CPG Care Objectives And Flowcharts

Question 1

What is evidence of hypoxaemia?

Answer 1

Breathlessness and SpOz levels.

Question 2

What defines mild-moderate hypoxaemia?

Answer 2

SpOz 85 - 91%.

Question 3

What is the action for mild-moderate hypoxaemia?

Answer 3

Titrate O2 flow to SpOz of 92 - 96% with an initial dose of 2 - 6 L/min via nasal cannulae.

Question 4

What should be assessed or considered in the oxygen therapy guideline?

Answer 4

Acute or chronic status, respiratory status, continuous monitoring of SpOz, and causes of hypoxaemia.

Question 5

What defines severe hypoxaemia?

Answer 5

SpOz < 85%.

Question 6

What are critical illnesses associated with hypoxaemia? (7)

Answer 6

1.Cardiac arrest
2. major trauma/head injury
3. shock
4. severe sepsis
5. anaphylaxis
6. status epilepticus
7. ketamine sedation.

Question 7

What is the initial management for severe hypoxaemia OR critical illness?

Answer 7

Initial dose nonrebreather mask 10-15 L/min.

Consider BVM / IPPV or LMA

Question 8

What to do if the severe hypoxaemia patient deteriorates or SP02 remains <85% after initial Mx?

Answer 8

BVM ventilation with 100% O2
Consider SGA

Question 9

What to do once the severe hypoxia patient is haemodynamically stable?

Answer 9

Titrate O2 flow to SpOz of 92 - 96%.

Question 10

What to do if the severe hypoxia patient deteriorates or SpOz remains < 85%?

Answer 10

BVM ventilation with 100% O2
- consider SGA

Question 11

What conditions define chronic hypoxaemia? (6)

Answer 11

1. COPD
2. neuromuscular disorders
3. cystic fibrosis
4. bronchiectasis
5. severe kyphoscoliosis
6. obesity.

Question 12

What should be avoided in COPD patients at risk of hypercapnic respiratory failure?

Answer 12

High-concentration O2.

Question 13

What is the action for chronic hypoxaemia?

Answer 13

Titrate O2 flow to SpOz of 88 - 92%

• if no critical illness present, initial dose of 2 - 6 L/min via nasal cannulae.

Question 14

What to do if the patient deteriorates or SpOz remains < 85% in chronic hypoxaemia?

Answer 14

Rx as per severe hypoxaemia.

• 10-15L via NRB
• consider BVM with 100% 02 if inadequate ventilation

Question 15

What is considered adequate SpO2?

Answer 15

SpO2 ≥ 92%.

Question 16

What action is required for adequate SpO2?

Answer 16

No O2 required; reassure the patient.

Question 17

What conditions require O2 regardless of SpO2? (5) and what is the Mx?

Answer 17

1. Toxic inhalation exposure
2. decompression illness
3. cord prolapse
4. postpartum hemorrhage
5. cluster headache.

10-15L 02 via NRB

Question 18

What is the action for toxic inhalation exposure?

Answer 18

O2 via nonrebreather mask for 10 - 15 min.