BTS Emergency Oxygen Therapy Flashcards
BTS guidelines on emergency oxygen therapy
Lag time between change in blood oxygenation and change in sats probe reading
30 - 90 seconds
Target oxygen saturations
patient not at risk of Type II Respiratory Failure
94 - 98%
Target oxygen saturations in patient at risk of Type II Respiratory Failure
88 - 92%
Oxygen saturations below… x … mean a patient should be considered critically ill.
What action should be taken?
SaO2 < 85%
15 L/min oxygen via non-rebreathe mask
Critical Illnesses Requiring High Levels of Supplemental Oxygen
(10)
15 L/min via non-rebreathe mask or bag-valve mask.
Do not wait for oximetry readings.
Cardiac Arrest or Resuscitation Shock Sepsis Major Trauma Major Pulmonary Haemorrhage Drowning Anaphylaxis Status Epilepticus Major Head Injury Carbon Monoxide Poisoning [disregard oximetry]
Target saturations for ALL critically ill patients
94 - 98%
Oxygen Therapy for:
Cardiac Arrest
15 L/min via non-rebreathe mask or bag-valve mask.
Do not wait for oximetry readings.
Oxygen Therapy for:
Shock
15 L/min via non-rebreathe mask.
Do not wait for oximetry readings.
Oxygen Therapy for:
Sepsis
15 L/min via non-rebreathe mask.
Do not wait for oximetry readings.
Oxygen Therapy for:
Major Trauma
15 L/min via non-rebreathe mask.
Do not wait for oximetry readings.
Oxygen Therapy for:
Major Pulmonary Haemorrhage
15 L/min via non-rebreathe mask.
Do not wait for oximetry readings.
Oxygen Therapy for:
Drowning
15 L/min via non-rebreathe mask.
Do not wait for oximetry readings.
Oxygen Therapy for:
Anaphylaxis
15 L/min via non-rebreathe mask.
Do not wait for oximetry readings.
Oxygen Therapy for:
Status Epilepticus
15 L/min via non-rebreathe mask.
Do not wait for oximetry readings.
Oxygen Therapy for:
Major Head Injury
15 L/min via non-rebreathe mask.
Do not wait for oximetry readings.
Oxygen Therapy for:
Carbon Monoxide Poisoning
15 L/min via non-rebreathe mask.
Do not wait for oximetry readings.
Oximetry readings will likely be fictitiously high.
Oxygen Therapy for:
Acute Hypoxaemia of Unknown Cause
SaO2 < 85%:
15 L/min via non-rebreathe mask.
Otherwise:
Aim for target saturations 94 - 98% using simple face mask or nasal cannulae
Oxygen Therapy for:
Acute Asthma
CONSIDER NEBULISED SALBUTAMOL
SaO2 < 85%:
15 L/min via non-rebreathe mask.
Otherwise:
Aim for target saturations using simple face mask or nasal cannulae
Oxygen Therapy for:
Acute Coronary Syndrome
Patients are often not hypoxaemic.
Oxygen is a vasoconstrictor so may be harmful.
Provide oxygen therapy if the patient is hypoxaemic.
Oxygen Therapy for:
Stroke
Patients are often not hypoxaemic.
Oxygen is a vasoconstrictor so may be harmful.
Provide oxygen therapy if the patient is hypoxaemic.
Oxygen Therapy for:
COPD Exacerbations in patients at risk of hypercapnic respiratory failure
SaO2 < 85%:
15 L/min via non-rebreathe mask.
Otherwise aim for 88 - 92% saturations
Aim for target saturations using venturi mask
Oxygen Therapy for:
Suspected Paraquat Poisoning
SaO2 < 85%:
15 L/min via non-rebreathe mask.
SaO2 > 88%
Discontinue oxygen therapy
High Concentration Reservoir Mask (Non-Rebreathe)
Concentration of oxygen delivered?
60 - 90% oxygen when used with 15 L/min
Simple Face Mask
Concentration of oxygen delivered?
40 - 60% oxygen when used with 6 - 10 L/min
Flow rates < 5 L/min should not be used, as this can cause increased CO2 build-up.
