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Medical Gas Therapy: Types & Procedure

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Medical Gas Therapy is one of the most common types of Respiratory Care. That means it’s a topic that every Respiratory Therapist (and student) should be thoroughly familiar with.

To help, we created this study guide which covers the basics of Medical Gas Therapy. We’ve also included some helpful practice questions for your benefit as well. So if you’re ready, let’s get started.

Medical Gas Therapy

What is Medical Gas Therapy?

Medical Gas Therapy refers to the deliverance of gases for therapeutic purposes. Medical gases are technically considered to be drugs, so they should be administered and delivered with the recommendation of the physician or Respiratory Therapist.

What are the Types of Medical Gas Therapy?

Oxygen therapy is the most common type of medical gas therapy, although there are a few other types as well. Here are all the types of medical gas therapy listed out:

  • Oxygen Therapy
  • Helium-Oxygen Therapy
  • Nitric Oxide Therapy
  • Carbon Dioxide–Oxygen Therapy

Now let’s dive deeper into oxygen therapy and how to administer it appropriately.

When is it Appropriate to Recommend Oxygen Therapy?

As a Respiratory Therapist, it’s important to know how to evaluate, recommend, and administer the oxygen therapy for patients in need. Here’s a tidbit of knowledge to remember:

Oxygen is a drug, so we must treat it as such.

Oxygen is a prescribed drug that Respiratory Therapists commonly administered to patients requiring emergency life support, pulmonary disability, and post-operative states that have or may develop cardiopulmonary complications.

The administration of oxygen and other medical gases is one of the main job duties of a Respiratory Therapist.

This is why it’s so important to understand the goals, indications, contraindications, and hazards of oxygen therapy. The Respiratory Therapist must be able to evaluate, recommend, and administer all medical gas modalities appropriately, as well as recognize adverse reactions of the therapy.

Now let’s take a look at the procedure for delivering oxygen therapy.

Procedure for Delivering Oxygen Therapy:

1. Verify the Physician’s Order.

First and foremost, you always want to review and evaluate the orders that were written by the doctor, so that you can fulfill them appropriately in order to give the right care to the right patient.

2. Examine the Patient’s Chart.

You want to do this so that you can review any relevant notes or data. For example, you may review the following in the patient’s chart: their diagnosis, medications, therapies, radiographs, laboratory results, hemodynamic, electrocardiograms, sleep lab reports.

3. Gather and Prepare All Needed Equipment.

In this step, you may need to wash your hands and disinfect any equipment if needed. Assemble any equipment appropriately to verify that it is functioning properly. This includes troubleshooting the equipment if necessary.

4. Explain the Procedure to the Patient.

Use two patient identifiers to confirm the identity of the patient and introduce yourself and be sure to state that you are with the respiratory therapy department. Explain the purpose and objective of the procedure and be sure that the patient understands you.

5. Assess the Patient and Implement the Therapy.

Make sure to position the patient properly. Fully assess the patient which includes obtaining their vital signs, breath sounds, oxygen saturation, and ventilatory status.

Attach the oxygen device to the patient and use the appropriate humidification if needed. Adjust the flow meter to the order or necessary liter flow to deliver the appropriate amount of oxygen to the patient. Make sure to position the interface so that it is comfortably placed on the patient’s face. Verify that it is comfortable for the patient.

6. Assess the Effectiveness of the Therapy and Make Any Needed Adjustments.

This may require you to re-check the patient’s vital signs. Say, for instance, you place the patient on 2 liters binasal cannula, but their oxygen saturation is still hovering around 87%. In this case, you would need to increase the liter flow in order to elevate the patient’s oxygen saturation back into the normal range.

7. Follow-up.

This is where you ensure the patient’s comfort and safety, as well as noting that the oxygen therapy is working effectively. You will need to perform proper hand-washing and dispose of any infectious wastes or materials. Proceed to document all of the important and pertinent information in the patient’s chart.

Also, if the treatment type is not a continuous modality, now is the time for you to remove or disconnect any equipment. However, if it is a continuous modality (like a nasal cannula) then you can leave it as-is and monitor the stability of the oxygenation parameters.

What Skills are Required to Administer Oxygen Therapy?

The following are some of the skills that a Respiratory Therapist must acquire in order to administer oxygen therapy:

  • You must know how to identify the contents of medical gas cylinders and identify the markings on the cylinders as defined by the department of transportation. Know how to store and transport the cylinders safely. 
  • Know the difference between the American Standard Safety System (ASSS), the Diameter Index Safety System (DISS), and the Pin Index Safety System (PISS). 
  • Be able to describe the two main types of valves found on “E” and “H” cylinders and their functions.

  • Know the components of a bulk liquid system and a reserve system. Understand the characteristics of a small and large liquid oxygen reservoir and the advantages and disadvantages of each.
  • Know how to operate and troubleshoot an air compressor. 
  • Know and understand the components of regulators, bourdon gages, and Thorpe tubes. This includes knowing the difference between a pressure-compensated and non-pressure compensated flowmeter.
  • Know how to set up and operate an oxygen blender.
  • Know how to locate and identify zone valves in your healthcare facility in case of an emergency. Also just know and understand the purpose of zone valves.
  • Know how to use the wall outlet quick-connect system.  
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