Therefore, humidification of nasal prong oxygen therapy is recommended. 
As with the other delivery systems the inspired FiO2 depends on the flow rate of oxygen and varies according to the patient's minute ventilation. < 40 cm H20. The child should appear clinically well. Position the tubing over the ears and secure behind the patients head. Any deviation should be documented on the observation chart as MET modifications. 
Available from: Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial, UK national COPD audit 2003: impact of hospital resources and organisation of care on patient outcome following admission for acute COPD exacerbation, Arterial blood gas reference values for sea level and an altitude of 1,400 meters, Diagnostic room-air pulse oximetry: effects of smoking, race, and sex, Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons, Guidelines for the management of severe traumatic brain injury, Consensus conference on mechanical ventilation January 2830, 1993 at Northbrook, Illinois, USA. Feeding adequate amounts orally. Hourly checks should be made for the following: Hourly checks should be made and recorded on the patient observation chart for the following (unless otherwise directed by the treating medical team): respiratory distress (descriptive assessment - i.e. ), Appendix A - Pediatric sizing guides for nasal prongs, Fisher and Paykel Optiflow junior range sizing guide. Intensive Care Medicine. Archives of Disease in Childhood - Fetal and Neonatal Edition, 88, F84 - F88. Non-Invasive Mode delivers gas at a comfortable level of humidity (31-36 degrees, >10mg/L). TRACH-VENT+: Alternatively a Hudson RCI HME - TRACH-VENT+ has an integrated oxygen side port which connects directly to oxygen tubing which is attached to the oxygen source (flow meter). The type of humidification device selected will depend on the oxygen delivery system in use, and the patient's requirements. Oxygen therapy can be delivered using a low flow or high flow system. Sydney, Australia: Brink, F; T Duke, T., Evans, J. High Flow Nasal Prong Therapy (HFNP), See the
On device start up, a green traffic light confirms the AIRVO 2 is safe for use on a new patient. Oxygen therapy: professional compliance with national guidelines. The humidifier should always be placed at a level below the patient's head. Care and considerations of child with simple nasal prongs: If the required flow rate exceeds those as recommended above this may result in nasal discomfort and irritation of the mucous membranes. At RCH both simple face masks (in various sizes) and tracheostomy masks are available. Supplemental Oxygen Delivery to the Nonventilated Neonate. Both hypoxaemia and hyperoxaemia are harmful. No difference was found between the two arms of the study in 30 day mortality or infarct size. Isolette use in paediatric wards, RCH internal link only. Oxygen therapy should be reduced or ceased if: This direction applies to patients treated with: See below nursing guidelines for additional guidance in assessment and monitoring: Unless clinically contraindicated, an attempt to wean oxygen therapy should be attempted at least once per shift. Oh's Intensive care manual. (2012) Current Therapies for Bronchiolitis. Note: In most low flow systems the flow is usually titrated (on the oxygen flow meter) and recorded in litres per minute (LPM). 
Publication is anticipated in 2014. In some conditions e.g. The Hudson Trach-Vent HME has a dead space of 10mL and is recommended for use in patients who have tidal volumes of 50mL and above. Online ISSN: 2073-4735, Copyright 2022 by the European Respiratory Society. This study will enrol 490 patients and includes controlled oxygen therapy in the pre-hospital setting [34]. Please consult user manuals for any other models in use. Mosby's Skills. The goal of oxygen delivery is to maintain targeted SpO2 levels in children through the provision of supplemental oxygen in a safe and effective way which is tolerated by infants and children to: Should an aerosol generating procedure be undertaken on a patient under droplet precautions then increase to airborne precautions by donning N95/P2 mask for at least the duration of the procedure. The pressure relief valve has been set to a limit of
On arrival his oxygen saturation is 82% on room air, the correct course of action is: Do not give oxygen until blood gas results are available. 4 503 504, Clinical Practice Guidelines: The Diagnosis, Management & Prevention of Bronchiolitis. Frey, B., & Shann, F. (2003). Where oxygen weaning is successful, continuous pulse oximetry monitoring may be discontinued. Has two modes: Link to : Optiflow Nasal Prong Flow Rate Guide. Fisher and Paykel Optiflow (adult) nasal cannula standard range guide). Neonatal Network. In spontaneously breathing tracheostomy patients who require oxygen flow rates of less than 4 LPM there are two options available: Note: HME are used without a heated humidifier circuit. The recommended target saturation range for patients not at risk of T2RF is 9294%. Change the adhesive tape weekly or more frequently as required, 4 LPM in infants/children under 2 years of age, Flow of 2 L/kg/min up to 12kg, plus 0.5 L/kg/min for each kg above 12kg (to a maximum of 50 LPM), Flow of 2L/kg/min up to 12kg, plus 0.5L/kg/min for each kg above 12kg (to a maximum of 50LPM), Flow of 2L/kg/min up to 12kg, plus 0.5L/kg/min for each kg above 12kg (to a maximum of 50 LPM), Any patient who does not exhibit signs of clinical stabilization, as described below, within 2 hours of commencement of HFNP therapy should be reviewed by PICU outreach service. Ensure the flow rate from the wall to the mask is adequate to maintain a fully inflated reservoir bag during the whole respiratory cycle (i.e. inspiration and expiration). post anaesthetic or surgical procedure. The key principles will remain that oxygen is a treatment of hypoxemia and that oxygen should be prescribed to a target range. The minimum flow rate through any face mask or tracheostomy mask is 4 LPM as this prevents the possibility of CO2 accumulation and CO2 re-breathing. (2014). We do not capture any email address. RT203 Circuit and O2 stem - click here for instructions for use), Low Flow - Suitable for patients using the Optiflow Junior Nasal Prongs. To ensure the highest concentration of oxygen is delivered to the patient the reservoir bag needs to be inflated prior to placing on the patients face. (2014). Please remember to read the
(2011) Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery. AIRVO 2 User Manual in conjunction with this Guideline. Oxygen is a drug and should be prescribed. All high flow systems require humidification. Fallacies regarding oxygen therapy, Acidosis, non-invasive ventilation and mortality in hospitalised COPD exacerbations, Emergency oxygen therapy for the COPD patient, British Thoracic Society Scottish Intercollegiate Guidelines Network, British Guideline on the management of asthma. In life-threatening emergencies, oxygen can be given without a prescription until the patient is stable.
THE FOLLOWING MAY BE UNDERTAKEN BY NURSES WITHOUT MEDICAL ORDERS: 1. The non-rebreathing mask system may also have a valve on the side ports of the mask which prevents entrainment of room air into the mask.
Medical gases, including air and oxygen, have a drying effect on mucous membranes resulting in airway damage. Do nothing, he is known to have COPD and is often breathless and anxious. Oxygen is indicated for all breathless patients. Note: MR850 Humidifier should be placed in Invasive Mode for Nasal Prongs Therapy. Ensure adequate clearance of secretions and limit the adverse events of hypothermia and insensible water loss by use of optimal humidification (dependent on mode of oxygen delivery). Optiflow Nasal Prong junior and standard humidification and flow rate guide for Airvo. If you require further information please click here for the Implementing the Rapid Response Report Oxygen Safety in Hospitals. We look forward to the publication of the results, which may provide some clarity for the optimal use of oxygen in acute myocardial infarction. The AIRVO 2 Humidifier requires cleaning and disinfection between patients. European Respiratory Society442 Glossop RoadSheffield S10 2PXUnited KingdomTel: +44 114 2672860Email: journals@ersnet.org, Print ISSN: 1810-6838 However, as compressed gas is drying and may damage the tracheal mucosa humidification might be indicated/appropriate for patients with increased/thickened secretions, secretion retention, or for generalized discomfort and compliance. British Journal of Nursing, 23(7), 382-386. Where the Airvo2 is used as an oxygen delivery device the flow from this device is independent to the flow of oxygen. National Patient Safety Agency, 2009. Follow the instructions in the disinfection kit manual: For routine cleaning instructions please refer to the following link: Select the appropriate size nasal prong for the patient's age and size. Nasal prong flow rates of greater than 2 LPM (under 2 years of age) or 4 LPM (over 2 years of age), Nasal prong flow rates of greater than 1 LPM in neonates, Facial mask flow rates of greater than 5 LPM. Oxygen is indicated in a patient with saturation 98% on room air. The main safety feature of the RT330 Oxygen Therapy System is the pressure relief valve. For nasal prong oxygen withhumidification a maximum flow of: Optiflow nasal prongs are compatible for use in humidified low or high flow oxygen delivery. Follow the manufacturers Instructions for use for each device and setup. Any patient who develops or has an increase in their oxygen requirement should be medically reviewed within 30 minutes. A quasi-randomized controlled trial, Arterial hyperoxia and in-hospital mortality after resuscitation from cardiac arrest, Arterial oxygen tension and mortality in mechanically ventilated patients, Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality, Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients, Has oxygen administration delayed appropriate respiratory care? May;37(5):847-52, Mayfield, S., Bogossian, F., OMalley, L., and Schibler, A. The target ranges specified in the 2008 guideline are likely to remain unchanged. MR850 User Manual in conjunction with this Guideline The above values are expected target ranges. Humidification during oxygen therapy and non-invasive ventilation: do we need some and how much?
disclaimer. Evidence-Based Protocols to Guide Pulse Oximetry and Oxygen Weaning in Inpatient Children with Asthma and Bronchiolitis: A Pilot Project. Updated July 2017.
Considerations when using a non-rebreathing face mask. This study was flawed in that patients were randomised to treatment in hospital and most had received high-flow oxygen in the ambulance en route to hospital. These masks are not commonly used but a non-rebreathing mask can provide higher concentration of FiO2 (> 60%) than is able to be provided with a standard face mask (which is approximately 40% - 50%) Fisher and Paykel Optiflow nasal cannula junior rangeFour sizes of prongs: See Non-rebreathing face mask are not designed to allow added humidification. Schibler, A., Pham, T.,Dunster, K., Foster, K., Barlow, A., Gibbons, K., and Hough, J. Nippers, I., & Sutton, A. Additionally in some conditions (eg. When commencing therapy on a new patient, ensure the disinfection cycle was performed. The development of this nursing guideline was coordinated by John Kemp, Nurse Educator, Sugar Glider, and approved by the Nursing Clinical Effectiveness Committee. Oxygen should be given to all patients having an acute stroke regardless of oxygen saturation. For nasal prong oxygen without humidification a maximum flow of: With the above flow rates humidification is not usually required. Commencement or Increase of Oxygen Therapy: 2. If oxygen wean successful perform vital sign observation, intermittent SpO2 monitoring 30 minutes later, then hourly for 2 hours. Junior Mode requires Junior Tube and Chamber Kit, Standard Mode requires standard Tube and Chamber Kit, 2 LPM in infants/children under 2 years of age. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. HFNP nursing clinical guideline for more information. All vital signs should be with normal limits (ViCTOR white zone or modified zone) It allows the oxygen therapy to continue during feeding/eating and the re-breathing of CO2 isn't a potential complication. A nebuliser mask, tracheostomy mask with a mask interface adaptor (Fisher&Paykel RT013), or Tracheostomy Direct Connection (Fisher&Paykel OPT870) are intended for use with the AIRVO 2 Humidifier. Simple nasal prongs are available in different sizes. < 90% for infants with bronchiolitis, The child with cyanotic heart disease reaches their baseline Sp0, Mechanical ventilation (do not alter other ventilator settings), Mask-BiPaP or CPAP (do not alter pressure or volume settings. Start 24 or 28% oxygen via a Venturi mask, then check blood gases. Below is an image of the Fisher and Paykel Optiflow nasal cannula junior range for AIRVO 2, Three sizes of Optiflow nasal prongs suitable for use with AIRVO 2 Humidifer (click here for: & Boyer, A. PICU High Flow Nasal Prong HFNP oxygen guideline. Has two modes: Follow instructions in the 91 - 95% for premature and term neonates (, 90% for infants with bronchiolitis (link to, The treatment of documented hypoxia/hypoxaemia as determined by SpO, Achieving targeted percentage of oxygen saturation (as per normal values unless a different target range is specified on the observation chart.). Thank you for your interest in spreading the word on European Respiratory Society . Normal values and SpO 2 targets, Appendix A - Paediatric sizing guides for nasal prongs. Part I. European Society of Intensive Care Medicine, the ACCP and the SCCM, Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock, The incidence and effect on outcome of hypoxemia in hospitalized medical patients, Reliability of pulse oximetry in titrating supplemental oxygen therapy in ventilator-dependent patients, Relationship between supranormal oxygen tension and outcome after resuscitation from cardiac arrest, The effect of supplemental oxygen on hypercapnia in subjects with obesity-associated hypoventilation: a randomized, crossover, clinical study, Randomised controlled trial of high concentration, Randomized controlled trial of high concentration oxygen in suspected community-acquired pneumonia, A randomized controlled trial of oxygen therapy in acute myocardial infarction Air Verses Oxygen In myocarDial infarction study (AVOID Study), A clinicians review of the respiratory microbiome, www.nrls.npsa.nhs.uk/resources/?entryid45=62811. Any patient who does not exhibit signs of clinical stabilization with 4 hours of commencement of HFNP should be considered for transfer to the PICU. This system is simple and convenient to use. Respiratory Distress (work of breathing) should be mild, or there should be no work of breathing. Martin, S., Martin, J., & Seigler, T. (2015). Invasive Mode - delivers saturated gas as close to body temperature (37 degrees, 44mg/L) as possible. The aim of this guideline is to describe the indications and procedure for the use of oxygen therapy, and its modes of delivery. For most patients with COPD, target saturation range should be set at 8892% until blood gases are available. Also 0-50 LPM PICU only. Which of the following statements regarding oxygen prescribing are true?
(7th ed.). High-flow nasal cannula oxygen therapy for infants with bronchiolitis: Pilot study.Journal of Paediatrics. Secretions can become thick & difficult to clear or cause airway obstruction. 24(5): 323-8, Miyamoto, K. & Nishimura, M. Nasal Dryness Discomfit in Individuals Receiving Dry Oxygen via Nasal cannula Respiratory Care April (2008) Vol 35 No. November, Vol.134, No.5, pge1474-e1502, Ramsey, K. (2012). Tracheostomy HME - Heat Moisture Exchange (HME) with oxygen attachment RT330 circuit - click here for instructions for use). (2013) High-Flow Nasal Prong Oxygen Therapy or Nasopharyngeal Continuous Positive Airway Pressure for Children With Moderate-to-Severe Respiratory Distress?www.pccmjounral.org September, Vol 14, No.3. O'Driscoll was paid an honorarium, by the ERS, for delivering a lecture on Emergency Oxygen Therapy at the ERS meeting in Vienna 2009. Use of oxygen in continuous positive airway pressure ventilation systems, heliox and nitrous oxide mixtures, procedures that require conscious sedation, the peri-operative period and in track and trigger warning systems (e.g. early warning scores) will also be included. May, Vol 50 (5) pp373-378, McKieman, C., Chua, L.C., Visintainer, P. and Allen, P. (2010) High Flow Nasal Cannulae Therapy in Infants with Bronchiolitis. (See Oxygen therapy and oxygen delivery principles (respiratory therapy). Clinical assessment and documentation including but not limited to: cardiovascular, respiratory and neurological systems should be done at the commencement of each shift and with any change in patient condition. Journal of Pediatrics 156:634-38, Spentzas, T., Minarik, M., Patters, AB., Vinson, B. and Stidham, G. (2009) Children with respiratory distress treated with high-flow nasal cannula. Check on the individual flow meter for where to read the ball (i.e. Oxygen does not need to be signed for on a drug chart. Position the nasal prongs along the patients cheek and secure the nasal prongs on the patients face with adhesive tape. A non-rebreathing face mask has an oxygen reservoir bag and one-way valve system which prevents exhaled gases mixing with fresh gas flow. Assessment of Severe Respiratory Conditions guideline. Use caution when adjusting the flow meter. Ralston, S.L., Lieberthal, A.S., Meissner, H.C., Alverston, B.K., Baley, J.E., Gadomski, A.M., Johnson, D.W., Light, M.J., Maraqa, n.F., Mendonca, E.A., Phelan, K.J., Zorc, J.J., Stanko-Lopp, D., Brown, M.A., Nathanson, I., Rosenblum, E., Sayles III, S. & Hernandez-Cancio, S. (2014) Pediatrics. Two sizes of Optiflow Junior nasal prongs suitable for use with AIRVO 2 Humidifier: FiO2 21-95% - Note, the oxygen flow rate from the wall or portable sources should not exceed the flow rate of the Airvo2 The treatment of an acute or emergency situation where hypoxaemia or hypoxia is suspected, and if the child is in respiratory distress manifested by: use of accessory muscles: nasal flaring, intercostal or sternal recession, tracheal tug, Short term therapy e.g. OXY-VENT with Tubing: The adaptor sits over the TRACH-VENT and the tubing attaches to the oxygen source (flow meter). Which of the following statements are true? use of accessory muscles/nasal flaring - see Respiratory Distress on EMR), Ensure the individual MET criteria are observed regardless of oxygen requirements, Cease oxygen therapy entirely and maintain line of sight for approximately 5 minutes, LOC = alert, note lethargy or irritability, Non re-breather face mask (mask with oxygen reservoir bag and one-way valves which aims to prevent/reduce room air entrainment), Isolette - neonates (usually for use in the Neonatal Intensive Care Unit only), Face mask or tracheostomy mask used in conjunction with an, NB: There is separate CPG for HFNP use in the NICU (see, Cold, dry air increases heat and fluid loss. Below is an image of the RT330 pressure relief valve. Note: Some flow meters may deliver greater than the maximum flow indicated on the flow meter if the ball is set above the highest amount. The AIRVO 2 Humidifier flow rate should be set to meet or exceed the patients entire ventilatory demand, to ensure the desired FiO2 is actually inspired by the patient. Journal of Pediatric Nursing, (30), 888-895. Reduction or Cessation of oxygen therapy. The new children's guideline will provide comprehensive guidance on the emergency use of oxygen in paediatric healthcare and the adult guideline has been extended to include first responders and palliative care settings. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. Oxygen therapy (concentration and flow) may be varied in most circumstances without specific medical orders, but medical orders override these standing orders. The recommended oxygen target saturation range in patients not at risk of type II respiratory failure is 9498%. Emergency oxygen therapy: from guideline to implementation, Manchester Academic Health Science Centre, University of Manchester, Dept of Respiratory Medicine, Salford Royal Foundation NHS Trust, Both authors contributed equally to this article, Audit of oxygen use in emergency ambulances and in a hospital emergency department, British Thoracic Society emergency oxygen audits, Short burst oxygen therapy in patients with COPD, BTS guideline for emergency oxygen use in adult patients, Effects of supplemental oxygen administration on coronary blood flow in patients undergoing cardiac catheterization, Systematic review of studies of the effect of hyperoxia on coronary blood flow, Postischemic reperfusion injury can be attenuated by oxygen tension control, Should stroke victims routinely receive supplemental oxygen? 50 Flemington Road Parkville Victoria 3052 Australia, Site Map | Copyright | Terms and Conditions, A great children's hospital, leading the way, Click here for Oxygen saturation SpO2 level targeting in neonates, Assessment of Severe Respiratory Conditions guideline, Observation and Monitoring Nursing Clinical Guidelinere: pulse oximetry monitoring, Nursing AssessmentNursing Clinical Guideline, level target in neonates nursing guideline, Bronchiolitis clinical practice guideline, Follow the instructions in the disinfection kit manual, Appendix A for further information regarding appropriate junior range sizing: Fisher and Paykel Optiflow junior range sizing guide, RT330 circuit - click here for instructions for use, RT203 Circuit and O2 stem - click here for instructions for use, Fisher and Paykel Optiflow (adult) nasal cannula standard range guide, High Flow Nasal Prong Therapy nursing clinical guideline, Oxygen Saturation Sp02 Level Targeting - Premature neonates, Junior Nasal Cannula instructions for use, RCH CPG Assessment of Severity of Respiratory Issues, F&P Optiflow Junior Nasal Cannula Fitting Guide, F&P Optiflow Junior Consult Instructions For Use, Clinical Guidelines (Nursing): Nursing Assessment, evidence table for this guideline can be viewed here, Relieve hypoxaemia and maintain adequate oxygenation of tissues and vital organs, as assessed by SpO, Give oxygen therapy in a way which prevents excessive CO. B.R. Bersten, A. D. & Soni, N. (2013). June, Vol.97, Issue 9, pg827-830, Ricard, J. Oxygen treatment should be commenced or increased to avoid hypoxaemia and should be reduced or ceased to avoid hyperoxaemia, For children receiving oxygen therapy SpO, Nurses can initiate oxygen if patients breach expected normal parameters of oxygen saturation, A medical review is required within 30 minutes, Persistently centre or top of ball), or dial (Perflow brand of flow meters) when setting the flow rate. Intensive Care Med (2009) 35: 963-965. OXYGEN THERAPY STANDING MEDICAL ORDERS FOR NURSES. evidence table for this guideline can be viewed here. Patients who require an FiO2 greater than 50% require PICU medical review. Check and document oxygen equipment set up at the commencement of each shift and with any change in patient condition. Select a mask which best fits from the child's bridge of nose to the cleft of jaw, and adjust the nose clip and head strap to secure in place. The image below is of the RT330 circuit. asthma, bronchiolitis, and pneumonia) and can be managed with SpO, Oxygen therapy should be closely monitored & assessed at regular intervals, Children with cyanotic congenital heart disease normally have SpO. NB: The above values are generalized to the paediatric population, for age/patient specific ranges please consult the covering medical team. 20 (6), 39-45. Humidification can be provided using either the MR850 Humidifier or the AIRVO 2 Humidifier. A patient with COPD and a history of hypercapnic respiratory failure becomes very breathless on the ward. Trach-Vent's are changed daily or as required if contaminated or blocked by secretions. Level of consciousness (LOC) = alert, colour = pink, behaviour = normal. If a patient's oxygen requirements increase, medical assessment is needed. The ongoing Air Versus Oxygen In myocarDial infarction (AVOID) study is a multicentre randomised controlled trial comparing high-flow versus controlled oxygen in STEMI. Oxygen is indicated in a patient who is suffering an acute MI who has saturation of 90%. Oxygen treatment is usually not necessary unless the SpO2 is less than 92%.That is, do not give oxygen if the SpO2 is 92%. An orange traffic light confirms the AIRVO 2 has not been cleaned and disinfected since last use, and is not safe for use on a new patient. Monitoring of SpO, Many children in the recovery phase of acute respiratory illnesses are characterised by ventilation/perfusion mismatch (e.g. The next version of the BTS emergency oxygen guideline will be titled: BTS guideline for oxygen use in adults in healthcare and emergency settings and there will be a separate guideline on emergency use in children. This valve has been designed to minimize the risk of excessive pressure being delivered to the infant in the event that the nasal prongs seal around the infant's nares while the mouth is closed.
Oxygen administration in infants. Check nasal prong and tubing for patency, kinks or twists at any point in the tubing and clear or change prongs if necessary. Journal of Intensive Care Medicine. min1 via facemask) or controlled oxygen with target saturation of 9498% prior to emergency percutaneous coronary intervention (PCI). See guide below for recommended patient sizing and flow rates. Frequently Asked Questions. RCH predominantly uses the Fisher & Paykel MR850 Humidifier & AIRVO 2 Humidifier. ( Why is a guideline for emergency oxygen necessary? Therefore, the results only apply to the short period of time between admission to hospital and primary PCI. Where considering the application of oxygen therapy it is essential to perform a thorough clinical assessment of the child. Oxygen is a drug and should be prescribed with a target saturation range. The BTS has paid his expenses to attend meetings related to the Guideline (no honorarium). Oxygen is a treatment for hypoxaemia not breathlessness. Oxygen (via intact upper airway) via a simple face mask at flow rates of 4LPM does not routinely require humidification. The FiO2 inspired will vary depending on the patient's inspiratory flow, mask fit/size and patient's respiratory rate. Maintain efficient and economical use of oxygen. Check nares for patency - clear with suction as required. For all critically ill patients, high concentration oxygen should be administered immediately until the patient is stable. St. Louis, MO: Elsevier, Nagakumar, P. Doull, I. RCH Equipment Cleaning Table, Prepared by Infection Prevention and Control Team, Click to view the delivery mode quick reference table. However, if humidification is clinically indicated - set up as per the recommended guidelines for the specific equipment used. Continuous pulse oximetry for 30 minutes post cessation of oxygen therapy