen delivery systems are categorised into low-flow and high-flow systems. Low-flow systems provide lower oxygen flow than the actual inspiratory flow (∼30 L·min⁻¹).

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What are the methods of oxygenation? ›

Adding supplemental oxygen or oxygen that is above the amount found in the atmosphere without alteration is most commonly delivered to the patient by nasal cannula, O2 mask (simple, non-rebreather, Venturi-mask) or added into a CPAP (continuous positive airway pressure) or BiPAP (bilevel positive airway pressure) ...

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What are the 3 types of respiratory structures for taking in oxygen? ›

Trachea: Passage connecting your throat and lungs. Bronchial tubes: Tubes at the bottom of your windpipe that connect into each lung. Lungs: Two organs that remove oxygen from the air and pass it into your blood.

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Is high flow oxygen better than nasal cannula? ›

When high-flow nasal cannula, or HFNC, is used to deliver oxygen, the flow rates are much higher than can be achieved with traditional nasal cannula. This results in a greater delivery of prescribed oxygen into the lungs, and less entrainment of room air.

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Why is high-flow O2 not given in COPD? ›

For patients with COPD, insufficient respiratory effort and/or inadequate alveolar ventilation, in a setting of uncontrolled oxygen delivery (where the precise Fio₂ is unknown) can result in dangerous levels of both oxygen and carbon dioxide.

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Why is high flow oxygen bad for COPD? ›

Administering supplemental O2 disturbs this careful balance with diseased sections seeing increased oxygen pressure and stealing perfusion away from better functioning areas. This results in shunting, dead space ventilation, and eventually high PaCO2.

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What is the best o2 flow rate for COPD? ›

Most COPD patients will start on low flow oxygen therapy via a nasal cannula at flow rates sufficient to being the oxygen levels up to a minimum SpO₂ of 88 – 90%. For many this calls for 1 to 3 or 4 liters per minute flow.

What is the highest liter of oxygen you can be on? ›

The highest flow oxygen concentrators output oxygen flow at 10 liters per minute.

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Who needs high flow oxygen? ›

High flow oxygen therapy is for in people in respiratory distress who still have low oxygen levels despite trying traditional oxygen therapy. High flow oxygen therapy supports breathing in people with: Acute heart failure. Acute Respiratory Distress Syndrome (ARDS)

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What is the maximum flow rate for a nasal cannula? ›

A traditional nasal cannula can only effectively provide only up to 4 to 6 liters per minute of supplemental oxygen. This equates to a FiO2 of approximately 0.37 to 0.45.

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Is 8 l of oxygen a lot? ›

The normal flow rate of oxygen is usually six to 10 litres per minute and provides a concentration of oxygen between 40-60%.

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How low is too low for oxygen while sleeping? ›

How Low Can Your Oxygen Levels Go During Sleep?

Blood Oxygen Level	Interpretation
96 to 100%	Normal range
93 to 95%	Borderline low
89 to 92%	Low
88% or lower	Dangerously low

Jun 23, 2023

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Does drinking water help oxygen saturation? ›

Keeping yourself hydrated is another important method to improve your blood's oxygen saturation level. When you drink lots of water, your lungs remain properly hydrated, which improves their ability to oxygenate and expel carbon dioxide. Therefore, the oxygen saturation level of your body gets improved.

Keep Reading ›

At what oxygen level should you go to the hospital? ›

90% or less This oxygen level is very concerning and may indicate a severe medical problem. Call 911 or go to the nearest emergency room immediately.

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Can inhaler increase oxygen level? ›

Albuterol Sulfate is among the most common medications used to treat shortness of breath in asthma and COPD. It relaxes the airways to make breathing easier, it may help bring your O2 level up a bit.

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What organ is damaged due to lack of oxygen? ›

While some of your tissues can adjust to temporary dips in oxygen levels, prolonged hypoxia can cause organ damage. Brain and heart damage are particularly dangerous and can lead to death. Lack of oxygen to your brain is called cerebral hypoxia.

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What organs are affected by low oxygen? ›

Without oxygen, your brain, liver, and other organs can be damaged just minutes after symptoms start. Hypoxemia (low oxygen in your blood) can cause hypoxia (low oxygen in your tissues) when your blood doesn't carry enough oxygen to your tissues to meet your body's needs.

How to increase o2 saturation nursing? ›

Encourage Enhanced Breathing and Coughing Techniques

Enhanced breathing and coughing techniques such as using pursed-lip breathing, coughing and deep breathing, huffing technique, incentive spirometry, and flutter valves may assist patients to clear their airway while maintaining their oxygen levels.

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How do you increase oxygen saturation in patients? ›

How to Increase Your Blood Oxygen Level

Stand or sit up straight. Rather than lying down, which may put pressure on your lungs and make it harder to breathe.
Cough. If you have a cold or the flu, difficulty breathing can decrease oxygen saturation in your blood. ...
Go outside. ...
Drink lots of water. ...
Take slow, deep breaths.

Nov 17, 2021

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What should the nurse do when a patient is ordered to receive 4 L min oxygen by nasal cannula? ›

4. What should the nurse do when a patient is ordered to receive 4 L/min oxygen by nasal cannula?

Encourage oral fluids.
Restrict fluids.
Ensure that humidification is present.
Measure blood pressure every hour.

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What is the nurses responsibility during o2 administration? ›

Steps

Verify provider order or protocol.
Gather supplies: pulse oximeter, oxygen delivery device, and tubing.
Perform safety steps: ...
Perform a focused respiratory assessment including airway, respiratory rate, pulse oximetry, and lung sounds.
Employ safety measures for oxygen therapy.

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What is the fastest way to increase oxygen saturation? ›

Check out these easy ways to improve your oxygen saturation level from your home:

Lie down in the "prone" position. Proning is the best position to increase the oxygen level of your body. ...
Include more antioxidants in your diet. ...
Practice slow and deep breathing. ...
Drink lots of fluid. ...
Try aerobic exercises.

May 9, 2021

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What are the methods to improve oxygenation? ›

Practice breathing exercises.

Pulmonary rehabilitation experts recommend using simple breathing exercises like pursed-lip breathing and deep belly breathing to open your airways and increase the amount of oxygen in your body.

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What happens when your oxygen level drops to 70? ›

What happens when the oxygen level drops to 70? When your oxygen level drops to 70, you will experience headaches and dizziness apart from breathlessness. You must consult with your doctor if you observe any of these symptoms so that you can be put on supplemental oxygen to raise the oxygen saturation of the blood.

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What vitamin puts oxygen in the blood? ›

B Vitamins

What is does: These vitamins, which include B1, B2, B6, B12, niacin, biotin, folic acid and pantothenic acid, help make energy and red blood cells that carry oxygen to different parts of your body.

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What is the best position to increase oxygen levels? ›

Although oxygen saturation values were within the normal range in the five different body positions, post hoc analysis showed that the best oxygenation was in the 'sitting upright' position while the lowest oxygenation was in the supine position.

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How long can someone live with low oxygen saturation? ›

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Do nasal cannula prongs point up or down? ›

The nasal cannula prongs are slightly curved. Make sure the prong tips curve DOWN into the nose following the natural curve of the nasal passage.

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What is the maximum oxygen that can be given to a patient? ›

For the otherwise healthy patient, oxygen saturation targets are generally at 92 to 98%. For patients with chronic hypercapnic conditions, target oxygen saturations are generally between 88 to 92%, with oxygen administration indicated at saturations below these levels.

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What 3 things should be detailed in a prescription for the patient to have oxygen? ›

1.2 Description of Procedure/Process

Oxygen is a drug and should be treated like any other drug. It must be prescribed on the 24 hourly oxygen prescription and monitoring chart with the required administration device; flow rate; concentration and target saturation level identified.

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What is the most important precaution when nurse administers oxygen therapy? ›

Never place the tank or machine near an open flame (e.g., matches, lit candles, a stove in use). Keep the oxygen tank at least six feet away. Always turn your oxygen off when not in use. Always check the oxygen levels on your oxygen tank.

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Can a nurse give oxygen in an emergency? ›

Any competent registered nurse/ health professional can commence oxygen therapy in an emergency situation (without the need for a formal prescription).

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Can a nursing assistant administer oxygen? ›

Many facilities include items on the Medication Administration Record (MAR) that are not medications such as tube feedings or oxygen. The CNA may work with tube feedings and oxygen as described in the Division 63 Authorized Duties.

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11.2: Basic Concepts of Oxygenation (2024)

Note

Video Review for Oxygenation Basics

View the TED-Ed Oxygen’s Journey video on YouTube[1]

Breathing Mechanics[2]

Gas Exchange[3]

Carbon Dioxide Transport[4]

Assessing Oxygenation Status

Hypoxia and Hypercapnia

Treating Hypoxia

Note

Enhanced Breathing and Coughing Techniques

Pursed-Lip Breathing

Note

Incentive Spirometry

Coughing and Deep Breathing

Huffing Technique

Vibratory PEP Therapy

Note

FAQs

What to do if o2 SAT is low nursing? ›

What is good oxygen flow? ›

How do you check oxygenation status? ›

Why is high-flow O2 not given in COPD? ›

Can inhaler increase oxygen level? ›

What vitamin puts oxygen in the blood? ›

View the TED-Ed Oxygen’s Journey video on YouTube^{^[1]}

Breathing Mechanics^{^[2]}

Gas Exchange^{^[3]}

Carbon Dioxide Transport^{^[4]}