QAS Drug Therapy Protocol — Oxygen

Primary indication for giving oxygen under QAS protocols

Presence or risk of systemic and/or localised hypoxia / hypoxaemia.

Target SpO₂ for most patients

92-96%.

Target SpO₂ in patients at risk of hypercapnia (e.g. COPD)

88-92%.

Situations where 100% oxygen should be given irrespective of SpO₂

Intra-arrest; carbon monoxide poisoning.

Reason for giving oxygen in carbon monoxide poisoning even if SpO₂ is high

Because pulse oximeters can't distinguish between oxyhaemoglobin and carboxyhaemoglobin.

Contraindications to giving supplemental oxygen according to QAS

Known paraquat poisoning with SpO₂ ≥ 88%; history of bleomycin therapy with SpO₂ ≥ 88%.

Potential adverse effect of giving too much oxygen in COPD patients

Respiratory drive suppression, resulting in hypercapnia.

Devices that can be used to administer oxygen

Nasal cannula, simple face mask, non-rebreather mask, nebuliser mask, BVM, SAD, ETT, CPAP.

Precaution when oxygen is used for prolonged periods in premature neonates

Avoid high concentrations due to risk of lung injury / retinopathy.

Common side effect of oxygen in the airways

Drying of mucous membranes.