Oxygen Therapy Flashcards

Flashcards based on Oxygen Therapy CPG A0001 Version 3.4.0 to help understand oxygen therapy principles and guidelines.

Hypoxaemia

A condition of abnormally low oxygen levels in the blood.

Target SpO2 in acutely ill patients

Normal or near normal.

Oxygen administration for short of breath patients

Prioritize before obtaining an O2 saturation reading, then titrate to a desired target saturation range.

Initial O2 dose if pulse oximetry is unavailable

2-6 L/min via nasal cannulae or 5-10 L/min via face mask until a reliable SpO2 reading or symptoms resolve.

Early aggressive O2 administration benefits

Patients who develop critical illnesses and are haemodynamically unstable, such as cardiac arrest or resuscitation; major trauma / head injury; shock; severe sepsis; and anaphylaxis.

Initial SpO2 target for critical illnesses

100%, then titrate to 92-96% once hemodynamically stable.

COPD suspicion criteria (over 40 years old)

Smoker or ex-smoker, experiencing dyspnoea that is progressive, persistent and worse with exercise, has a chronic cough or chronic sputum production, has a family history of COPD.

Special circumstances where O2 therapy may be detrimental

Paraquat and bleomycin poisoning; maintain prophylactic hypoxaemia (SpO2 of 85-88%).

Conditions affecting pulse oximetry reliability

Peripheral vascular disease, severe asthma, severe anaemia, cold extremities or peripherally 'shut down', severe hypotension and carbon monoxide poisoning.

SpO2 reading inaccuracy

An SpO2 reading below 80% increases the chance of being inaccurate.

Patients with potentially toxic gases inhalation

Should be given high dose O2 regardless of Sp02 or signs of breathlessness.

Patients with medically diagnosed pneumothorax

May benefit from high dose O2 regardless of SpO2, if without an intercostal catheter in situ.

Preferred position when administering O2

Upright position, unless other clinical problems determine otherwise.

Considerations for pulse oximetry

Ensure the patient's fingertip are clean of soil or nail polish and be aware that the presence of nail infection may also cause falsely low readings.

Anxiety/panic disorders and O2

O2 is not required however no attempt should be made to retain CO2 (e.g. paper bag breathing).

Pregnant women (>20 weeks) with hypoxaemia

Should be managed with left lateral tilt to improve cardiac output.

Face masks and flow rates

Should not be used for flow rates < 5 L/min due to the risk of CO2 retention.

Nasal cannulae vs face masks

Nasal cannulae are likely to be just as effective with mouth-breathers; use face masks if nasal passages are congested or blocked.