Ensuring the safe use of emergency oxygen therapy in acutely ill patientsDigital Edition: Ensuring the safe use of emergency oxygen therapy in acutely ill patients 11 March, 2019 Show
Excessive emergency oxygen therapy potentially causes more harm than good. Health professionals need to follow existing guidance. This article comes with a self-assessment enabling you to test your knowledge after reading it To continue reading this clinical article please log in or subscribe. Subscribe for unlimited access
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Register Already have an account, to sign in Oxygen, a gas found in the air we breathe, is necessary for human life. Some people with breathing disorders can’t get enough oxygen naturally. They may need supplemental oxygen, or oxygen therapy. People who receive oxygen therapy often see improved energy levels and sleep, and better quality of life. Who needs oxygen therapy?Oxygen therapy is prescribed for people who can’t get enough oxygen on their own. This is often because of lung conditions that prevents the lungs from absorbing oxygen, including:
To determine whether a person will benefit from oxygen therapy, doctors test the amount of oxygen in their arterial blood. Another way to check is using a pulse oximeter that indirectly measures oxygen levels, or saturation, without requiring a blood sample. The pulse oximeter clips onto a person’s body part, like a finger. Low levels mean that a person may be a good candidate for supplemental oxygen. Normal levels of arterial blood oxygen are between 75 and 100 mmHg (millimeters of mercury). An oxygen level of 60 mmHg or lower indicates the need for supplemental oxygen. Too much oxygen can be dangerous as well, and can damage the cells in your lungs. Your oxygen level should not go above 110 mmHg. Some people need oxygen therapy all the time, while others need it only occasionally or in certain situations. Some oxygen therapy is done at a doctor’s office, and other times people have an oxygen supply in their homes, or a portable oxygen system. Is My Blood Oxygen Level Normal?What are the symptoms of low oxygen?When you aren’t getting enough oxygen, you’ll experience a host of symptoms, including:
If you experience any of these symptoms, seek immediate medical attention. What are the different types of oxygen therapies?There are a number of different types of oxygen therapies that can be used. These include:
Oxygen gasOxygen gas can be stored in a portable tank. These are called compressed gas systems. A larger stationary concentrator is used within the home, and a smaller oxygen tank can be taken to use outside the home. The smaller tanks might be used along with oxygen-conserving devices so that the oxygen supply lasts longer. The oxygen is delivered in pulses, not continuously. Liquid oxygenLiquid oxygen also can be stored in a portable tank. Liquid oxygen is more highly concentrated, so more oxygen can fit in a smaller tank. This is helpful for people who are very active, but it will evaporate if it isn’t used in a timely manner. These tanks are refillable. Both liquid oxygen and oxygen gas are available for home delivery in many locations. Oxygen concentratorsOxygen concentrators are less portable than the other options. An oxygen concentrator is a device that takes oxygen from the room, concentrates it for therapeutic use, and removes other naturally occurring gases. The benefits of concentrators are that they are less expensive and don’t require filling like tanks. Portable versions are available. However, most models are too large to be truly portable. Oxygen is distributed from the tank through a tube. It enters the lungs through nasal tubes, a face mask, or a tube inserted directly into the person’s windpipe. Hyperbaric oxygen therapyHyperbaric oxygen therapy is unlike the other methods of oxygen therapy. People will breathe in pure oxygen in a pressurized room or chamber. In the hyperbaric chambers, the air pressure is increased to three or four times the normal air pressure levels. This increases the amount of oxygen delivered to the body’s tissue. This type of oxygen delivery is often used to treat wounds, serious infections, or bubbles of air in your blood vessels. Hyperbaric therapy should be carried out carefully so that blood oxygen levels don’t become too high. Delivery methodsThe most common delivery method is the nasal cannula, which consists of a tube that runs through both nostrils. Other delivery methods include:
Learn more: Using CPAP, a sleep apnea treatment, for COPD » What are the benefits of oxygen therapy?Oxygen therapy can be extremely beneficial for those who frequently experience low oxygen levels, regardless of the reason. If needed, regularly utilizing oxygen therapy can allow people to be more active and mobile by decreasing shortness of breath. It also can significantly improve quality of life, and in many cases extend life expectancy. Oxygen therapy can also reduce symptoms such as:
Oxygen therapy can help the growth and development of children who have chronic lung conditions. It can also lessen symptoms such as headaches caused by low oxygen levels, and behavioral changes or problems. How does oxygen therapy help with COPD?Many people with severe COPD require long-term oxygen therapy. COPD is an umbrella term that includes progressive lung diseases that lead to increased breathlessness. Some people will experience declining lung function over time, leading them to struggle to get enough oxygen. Long term, regular oxygen therapy can significantly improve the quality and length of life for people with COPD. Many of them may need to receive oxygen therapy for at least 15 hours every day. One studyfound that continuous supplemental oxygen is most beneficial to people with COPD, and can increase survival rates. Read more: Find treatments for COPD » What are the guidelines for using oxygen therapy?Your doctor will write you a prescription to begin oxygen therapy. They’ll tell you how to use it and how often you should use it. This will include the flow rate, or how much oxygen you’ll need per minute. It is essential that you follow all of your doctor’s specific instructions. If you don’t think the oxygen therapy is working for you, see them before making any changes. Some people only need oxygen during certain activities, like exercising or sleeping. Other people need oxygen constantly. Most types of oxygen therapy come with portable oxygen tanks so you can leave home with them if necessary. Do not use drugs or alcohol while taking oxygen therapy, as they can slow your breathing. When discussing oxygen therapy with your doctor, make them aware of any other prescription medications you may be taking. What are the safety considerations for oxygen therapy?Even though oxygen is not a flammable gas, it’s also necessary for combustion. Fires in areas with excessive oxygen are likely to burn more quickly. Be cautious with oxygen tanks around open flames and heaters, and be sure to store oxygen tanks safely. Safety tips
What is the outlook for people who use oxygen therapy?Many people who need supplemental oxygen live normal, active lives. In many cases, the oxygen therapy helps make activity easier, increases stamina, and decreases shortness of breath. In some cases, oxygen therapy can increase life expectancy. Even people who need ongoing therapy due to chronic conditions can live normal lives. Once a person learns to manage the oxygen equipment, the therapy doesn’t have to limit their routine. Does oxygen have to be prescribed in an emergency?Oxygen is probably the most common drug used in medical emergencies. It should be prescribed initially to achieve a normal or near–normal oxygen saturation; in most acutely ill patients with a normal or low arterial carbon dioxide (PaCO2), oxygen saturation should be 94–98% oxygen saturation.
What is oxygen therapy used for?Oxygen therapy is a treatment that delivers oxygen for you to breathe. You can receive oxygen therapy from tubes resting in your nose, a face mask, or a tube placed in your trachea (windpipe). You may need oxygen therapy if you have a condition that causes your blood oxygen levels to be too low.
When should you apply oxygen to a patient?When the oxygen saturation falls below 89 percent, or the arterial oxygen pressure falls below 60 mmHg — whether during rest, activity, sleep or at altitude — then supplemental oxygen is needed.
How much oxygen should be given in an emergency situation?Oxygen should be prescribed to achieve a target saturation of 94–98% for most acutely ill patients or 88–92% for those at risk of hypercapnic respiratory failure (tables 1–3).
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