Equipment, Oxygen and Environmental Hazard Safety

Oxygen Administration, Storage, and Client Care

Oxygen is a therapeutic gas that strongly supports combustion and rapidly accelerates the spread of fire. Post the oxygen-warning and no-smoking signs required by facility policy and local fire codes; an 'Oxygen in Use' sign identifies an area where oxygen is being administered, not an area used only for cylinder storage. Smoking, open flames, and burning candles are strictly prohibited near active oxygen therapy systems. In addition, items that can spark or generate heat, such as electric razors, hair dryers, and heating pads, must be kept away from oxygen delivery sites, following facility or supplier instructions. Flammable solvents and aerosol products must also be kept away from oxygen equipment, and any alcohol-based products must be allowed to dry fully before they are exposed to an ignition source.

Clothing and skin care require specific precautions during oxygen administration. Practical nurses must follow facility or oxygen-supplier guidance regarding fabrics that may generate static electricity near oxygen equipment, and all fabrics must be kept away from flames and sparks. Wearing cotton clothing and using cotton bedding may help reduce static buildup, but cotton is not required; practical nurses must remember that cotton remains flammable and must always be kept away from ignition sources. For client comfort, petroleum-based products such as petroleum jelly are flammable and must never be applied around oxygen delivery sites. If oxygen therapy causes nasal or lip dryness, the practical nurse applies a water-soluble product approved by facility policy or the oxygen supplier, rather than applying lubricants routinely.

Oxygen cylinders store gas under extreme pressure and require strict physical safeguards to prevent catastrophic accidents. Cylinders must be stored secured upright in approved stands or racks, or placed horizontally in racks designed to prevent rolling, according to facility policy. Secure upright cylinders with an approved chain or strap; cylinders stored horizontally must be in an approved rack or cradle that prevents rolling, according to facility policy. An unrestrained oxygen cylinder with a broken valve can become a lethal projectile under high pressure. Practical nurses must never leave oxygen cylinders unsecured on the floor or store them near heat sources. When preparing for client transport, the practical nurse checks that portable oxygen tanks have sufficient pressure before leaving the area.

Routine clinical care involves focused data collection, equipment checks, and timely communication with the registered nurse (RN). At the start of the shift, the practical nurse checks that the oxygen and suction equipment needed for the client's care are available and working, according to facility policy, and reports any defects to the RN. When higher-flow nasal-cannula oxygen is administered, often above 4 L/min, humidification may be used when ordered or required by policy; the nurse uses the water specified for the device, which is commonly sterile water. During care, the practical nurse inspects the client's skin behind the ears and around the nares for breakdown caused by oxygen tubing. The practical nurse reinforces safety teaching regarding home oxygen precautions that were initiated by the RN, and immediately reports any client signs of hypoxia, respiratory depression, or oxygen toxicity to the RN.