# Oxygen

Adult and pediatric oxygen delivery, ventilation support, and condition-specific exceptions.

Population: Adult & pediatric guidance. Scope: ALS.
Status: published. Source-linked OCEMS summary.
Summary updated: 2026-09-16.
Source checked: 2026-09-16.
Source version: I-15 revised March 31, 2026; I-20 revised March 26, 2026. Both implemented April 1, 2026. See linked condition-specific sources..
Canonical page: https://www.ocmedic.com/guides/oxygen/
Official source: [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf)

Independent OC Medic summary. Does not replace the complete policy, current system notices, or clinical judgment.

## Check before giving

- A normal or high pulse-oximeter reading may be misleading with smoke/carbon-monoxide exposure.
- Do not mistake oxygen delivery for correction of apnea or inadequate ventilation.

## Source documents

- [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf#page=5)
- [SO-M-035 — Respiratory Distress](https://www.ochealthinfo.com/sites/healthcare/files/2025-10/SO-M-35%20Respiratory%2010-2025.pdf)
- [SO-P-035 — Acute Respiratory Distress - Pediatric](https://www.ochealthinfo.com/sites/healthcare/files/2025-10/SO-P-35%20Respiratory%2010-2025.pdf)
- [SO-E-005 — Burn (Thermal, Electrical, Chemical) - Adult](https://www.ochealthinfo.com/sites/healthcare/files/2024-03/SO-E-05%20Burn%204-2024_0.pdf)
- [SO-P-040 — Cardiopulmonary Arrest - Pediatric](https://www.ochealthinfo.com/sites/healthcare/files/2025-11/SO-P-40%20Cardiac%20Arrest%2011-25.pdf)

## Use in OCEMS

- Used for hypoxia and in selected smoke/CO exposure, resuscitation, and diving-related pathways.
- SpO₂ alone cannot assess ventilation; use respiratory effort and available capnography alongside oximetry.

## Adult / adolescent

| Indication / route | Dose & limits |
| --- | --- |
| General I-15 oxygen therapy | High-flow mask (preferred; I-15 lists 10 L/min) or nasal cannula at 6 L/min, as tolerated, for suspected hypoxia/SpO₂ below 95% and specified exposure indications. |
| COPD respiratory distress — SO-M-035 | The initial NC option is 2 L/min. Do not withhold oxygen in severe hypoxia/distress; prepare to assist ventilation. |
| Chronic home oxygen | I-15 lists maintenance of the home flow rate; acute distress still requires assessment and treatment under its standing order. |

## Pediatric

- Pediatric respiratory orders use high-flow mask or nasal cannula/direct blow-by at 6 L/min as tolerated when SpO₂ is below 95%.
- Support inadequate ventilation with BVM as indicated. The adult COPD-specific 2 L/min wording is not a pediatric default.

## Pediatric dose by age / weight

- SO-P-035 uses oxygen according to respiratory status and oxygen saturation, not an mg/kg formula. Assist inadequate ventilation with BVM.
| Weight | Treatment trigger | Delivery |
| --- | --- | --- |
| Any pediatric weight | Room-air SpO₂ below 95% under the respiratory order | High-flow mask or nasal cannula/direct blow-by at 6 L/min, as tolerated |

## Preparation & reassessment

- Select the device and flow specified for the condition and reassess tolerance, work of breathing, oxygenation, and ventilation.
- For cardiac arrest, use the resuscitation airway/ventilation pathway. For CPAP, check age, contraindications, pressure, and monitoring separately.