Oxygenation may refer to:

Oxygenation (environmental), a measurement of dissolved oxygen concentration in soil or water

Oxygenation (medicine), the process by which concentrations of oxygen increase within a tissue
Water oxygenation, the process of increasing the oxygen saturation of the water
Dioxygen complex, the chemical details of how metals bind oxygen
Great Oxygenation Event, an ancient event that led to the rise of oxygen within our atmosphere
Types of Oxygen Therapy Systems
There are three different types of oxygen therapy systems:
Compressed oxygen cylinders, or "green tanks"
Oxygen concentrators
Liquid oxygen systems
The type of system your child gets depends on the amount of oxygen your child needs, what your
insurance company will provide, and what activities will occur outside your home. Work with your
case manager and home equipment provider to determine what will work best for your child.

Compressed Oxygen Cylinders

Green tanks, usually large tanks or "H tanks," are
delivered to your house and must be secured in a
safe corner of a room. Portable smaller units
called "E" or "D" tanks are used for transport and
will also be delivered. A key is required to turn
the tank on and off. The portable tanks must be
replaced when empty. Therefore, your family must
plan ahead for trips outside of the home.
Oxygen Concentrators

These devices concentrate oxygen from the air
and deliver it to your child. This is not portable
and requires electricity to work. Portable E tanks
are also delivered for transport and may be used
for backup in case of power failure. Oxygen
concentrators are often used for individuals who
are on oxygen only at night, but they can be used
24-hours a day.
Liquid Oxygen Systems

These systems consist of a large silver main tank
and one or two portable units. The portable units
are used as needed for travel outside of the
home. When they are empty, they can be refilled
from the large tank. Portable units weigh 8 to 10
pounds and can be carried with a shoulder strap or
cart. Liquid oxygen will evaporate if not used
frequently, therefore portable units should be
filled just prior to use. The liquid systems are
often more costly.

Other Necessary Equipment
The gauges at the top are the oxygen
regulator.
You will have a regulator/flow meter delivered
with your home oxygen system. The amount of
oxygen your child gets is measured in liters per
minute and in some cases fractions of a liter per
minute. Make sure you have the correct type of
flow meter to deliver the prescribed amount of
oxygen for both your main and portable systems.
Oxygen extension tubing is also available.
However, for small children on small amounts of
oxygen, it is recommended that no more than 14
feet of extension tubing be used.
A close-up of the flowmeter and
pressure gauge.

Your oxygen supply company should supply written information to you on the set up, care, use, and trouble
shooting of your child's oxygen system.
Cost
Oxygen supply companies usually charge a monthly rental fee for the system you use. If an oxygen
concentrator is to be used for a long period of time, it may be purchased by your insurance company.
Introduction
The goal of oxygen delivery is to maintain targeted SpO
2
levels in children through the provision of
supplemental oxygen in a safe and effective way which is tolerated by infants and children to:
Relieve hypoxemia and maintain adequate oxygenation of tissues and vital organs, as assessed by
SpO
2
/SaO
2
monitoring and clinical signs.
Give oxygen therapy in a way which prevents excessive CO
2
accumulation - i.e. selection of the
appropriate flow rate and delivery device.
Reduce the work of breathing.
Maintain efficient and economical use of oxygen.
Ensure adequate clearance of secretions and limit the adverse events of hypothermia and insensible
water loss by use of optimal humidification (dependant on mode of oxygen delivery.)
Definition of terms
FiO
2
: Fraction of inspired oxygen (%).
PaCO
2
: The partial pressure of CO
2
in the blood. It is used to assess the adequacy of ventilation.
PaO
2
: The partial pressure of oxygen in the blood. It is used to assess the adequacy of oxygenation.
SaO
2
: Arterial oxygen saturation measured from blood specimen.
SpO
2
: Arterial oxygen saturation measured via pulse oximetry.
Air entrainment device (venturi principle): Allows air to be incorporated in to the oxygen/
humidification circuit, resulting in an accurate percentage of oxygen being delivered to the patient.
This results in an increased flow volume to the patient, up to 45 LPM. Where the total flow
delivered to the patient meets or exceeds their Peak Inspiratory Flow Rate the FiO
2
delivered to
the patient will be accurate.
Heat Moisture Exchange (HME) product: are devices that retain heat and moisture minimizing
moisture loss to the patient airway.
High flow: High flow systems are specific devices that deliver the patient's entire ventilatory
demand (minute volume.) High flow in approved areas only. Consult your NUM if unsure.
Humidification is the addition of heat and moisture to a gas. The amount of water vapor that a gas
can carry increases with temperature.
Hypercapnea: Increased amounts of carbon dioxide in the blood.
Hypoxaemia: Low arterial oxygen tension (in the blood.)
Hypoxia: Low oxygen level at the tissues.
Low flow: Low flow systems are specific devices that do not provide the patient's entire ventilatory
requirements.
Minute ventilation: The total amount of gas moving into and out of the lungs per minute. The minute
ventilation (volume) is calculated by multiplying the tidal volume by the respiration rate, measured in
litres per minute.
Peak Inspiratory Flow Rate (PIFR): The fastest flow rate of air during inspiration, measured in
litres per second.
Tidal Volume: The amount of gas that moves in, and out, of the lungs with each breath, measured in
millilitres (6-10 ml/kg).
Ventilation - Perfusion (VQ) mismatch: An imbalance between alveolar ventilation and pulmonary
capillary blood flow.

Normal Values
Partial pressure of arterial oxygen (PaO
2
)
80 -100 mmHg - children/adults
50 - 80 mmHg - neonates
Partial pressure of arterial CO
2
(PaCO
2
)
35 - 45 mmHg children/adults
pH = 7.35 -7.45
SpO
2

>95% for infants, children and adults
>91% for neonates (Click here for Premature Neonates SpO
2
guideline)
>60% Cyanotic heart disease
NB: The above values are genearlised to the paediatric population, for age specific ranges please consult
CLARA and/or the medical team.

The above values are expected target ranges. Any deviation should be documented on the observation chart
as MET modifications.
Indications for oxygen delivery
The treatment of documented hypoxia/hypoxaemia as determined by SpO
2
or inadequate blood
oxygen tensions (PaO
2
).
Achieving targeted percentage of oxygen saturation (as per normal values unless a different target
range is specified on the observation chart.)
The treatment of an acute or emergency situation where hypoxaemia or hypoxia is suspected, and if
the child is in respiratory distress manifested by:
dyspnoea, tachypnoea, bradypnoea, apnoea
pallor, cyanosis
lethargy or restlessness
use of accessory muscles: nasal flaring, intercostal or sternal recession, tracheal tug
If you require further information please click here for the Assessment of Severe Respiratory Conditions
guideline.
Short term therapy e.g. post anaesthetic or surgical procedure
Palliative care - for comfort
Oxygen is a drug and requires a medical order. Each episode of oxygen delivery should be ordered on
the medication chart either as a one-off order or on-going treatment.
Nurse initiated oxygen
Nurses can initiate oxygen if patients breach expected normal parameters of oxygen saturation
A medical review is required within 30 minutes
At the time of the medical review a prescription for oxygen should be written

Patient assessment and documentation
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.
Check and document oxygen equipment set up at the commencement of each shift and with any
change in patient condition.
Hourly checks should be made for the following:
oxygen flow rate
patency of tubing
humidifier settings (if being used)
Hourly checks should be made and recorded on the patient observation chart for the following
(unless otherwise directed by the treating medical team):
heart rate
respiratory rate
work of breathing (descriptive assessment - i.e. use of accessory muscles/nasal flaring)
oxygen saturation
Ensure the individual MET criteria are observed regardless of oxygen requirements
Clinical Guidelines (Nursing): Nursing Assessment

Selecting the delivery method
A range of flow meters are available at RCH (0-1 LPM, 0-2.5 LPM, 0-15 LPM, 0-50 LPM (PICU only). Check
on the individual flow meter for where to read the ball (i.e. centre or top of ball), or dial (Perflow brand of
flow meters) when setting the flow rate.

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. Use caution when adjusting the flow meter.

Oxygen delivery method selected depends on:
age of the patient
oxygen requirements/therapeutic goals
patient tolerance to selected interface
humidification needs
Note: Oxygen therapy should not be delayed in the treatment of life threatening hypoxia.

Low flow delivery method
Low-flow systems include:
Simple face mask (without air entrainment device)
Non re-breather face mask (mask with oxygen reservoir bag and one-way valves which aims to
prevent/reduce room air entrainment)
Nasal prongs (low flow)
Tracheostomy mask (without air entrainment device)
Tracheostomy HME connector
Isolette - neonates (usually for use in the Neonatal Unit only)
Note: In low flow systems the flow is usually titrated (on the flow meter) and recorded in litres per minute
(LPM).

High flow delivery method
High flow systems include:
Ventilators
CPAP/BiPaP drivers
Face mask or tracheostomy mask used in conjunction with an entrainment device or AIRVO 2
Humidifier
High flow nasal prongs (HFNP)

Air entrainment devices
When using an air entrainment device it is important that:
Oxygen must be humidified and warmed (MR850 Humidifier set on Non-Invasive Mode) as
compressed gas is drying and may damage the tracheal mucosa.
To achieve the desired FiO
2
use the diagram below. This table advises the appropriate air
entrainment position for desired FiO
2
the oxygen flow rate and total flow that will be delivered to
patient when these settings are utilized. To ensure the patient is breathing the FiO2 that the
device is delivering the total flow should equal or exceed the patients Peak Inspiratory Flow Rate.
This is not really measureable but is at least 3 to 4 times the patients minute ventilation.
Note: Air entrainment devices are not effective for delivering FiO
2
greater than 50%
Documentation:
Document the FiO
2
as indicated on air entrainment device & total flow as per Air Entrainer chart
below and wall O
2
flowmeter flow.

Air Entrainer: %O
2
to recommended oxygen flow guide


Humidification

Oxygen therapy can be delivered using a low flow or high flow system. All high flow systems require
humidification. The type of humidification device selected will depend on the oxygen delivery system in use,
and the patient's requirements. The humidifier should always be placed at a level below the patient's head.
Rationale:
Cold, dry air increases heat and fluid loss
Medical gases including air and oxygen have a drying effect and mucous membranes become dry
resulting in airway damage.
Secretions can become thick & difficult to clear or cause airway obstruction
In some conditions e.g. asthma, the hyperventilation of dry gases can compound
bronchoconstriction.
Indications:
Patients with thick copious secretions
Non-invasive and invasive ventilation
Nasal prong flow rates of greater than 2 LPM (under 2 years of age) or 4 LPM (over 2 years of age)
Facial mask flow rates of greater than 5 LPM
Patients with tracheostomy
RCH predominantly uses the Fisher & Paykel MR850 Humidifier & AIRVO 2 Humidifier. Please consult user
manuals for any other models in use.
Fisher & Paykel MR 850 Humidifier
Follow instructions in the MR850 User Manual in conjunction with this Guideline
Has two modes:
Invasive Mode - delivers saturated gas as close to body temperature (37 degrees, 44mg/L) as
possible.
Suitable for patients with bypassed airways:
Invasive Ventilation
Tracheostomy attachment or mask
Nasal Prongs
Non-Invasive Mode delivers gas at a comfortable level of humidity (31-36 degrees, >10mg/L).
Suitable for patients receiving:
Face mask therapy:
Non-invasive ventilation (CPAP/BIPAP)
Nebuliser mask (with RT308 circuit)
AIRVO 2 Humidifier
Follow instructions in the AIRVO 2 User Manual in conjunction with this Guideline.
Has two modes:
Junior Mode
Suitable for patients using Optiflow Junior Infant and Paediatric Nasal Prongs
Standard Mode
Suitable for patients using:
Optiflow adult nasal prongs
Nebuliser mask (via Mask Interface Adaptor)
Tracheostomy mask (via Mask Interface Adaptor)
Tracheostomy direct connection
Link to : Optiflow Nasal Prong Flow Rate Guide
The AIRVO 2 Humidifier requires cleaning and disinfection between patients.
Follow the instructions in the disinfection kit manual:


For routine cleaning instructions please refer to the following link: RCH Equipment Cleaning Table Prepared
by Infection Prevention and Control Team
When commencing therapy on a new patient, ensure the disinfection cycle was performed. On device start
up, a green traffic light confirms the AIRVO 2 is safe for use on a new patient. 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.

Delivery Mode
Click to view the delivery mode quick reference table
Simple Nasal Prongs
Nasal prongs without humidification
This system is simple and convenient to use. It allows the oxygen therapy to continue during feeding/eating
and the re-breathing of CO
2
isn't a potential complication.
Simple nasal prongs are available in different sizes To ensure the patient is able to entrain room air around
the nasal prongs and a complete seal is not created the prong size should be approximately half the
diameter of the nares. Select the appropriate size nasal prong for the patient's age and size.

Note: Do not use air entrainment device with simple nasal prongs.

A maximum flow of:
2 LPM in infants/children under 2 years of age
4 LPM for children over 2 years of age.
With the above flow rates humidification is not usually required. However, if humidification is clinically
indicated - set up as per the recommended guidelines for the specific equipment used. As with the other
delivery systems the inspired FiO
2
depends on the flow rate of oxygen and varies according to the
patient's minute ventilation.
Care and considerations of child with simple nasal prongs:
Position the nasal prongs along the patient's cheek and secure the nasal prongs on the patient's
face with adhesive tape.
Position the tubing over the ears and secure behind the patient's head. Ensure straps and tubing
are away from the patient's neck to prevent risk of airway obstruction.
Check nasal prong and tubing for patency, kinks or twists at any point in the tubing and clear or
change prongs if necessary.
Check nares for patency - clear with suction as required.
Change the adhesive tape weekly or more frequently as required
Nasal prongs with humidification system
If the flow rate exceeds those as recommended above this may result in nasal discomfort and irritation of
the mucous membranes. Therefore, humidification of nasal prong oxygen therapy is recommended.

Note: Do not use air entrainment device with simple nasal prongs

Humidification can be provided using either the MR850 Humidifier or the AIRVO 2 Humidifier. Follow the
manufacturer's Instructions for Use for each device and setup.

Optiflow Nasal Prongs Humidification using MR850 Humidifier
Optiflow nasal prongs are compatible for use in humidified low or high flow oxygen delivery.

Note: MR850 Humidifier should be placed in Invasive Mode for Nasal Prongs Therapy.
See guides below for recommended patient sizing and flow rates.

Fisher and Paykel Optiflow nasal cannula junior range
Four sizes of prongs:
Premature
Neonate
Infant
Paediatric

See Appendix A for further information regarding appropriate junior range sizing: Fisher and Paykel
Optiflow junior range sizing guide
Fisher and Paykel Optiflow nasal cannula standard range
Three sizes of prongs
Small
Medium
Large
Paediatric Patients
(RT330 circuit - click here for instructions for use)
High flow (in approved areas only, see relevant guidelines)
Flow of 2 L/kg/min up to 10kg, plus 0.5 L/kg/min for each kg above 10kg (to a maximum of 50 LPM)
FiO
2
21-50% (blender must be used)
FiO
2
above 50% requires PICU review
The main safety feature of the RT330 Oxygen Therapy System is the pressure relief valve. The pressure
relief valve has been set to a limit of < 40 cm H
2
0. 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.

The image below is of the RT330 circuit.


Below is an image of the RT330 pressure relief valve.

Older children and adolescent patients
(RT203 Circuit and O2 stem - click here for instructions for use)
3 sizes of prongs:
Small
Medium
Large
Low flow, a maximum of:
4 LPM for children over 2 years of age
FiO
2
21-100% (direct from O
2
wall source or via a blender)
High flow (in approved areas only, see relevant recommendations above)
Flow of 2L/kg/min up to 10kg, plus 0.5L/kg/min for each kg above 10kg (to a maximum of
50LPM)
FiO
2
above 50% requires PICU review
Optiflow Nasal Prongs Humidification using AIRVO 2 Humidifier
The AIRVO 2 Humidifier has two modes:
Junior Mode
Standard Mode
Junior Mode
Suitable for patients using the Optiflow Junior Nasal Prongs
Two sizes of Optiflow Junior nasal prongs suitable for use with AIRVO 2 Humidifier
Optiflow Junior Infant
Optiflow Junior Paediatric
FiO
2
21-95%
High Flow (in approved areas only, see relevant guideline)
Flow of 2L/kg/min up to 10kg, plus 0.5L/kg/min for each kg above 10kg (to a maximum of 50
LPM)
FiO
2
21-50%
Patients requiring FiO
2
> 50% require a medical review and close monitoring. Consider PICU
transfer if after one hour no clinical improvement has occurred
Fisher and Paykel Optiflow nasal cannula junior range for AIRVO 2

Below is an image of the Fisher and Paykel Optiflow nasal cannula junior range for AIRVO 2

Standard Mode
Three sizes of Optiflow nasal prongs suitable for use with AIRVO 2 Humidifer (click here
for: Fisher and Paykel Optiflow (adult) nasal cannula standard range guide)
Small
Medium
Large
High Flow (in approved areas only)
Flow of 2L/kg/min up to 10kg, plus 0.5L/kg/min for each kg above 10kg (to a maximum of 50
LPM)
FiO
2
21-50%
Patients requiring FiO
2
> 50% require a medical review and close monitoring. Consider PICU
transfer if after one hour no clinical improvement has occurred

Optiflow Nasal Prong junior and standard humidification and flow rate guidefor Airvo.


Face Mask
Click to view the delivery mode quick reference table
Simple Face Mask

The FiO2 inspired will vary depending on the patient's inspiratory flow, mask fit/size and patient's
respiratory rate. At RCH both simple face masks (in various sizes) and tracheostomy masks are available.

The minimum flow rate through any face mask or tracheostomy mask is 4 LPM as this prevents the
possibility of CO
2
accumulation, CO
2
re-breathing and drowsiness. 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.
Oxygen (via intact upper airway) via a simple face mask at flow rates of 4LPM does not require routine
humidification. However, as compressed gas is drying and may damage the tracheal mucosa humidification
might be indicated/appropriate for patients with secretions retention, or discomfort. Additionally in some
conditions (eg. Asthma), the inhalation of dry gases can compound bronchoconstriction.
Nebuliser mask

Nebuliser mask or tracheostomy mask in conjunction with a humidification system
A nebuliser mask or tracheostomy mask with an air entrainment device is intended for use with a MR850
Humidifier). By entraining room air into the delivery system, the total gas flow to the patient can be
increased up to approximately 45 LPM. When the instructions on the air entrainment device are followed, it
is possible to deliver a specific FiO
2.
This system is useful in accurately delivering low concentrations of
oxygen (28-50%).
A nebuliser mask or tracheostomy mask with a mask interface adaptor is intended for use with an AIRVO 2
Humidifier. A tracheostomy direct connection may be used with an AIRVO 2 Humidifier. The AIRVO 2
Humidifier flow rate should be set to meet or exceed the patient's entire ventilatory demand, to ensure
the desired FiO
2
is actually inspired by the patient. This system is useful in accurately delivering
concentrations of oxygen (21 95%). Patients who require an FiO
2
greater than 50% require medical
review.
With both systems, as the gas flow is > 4LPM re-breathing of expired gas is not a potential problem.
Therefore this system reduces the risk of carbon dioxide retention.

NOTE: While a specific FiO
2
is delivered to the patient the FiO
2
that is actually inspired by the patient (ie
what the patient actually receives) varies depending on:
flow rate delivered to the patient (see air entrainment device below)
mask size and fit
the patient's respiratory rate
Non-rebreathing face mask
A non-rebreathing face mask is a mask with an oxygen reservoir bag that has a one-way valve system which
prevents exhaled gases mixing with fresh gas flow. 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. These masks are not
commonly used but a non-rebreathing mask can provide higher concentration of FiO
2
(> 60%) than is able to
be provided with a standard face mask (which is approximately 40% - 50%)

Considerations when using a non-rebreathing face mask
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.
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).
Do not use with humidification system as this can cause excessive 'rain out' in the reservoir bag.
Not routinely used outside of ED and PICU and should only be used in consultation with the
medical team.
Tracheostomy
Click to view the delivery mode quick reference table
Tracheostomy HME - Heat Moisture Exchanger (Swedish nose filter) with oxygen attachment

In spontaneously breathing tracheostomy patients who require oxygen flow rates of less than 4 LPM there
are two options available:
OXY-VENT with Tubing: The adaptor sits over the TRACH-VENT and the tubing attaches to
the oxygen source (flow meter).
TRACH-VENT+: Alternatively a Hudson RCI HME - TRACH-VENT+ (Swedish nose filter) has an
integrated oxygen side port which connects directly to oxygen tubing which is attached to the
oxygen source (flow meter).
Note: HME are used without a heated humidifier circuit.
Considerations:
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.
Trach-Vent's are changed daily or as required if contaminated or blocked by secretions.
Isolette
At the RCH, oxygen therapy via an isolette is usually only for use in the Butterfly neonatal intensive care
unit. (See Isolette use in paediatric wards, RCH internal link only.)
Considerations
Oxygen is a drug and use outside of an emergency situation should be prescribed by a medical
practitioner
Supplemental oxygen relieves hypoxaemia but does not improve ventilation or treat the underlying
cause of the hypoxaemia. Monitoring of SpO
2
indicates oxygenation not ventilation. Therefore,
beware the use of high FiO
2
in the presence of reduced minute ventilation.
Many children in the recovery phase of acute respiratory illnesses are characterised by
ventilation/perfusion mismatch (e.g. asthma, bronchiolitis, and pneumonia) and can be managed with
SpO
2
in the low 90's as long as they are clinically improving, feeding well and don't have obvious
respiratory distress.
Normal SpO
2
values may be found despite rising blood carbon dioxide levels (hypercapnea). High
oxygen concentrations have the potential to mask signs and symptoms of hypercapnea.
Oxygen therapy should be closely monitored & assessed at regular intervals
Therapeutic procedures & handling may increase the child's oxygen consumption & lead to worsening
hypoxaemia
Children with cyanotic congenital heart disease normally have SpO
2
between 60%- 90% in room air.
Increasing SpO
2
> 90% with supplemental oxygen is not recommended due to risk of over circulation
to the pulmonary system while adversely decreasing systemic circulation. However, in emergency
situations with increasing cyanosis supplemental oxygen should be administered to maintain their
normal level of SpO
2

Potential complications of oxygen use
CO
2
Narcosis - This occurs in patients who have chronic respiratory obstruction or respiratory
insufficiency which results in them developing hypercapnea (i.e. raised PaCO
2
). In these patients the
respiratory centre relies on hypoxaemia to maintain adequate ventilation. If these patients are
given oxygen this can reduce their respiratory drive, causing respiratory depression and a further
rise in PaCO
2
resulting in increased CO
2
levels in the blood and CO
2
narcosis.
Monitoring of SpO
2
or SaO
2
informs of oxygenation only. Therefore, beware of the use of high
FiO
2
in the presence of reduced minute ventilation.
Pulmonary Atelectasis
Pulmonary oxygen toxicity - High concentrations of oxygen (>60%) may damage the alveolar
membrane when inhaled for more than 48 hours resulting in pathological lung changes.
Retrolental fibroplasia (also known as retinopathy of prematurity) An alteration of the normal
retinal vascular development, mainly affecting premature neonates (<32 weeks gestation or 1250g
birthweight), which can lead to visual impairment and blindness.
Substernal pain-due: characterised by difficulty in breathing and pain within the chest,
occurring when breathing elevated pressures of oxygen for extended periods.
Oxygen safety
Oxygen is not a flammable gas but it does support combustion (rapid burning). Due to this the following
rules should be followed:
Do not smoke in the vicinity of oxygen equipment.
Do not use aerosol sprays in the same room as the oxygen equipment.
Turn off oxygen immediately when not in use. Oxygen is heavier than air and will pool in fabric
making the material more flammable. Therefore, never leave the nasal prongs or mask under or on
bed coverings or cushions whilst the oxygen is being supplied.
Oxygen cylinders should be secured safely to avoid injury.
Do not store oxygen cylinders in hot places.
Keep the oxygen equipment out of reach of children.
Do not use any petroleum products or petroleum byproducts e.g. petroleum jelly/Vaseline whilst
using oxygen.