What is the difference between a non-rebreather mask and a nasal cannula?

A non-rebreather mask delivers high concentrations of oxygen (up to 90% FiO2) at flow rates of 10-15 L/min and is used for severe hypoxia. It has a reservoir bag and one-way valves to prevent rebreathing of exhaled air. A nasal cannula delivers lower concentrations (24-44% FiO2) at 1-6 L/min and is more comfortable for patients who need mild to moderate oxygen therapy, such as those with chronic lung conditions.

Can I give oxygen to a patient with COPD?

Yes, but with caution. Patients with chronic obstructive pulmonary disease (COPD) may rely on a hypoxic drive to breathe, meaning low oxygen levels stimulate their breathing. Giving high-flow oxygen can suppress this drive, leading to carbon dioxide retention and respiratory failure. For COPD patients, target an SpO2 of 88-92% and use a controlled oxygen delivery system, such as a Venturi mask, at the lowest effective flow rate.

How do I know if a patient needs oxygen?

Look for signs of hypoxia: cyanosis (blue lips or fingertips), confusion, restlessness, rapid breathing (tachypnoea), and low oxygen saturation (SpO2 <94% on a pulse oximeter). In an emergency, if the patient is struggling to breathe or has a condition like anaphylaxis, asthma attack, or heart attack, oxygen should be administered immediately while awaiting further medical help.

What are the risks of giving too much oxygen?

Excessive oxygen can cause oxygen toxicity, leading to pulmonary damage (e.g., acute respiratory distress syndrome), retinopathy in premature infants, and absorption atelectasis (collapse of alveoli). In COPD patients, it can cause hypercapnic respiratory failure. Always monitor SpO2 and adjust flow rates to stay within the target range.

Do I need a prescription to administer oxygen?

In a first aid or emergency setting, you can administer oxygen under the guidance of protocols or a patient group direction (PGD) without a specific prescription. However, in a clinical setting, oxygen is a medicine and should be prescribed by a doctor or qualified practitioner. Always follow your organisation's policies and the FAA Level 3 training guidelines.

How often should I check the oxygen cylinder pressure?

Check the cylinder pressure before each use and during prolonged therapy. The pressure gauge should be in the green zone (typically >100 bar for a full cylinder). If the pressure drops below 50 bar, replace the cylinder to ensure adequate flow. Also, check for leaks by listening for hissing sounds and ensuring the valve is fully open.

Administration of oxygen therapy

Q: What are the risks of giving too much oxygen?

Excessive oxygen can cause oxygen toxicity, leading to pulmonary damage (e.g., acute respiratory distress syndrome), retinopathy in premature infants, and absorption atelectasis (collapse of alveoli). In COPD patients, it can cause hypercapnic respiratory failure. Always monitor SpO2 and adjust flow rates to stay within the target range.

Q: Do I need a prescription to administer oxygen?

In a first aid or emergency setting, you can administer oxygen under the guidance of protocols or a patient group direction (PGD) without a specific prescription. However, in a clinical setting, oxygen is a medicine and should be prescribed by a doctor or qualified practitioner. Always follow your organisation's policies and the FAA Level 3 training guidelines.

Q: How often should I check the oxygen cylinder pressure?

Check the cylinder pressure before each use and during prolonged therapy. The pressure gauge should be in the green zone (typically >100 bar for a full cylinder). If the pressure drops below 50 bar, replace the cylinder to ensure adequate flow. Also, check for leaks by listening for hissing sounds and ensuring the valve is fully open.

FIRST AID AWARDS LTD

vocational

This subtopic covers the safe and effective administration of emergency oxygen therapy, focusing on the practical application of guidelines such as those from the Resuscitation Council (UK) and the British Thoracic Society. Learners must understand indications for oxygen use, appropriate delivery devices, flow rates, and monitoring to manage hypoxia in acute settings while avoiding hyperoxia and other complications.

Learning Outcomes

Assessment Guidance

Key Skills

Key Terms

Assessment Criteria

Assessment criteria

FAA Level 3 Award in Oxygen Therapy Administration

Topic Overview

The FAA Level 3 Award in Oxygen Therapy Administration is a vocational qualification designed for healthcare professionals, first responders, and those working in health and social care settings who may need to administer emergency oxygen. This course covers the theoretical knowledge and practical skills required to safely assess, prepare, and administer oxygen therapy to patients experiencing respiratory distress or hypoxia. It is a critical component of first aid and emergency care, as oxygen is a drug that must be handled with precision to avoid harm.

Understanding oxygen therapy is essential because hypoxia—a deficiency in oxygen reaching tissues—can lead to irreversible organ damage or death if not treated promptly. This qualification ensures that students can identify when oxygen is needed, select the appropriate delivery device (e.g., non-rebreather mask, nasal cannula), and monitor the patient's response. It also emphasises safety protocols, including checking equipment, maintaining oxygen flow rates, and recognising contraindications such as carbon monoxide poisoning or chronic obstructive pulmonary disease (COPD).

Within the wider Health & Social Care curriculum, this award bridges basic first aid and advanced life support. It is often taken alongside other FAA qualifications like the Level 3 Award in First Aid at Work or the Level 3 Award in Emergency First Aid at Work. Mastery of oxygen therapy administration enhances a student's ability to manage medical emergencies in community, workplace, or clinical settings, making them more competent and confident responders.

Key Concepts

Core ideas you must understand for this topic

→Hypoxia and its signs: Early recognition of hypoxia (e.g., cyanosis, confusion, tachypnoea) is crucial for timely oxygen administration.
→Oxygen delivery devices: Understand the differences between a non-rebreather mask (high concentration, ~15 L/min), a nasal cannula (low to moderate concentration, 1-6 L/min), and a bag-valve-mask (for ventilatory support).
→Oxygen flow rates and FiO2: Know how to set flow rates to achieve the desired fraction of inspired oxygen (FiO2) and avoid oxygen toxicity.
→Safety checks: Always check the oxygen cylinder is full, the regulator is functioning, and the tubing is patent before use. Never use oil or grease near oxygen equipment.
→Contraindications: Oxygen should be used cautiously in patients with COPD (risk of carbon dioxide retention) and in cases of paraquat poisoning or bleomycin therapy.

Learning Objectives

What you need to know and understand

Know guidelines for the use of oxygen therapy., Be able to administer oxygen therapy

Assessment Criteria

Key criteria assessors look for in your portfolio

Award credit for correctly identifying indications for oxygen therapy, such as major trauma, shock, or hypoxia with oxygen saturations below 94%.
Require demonstration of assembling and checking oxygen administration equipment, including selecting the correct mask or cannula and setting the prescribed flow rate.
Expect clear communication with the casualty throughout the procedure, including explaining the need for oxygen and gaining consent where possible.

Assessment Guidance

Guidance for achieving higher grades

💡Always confirm oxygen saturation levels using a pulse oximeter, where available, before and during administration, documenting readings as evidence.
💡In practical assessments, narrate your actions clearly, stating the rationale for each step—for example, explaining why a non-rebreathe mask at 15 litres per minute is appropriate for a critically ill casualty.
💡Remember to prioritise safety by avoiding sources of ignition and ensuring adequate ventilation when using oxygen cylinders.
💡In practical assessments, always verbalise your safety checks (e.g., 'I am checking the cylinder pressure is within the green zone')—examiners award marks for demonstrating awareness, not just doing.
💡When answering written questions, use the acronym 'SOAP' (Signs, Oxygen delivery, Assessment, Plan) to structure your responses for scenario-based questions.
💡Memorise the target oxygen saturation ranges: For most patients, aim for SpO2 94-98%; for those at risk of hypercapnia (e.g., COPD), aim for 88-92%.

Common Mistakes

Common errors to avoid in your coursework

Administering high-flow oxygen to patients with known chronic obstructive pulmonary disease (COPD) without caution, potentially causing hypercapnia.
Failing to check oxygen cylinder contents and expiry date before use, leading to insufficient supply during an emergency.
Poor mask seal leading to ineffective oxygen delivery due to inappropriate mask size or incorrect fitting.
Misconception: 'More oxygen is always better.' Correction: High concentrations of oxygen can cause oxygen toxicity (e.g., pulmonary damage) and suppress the respiratory drive in COPD patients. Always use the lowest effective concentration.
Misconception: 'Oxygen is not a drug.' Correction: Oxygen is a prescription-only medicine in many contexts and must be administered with the same caution as any other drug, following a prescription or protocol.
Misconception: 'Any mask will do.' Correction: Different masks deliver different oxygen concentrations. Using a simple face mask when a non-rebreather is needed may not correct severe hypoxia.

Frequently Asked Questions

Common questions students ask about this topic

Before You Start

Prior knowledge that will help with this topic

•Basic first aid knowledge (e.g., recovery position, CPR) is recommended.
•Understanding of respiratory anatomy and physiology (e.g., how gas exchange occurs in the alveoli).
•Familiarity with the use of medical equipment (e.g., how to read a pressure gauge).

Key Terminology

Essential terms to know

Know guidelines for the use of oxygen therapy., Be able to administer oxygen therapy

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Administration of oxygen therapy

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