How to deliver supplemental oxygen to a child

What is the recommended way to deliver supplemental oxygen to a child? 

Supplemental oxygen can be delivered to a child by a variety of different means. For the sickest patients, oxygen should be delivered in the highest concentration and by the most direct method possible. Children who demonstrate spontaneous breathing might require less invasive means of administration of supplemental oxygen. Here is the table which lists some different methods of oxygen delivery with their associated delivery capabilities.

Methods of Oxygen Delivery and Their Delivery Capabilities

Nasal cannula: 30-40% oxygen
Simple masks: 30-60% oxygen
Partial rebreather masks: 50-60% oxygen
Oxygen tents: 30-50% oxygen
Oxygen hoods: 80-90% oxygen
Nonrebreather masks: ~ 100% oxygen

Children without adequate spontaneous breathing effort require mechanical support. Different bag-valve-mask devices have different oxygen delivery capabilities. Self-inflating bag-valve devices are capable of delivering 60% to 90% oxygen, but non–self-inflating devices (anesthesia ventilation systems) deliver 100% oxygen to the patient. Endotracheal intubation offers the most secure and direct means of delivery of 100% oxygen to the patient. 

Sources

American Heart Association: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Part 10: Pediatric Basic and Advanced Life Support. Circulation 2010;122:S466-S515.

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