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Applying oxygen to respiratory emergency patients, MELANY TOALA, EIBAR…
Applying oxygen to respiratory
emergency patients
Choosing controlled or uncontrolled oxygen
target saturations for the administration of all emergency oxygen therapy. They recommend that oxygen should be prescribed to achieve a target saturation of 94–98% for patients aged <70 and 92–98% for those 70 or above. The exception is patients with COPD or respiratory failure
The use of some uncontrolled delivery devices (Box 3) can produce unexpectedly high concentrations of inspired oxygen (hyperoxia) but is generally assumed to be safe. However, there is evidence that in some patients, for example those with acute exacerbations of COPD, hyperoxia may be harmful
These patients require controlled oxygen therapy during an acute phase to ensure accurate doses, irrespective of their breathing pattern. This is best achieved with high-flow Venturi masks, available to provide oxygen concentrations of between 24% and 60%.
Administration of oxygen therapy : :question:
Oxygen therapy administration can be described as controlled or uncontrolled. It is also referred to as high and low flow
is important to decide how oxygen should be delivered and this is determined by the patient’s condition and diagnosis.
Oxygen therapy during an
acute exacerbation of COPD
These guidelines recommend target oxygen saturations of 88–92% for patients with COPD treated in ambulances or emergency departments prior to the availability of blood gas results. This will prevent most cases of hyperoxia and acidosis and reflects the NICE (2004) guidance for the management of COPD.
Psychological care
Patients who require emergency oxygen therapy are acutely ill and many are in a life-threatening situation.
Patients are often frightened, anxious and distressed.
It is vital that the health professional is calm and reassuring in her or his approach, especially if the patient feels claustrophobic when a face mask is applied.
When is emergency oxygen used?
Emergency care will often require the delivery of high concentrations of oxygen (40–60%).
Most patients who are acutely short of breath will have conditions such as asthma, heart failure, pneumonia or pulmonary embolism
Assessing need for oxygen therapy
Early recognition of the need for oxygen can be difficult as clinical features are often non-specific, including altered mental state, dyspnoea, cyanosis, tachypnoea, cardiac arrhythmias and coma.
Stopping oxygen therapy
Oxygen therapy should be titrated downwards and stopped when the patient is clinically stable and arterial oxygenation is adequate with the patient breathing room air
MELANY TOALA
EIBAR MARTINEZ
