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Oxygen(O2) is gas used as a drug/medication and a such should be prescribed and administered in the right manner with regards to presenting indications for it's use,which is always in the case of hypoxaemia.

Indications For Oxygen Therapy
Oxygen is rarely indicated for any other reason than Hypoxaemia.

Hypoxaemia: Oxygen can be given in high or low concentration in all the conditions associated with hypoxaemia. Hypoxaemia occurs frequently in diseases like lower respiratory tract infection (severe pneumonia or bronchiolitis), upper airway obstruction, severe asthma, common neonatal conditions like birth asphyxia and in respiratory distress syndrome, severe sepsis, heart failure, cardiac arrest, trauma, carbon monoxide poisoning, and obstetric and perioperative emergencies.

Delivery Devices for Oxygen Therapy

The oxygen delivery devices are grouped into two:

Low flow oxygen delivery system

High flow oxygen delivery system

Low flow oxygen delivery systems are those that the exact fraction of oxygen in the inspired air (FiO2) will be based on the patient's anatomic reservoir and minute ventilation.


Nasal Cannula: It can carry upto 1 – 6 Litres of O2 Per Minute with FiO2 0.24 – 0.44 (approximate 4% per liter flow) and FiO2 decreases as Ventilation rate increases. It is the recommended device for oxygen delivery in children less than 5 years of age (level 1 evidence) It is ideal for long term oxygen therapy. It does not increase dead space and there is no rebreathing.

Simple Mask: It can carry upto 5 –10 Litres of O2 per Minute with FIO2 0.35 – 0.55 (approximate flow rate of 40%). Flow Rates should be set at 5 L/min or more to avoid rebreathing expired CO2 retained in the mask[18]. It slightly increases dead space and there is little rebreathing[19]. It is usually uncomfortable for patients, obstruct eating and drinking and also, muffles speech.

Partial Rebreather is a simple mask with a reservoir bag. Oxygen flow should always be supplied to maintain the reservoir bag on inspiration thus avoiding reservoir bag deflation. At a flow of 6-10 L/min the system can provide 50-70% oxygen.

Non- rebreather: The non- rebreathing mask is similar to the partial rebreathing mask except it has a series of one-way valves. One valve is placed between the bag and the mask to prevent exhaled air from returning to the bag. There should be a minimum flow of 10 L/min. The delivered FiO2 of this system is 7-10%
High flow oxygen delivery systems[20] deliver a prescribed gas mixture (either high or low) at flow rates that exceed patient demand.

Venturi Mask: the flow rate is at about FiO2 0.24 – 0.50 with variable LPM. Flow and corresponding FiO2 varies by manufacturer
If air-entrainment masks is available it can be used to accurately deliver preset oxygen concentration to the trachea up to 40% but the inspiratory flow rates is usually inadequate for adults in respiratory distress.

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Lesson plan on Oxygen administration
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Lesson plan on oxygen administration