Oxygen therapy via a face mask is a vital intervention in Nigerian clinical practice, utilized whenever a patient cannot maintain adequate oxygen saturation through room air alone. Medical-surgical wards and emergency units routinely manage cases such as severe malaria with respiratory distress, lobar pneumonia, acute asthma exacerbations, and post-operative recovery where hypoxemia threatens organ function. The primary goal is to reverse tissue hypoxia by delivering a higher fraction of inspired oxygen than is found in ambient air. Nurses must recognize that hypoxia manifests differently across age groups, often presenting as restlessness or confusion in elderly patients before cyanosis appears.
Before initiating therapy, assemble all necessary materials at the bedside to ensure a smooth procedure.
Different masks deliver varying concentrations of oxygen depending on their design and the flow rate applied.
Thorough preparation ensures patient safety and cooperation. Begin by assessing the patient's baseline respiratory rate, depth, pattern, and oxygen saturation level via pulse oximetry. Inspect the nares, mouth, and facial skin for any existing breakdown, irritation, or secretions. Explain the procedure clearly to the patient and relatives to alleviate anxiety, as panic increases oxygen consumption. Ensure the patient is sitting in a semi-Fowler's or high-Fowler's position to maximize lung expansion, and remove any makeup, oil, or food debris from the face before applying the mask.
Oxygen is a drug and must be monitored continuously. Check the flow rate and humidifier water level every shift. Inspect the skin over the ears and nasal bridge every four hours for signs of pressure injury caused by elastic straps or mask edges. Monitor vital signs and pulse oximetry readings regularly to evaluate the effectiveness of therapy. Enforce strict fire safety rules: oxygen supports combustion, so smoking, naked flames, and electrical sparks must be strictly prohibited near the patient's bed.
While oxygen is lifesaving, improper administration can lead to complications. Oxygen toxicity can occur when high concentrations of oxygen are administered for extended periods, leading to pulmonary damage. In patients with chronic respiratory conditions who rely on hypoxic drive, high flow rates can depress breathing and cause carbon dioxide narcosis. Drying of the nasal and oral mucosa is common and can be mitigated by ensuring adequate humidification and offering frequent mouth care. Skin breakdown under the mask requires regular repositioning of straps and barrier creams where appropriate.