One-Pager

NREMT Oxygen Administration Skill: Non-Rebreather

Set up an oxygen cylinder and regulator, prefill and fit a non-rebreather mask, then step down to a nasal cannula

Reviewed by Alex G, BSN, RN, CEN, CCRN, CMC, NREMT-P · Checked against current sources October 2026

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NREMT oxygen administration: what it tests

The NREMT oxygen administration station tests whether you can safely put an oxygen cylinder into service and give high-concentration oxygen by non-rebreather mask, then change to a nasal cannula when told. It is short, so small misses cost a lot.

Set up the cylinder

Protective equipment on. Check the label says oxygen and look at the cylinder for damage.
Remove the plastic seal from the valve.
Point the outlet away from everyone and open the valve briefly to blow out dust ("crack" it), then close it.
Seat the regulator on the valve stem, line up the pins and hand-tighten.
Open the cylinder valve slowly and read the pressure gauge.
Listen and feel for leaks; reseat the regulator if you hear hissing.

Apply the non-rebreather

Attach the mask tubing to the regulator outlet.
Set the flow to 10 to 15 L/min.
Prefill the reservoir bag: cover the valve inside the mask with a finger until the bag is full.
Explain to the patient, place the mask over nose and mouth, fit the elastic and pinch the nose clip.
Watch the bag: it should stay at least partly full when the patient breathes in. If it collapses, turn the flow up.

Typical ranges; the real oxygen level depends on how the patient breathes.
Device	Flow	About how much oxygen
Nasal cannula	1 to 6 L/min	24 to 40%
Simple face mask	5 to 10 L/min	35 to 55%
Non-rebreather	10 to 15 L/min	80 to 95%

Switch to a nasal cannula

When the examiner says the patient cannot tolerate the mask or needs less oxygen, remove the mask.
Attach the cannula, set 1 to 6 L/min, place the prongs in the nose and loop the tubing over the ears.
In real care, titrate to an SpO2 of 94 to 98%.

Critical-fail themes

Applying the mask before the bag is full.
Flow too low for the device, so the bag collapses.
A leaking regulator left in place, or unsafe cylinder handling.
Using a non-rebreather on a patient who is not breathing adequately. That patient needs a bag-valve mask.

In depth

The one-page summary above is what the PDF prints. These sections go further.

How a non-rebreather works

A one-way valve between the mask and the reservoir bag lets the patient breathe in from the bag but blocks exhaled air from going back into it, and flaps on the sides let exhaled air out. Because the patient draws from a bag of nearly pure oxygen, it delivers the highest concentration of the low-flow devices. Below about 10 L/min the bag can empty with each breath, and the patient pulls in room air or struggles.

When oxygen is and is not the answer

Give oxygen to treat low saturation or respiratory distress; aim for 94 to 98%.
Patients with normal saturation and no distress do not need it routinely.
An NRB adds oxygen but does not move air. Slow, shallow breathing needs assisted ventilation.
Above 6 L/min a nasal cannula mainly dries the nose; move to a mask instead.

Exam pearls

Say the pressure you read on the gauge.
Say "prefilling the reservoir" while you do it.
Turn the cylinder off and bleed the regulator when you finish, if asked to take it out of service.

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Sources

Hardavella G, Karampinis I, Frille A, Sreter K, Rousalova I. Oxygen devices and delivery systems. Breathe (Sheff). 2019;15(3):e108-e116. Link
National Association of State EMS Officials. National Model EMS Clinical Guidelines, Version 3.0. March 2022. Universal Care; Airway Management. Link