OXYGEN THERAPY

Oxygen Therapy is an NMC CBME-aligned undergraduate medical education course designed to equip MBBS students with the essential knowledge, clinical reasoning and practical skills required to administer oxygen safely, appropriately and effectively in hospital and home-care settings.

Oxygen is one of the most frequently used therapeutic interventions in clinical practice, but its administration requires appropriate assessment, device selection, target-based therapy and continuous monitoring. This course therefore emphasizes an important clinical principle: oxygen is a medication and should be prescribed, titrated and monitored according to the patient's clinical condition.

Through a combination of interactive learning, clinical case discussion, faculty demonstration, DOAP-based skills practice and simulation, students progressively develop the ability to recognize hypoxaemia, assess the patient, select an appropriate oxygen-delivery device, initiate therapy, monitor the response and recognize when escalation is required.

Learning Objectives

By the end of this course, students should be able to:

Knowledge

• Define oxygen therapy and explain its clinical purpose.
• Explain the basic principles of oxygen administration.
• Identify indications for supplemental oxygen.
• Recognize clinical features of hypoxaemia and respiratory distress.
• Explain the role and limitations of pulse oximetry.
• Identify common hospital oxygen sources.
• Describe commonly used oxygen-delivery devices.
• Explain the principles of target-based oxygen therapy.
• Describe important complications and hazards of oxygen therapy.
• Explain basic principles of home oxygen therapy and safety.

Clinical Skills

Students will be able to:

• Perform an initial ABCDE assessment of a patient requiring oxygen.
• Assess and interpret SpO₂ in the clinical context.
• Select an appropriate oxygen-delivery device.
• Check and prepare oxygen equipment.
• Correctly apply nasal cannulae and face masks.
• Demonstrate appropriate use of Venturi and reservoir masks.
• Initiate oxygen therapy safely.
• Titrate oxygen according to an appropriate target.
• Reassess the patient's clinical response.
• Recognize persistent hypoxaemia or treatment failure.
• Identify the need for escalation and senior/critical-care assistance.

Communication and Professionalism

Students will also learn to:

• Explain oxygen therapy to patients in simple language.
• Reassure an anxious breathless patient.
• Communicate treatment decisions clearly.
• Counsel patients and caregivers regarding home oxygen safety.
• Document oxygen therapy appropriately.

Course Content

Module 1 — Recognising Hypoxaemia

Students learn to identify:

• Hypoxaemia
• Respiratory distress
• Tachypnoea
• Increased work of breathing
• Cyanosis
• Altered mental status
• Low SpO₂

The module reinforces the importance of clinical assessment rather than relying solely on a numerical oxygen saturation reading.

Module 2 — Oxygen as a Therapeutic Agent

Students are introduced to the concept:

“Oxygen is a drug.”

The course explains:

Indication → Device → Dose/Concentration → Target → Monitoring → Reassessment

Students learn why oxygen should not simply be administered at maximum flow to every breathless patient.

Module 3 — Oxygen Sources

Students become familiar with:

• Central hospital oxygen pipeline
• Oxygen cylinders
• Oxygen concentrators
• Hospital oxygen-generation systems
• Regulators and flowmeters
• Oxygen tubing and connectors

The practical session emphasizes equipment checking and safe handling.

Module 4 — Oxygen-Delivery Devices

Students identify and compare:

• Nasal cannula
• Simple face mask
• Venturi mask
• Reservoir/non-rebreather mask
• High-flow nasal cannula

Students learn that device selection should be based on the patient's clinical condition and oxygen requirement.

Module 5 — Oxygen Targets and Titration

Students learn the concept of target-based oxygen therapy.

For most acutely ill adults, a commonly used target is:

SpO₂ 94–98%

For selected patients at risk of hypercapnic respiratory failure:

SpO₂ 88–92%

Students are taught that targets should be individualized according to the clinical situation and current institutional protocols.

Module 6 — Monitoring and Reassessment

Students practise assessing:

• SpO₂
• Respiratory rate
• Work of breathing
• Heart rate
• Mental status
• Overall clinical response
• Oxygen equipment function

The key principle is:

Starting oxygen is not the end of treatment. Reassessment is essential.

Module 7 — Recognising Treatment Failure

Students learn how to respond when oxygen therapy does not produce adequate improvement.

The approach includes:

REASSESS → CHECK EQUIPMENT → OPTIMISE OXYGEN → INVESTIGATE → ESCALATE

Students are introduced to the importance of blood gas assessment where clinically indicated and timely senior/critical-care involvement.

Module 8 — Oxygen Safety

The course emphasizes:

• Fire prevention
• No smoking near oxygen
• No open flames
• Safe cylinder storage
• Correct equipment handling
• Appropriate oxygen flow
• Avoiding inappropriate oxygen administration
• Equipment checks

A key safety message is:

“Oxygen supports combustion.”

Module 9 — Home Oxygen Therapy

Students learn the fundamentals of:

• Appropriate use of prescribed home oxygen
• Oxygen equipment
• Patient and caregiver education
• Fire safety
• Smoking prohibition
• Equipment storage
• Prescribed flow and duration
• Recognizing deterioration
• Follow-up requirements

Practical Skills Component

Students participate in a DOAP (Demonstrate–Observe–Assess–Perform) session.

They practise:

1. Hand hygiene
2. Patient identification
3. Explaining oxygen therapy
4. ABCDE assessment
5. Pulse oximetry
6. Selecting an oxygen device
7. Checking the oxygen source
8. Connecting equipment
9. Setting oxygen flow/concentration
10. Applying the device
11. Monitoring response
12. Titrating oxygen
13. Recognising treatment failure
14. Escalating care
15. Documenting treatment
16. Providing oxygen-safety counselling