Oxygen guideline Flashcards
what is bleomycin?
chemo drug - Bleomycin is a chemotherapeutic agent commonly used to treat germ cell
malignancies (most commonly testicular and ovarian cancers), squamous
cell carcinomas, and Hodgkin’s lymphoma
What is paraquat?
Paraquat is a highly toxic herbicide which is rapidly absorbed into lung tissue
leading to pneumonitis and pulmonary fibrosis, as well as causing renal and
hepatic injury. It causes cell death via oxidative mechanisms, thus effects are
exacerbated in the presence of supplemental oxygen.
What is adequate oxygen
92%
What is mild to moderate oxygen and mx
85-81
Titrate to 92-96
Via nasal cannula 2-6L
Simple face mask 5-10
what % is considered severe hypoxemia?
Severe hypoxia is O2 < 85%
what is listed as the critical illnesses? (8) (SCHMAKSS-)
• Cardiac arrest or resuscitation • Major trauma . head injury • Shock • Severe sepsis • Anaphylaxis • Status epilepticus • Ketamine sedation
what is the mx for critical illnesses or hypoxemia? initial mx/once stable/if deteriorates
• Initial Mx: - Initial dose nonrebreather mask 10-15 L/min - If inadequate VT , consider BVM ventilation with 100% O₂
• Once Pt haemodynamically stable and
has reliable oximetry reading
- Titrate O₂ flow to Sp ₂ of 92 – 96%
• If Pt deteriorates or SpO₂ remains < 85%
- BVM ventilation with 100% O₂
- Consider SGA as per CPG A0301
Supra-Glottic Airway
what conditions are regarded as chronic hypoxaemia? (6)
- COPD
- Neuromuscular disorders
- Cystic Fibrosis
- Bronchiectasis
- Severe kyphoscoliosis
- Obesity
what is the mx for chronic hypoxemia if there is no critical illness present or pt deteriorates?
• Titrate O₂ flow to Sp ₂ of 88 – 92% If no critical illness present - Initial dose of 2 – 6 L/min via nasal cannulae - Consider simple face mask 5 – 10 L/min
• If Pt deteriorates or SpO₂ remains < 85%
- Rx as per Severe hypoxaemia
which illnesses get high flow oxygen regardless of spo2? (6)
- Toxic inhalation exposure
- Decompression Illness
- Cord prolapse
- Postpartum haemorrhage
- Shoulder dystocia
- Cluster headache
Why is high flow oxygen given to DCI?
High flow oxygen therapy provides the maximum gradient for diffusion of nitrogen in decompression illness and has been shown to significantly improve patient outcomes.
why is high flow oxygen given to toxic gas inhalation despite adequate SPO2 levels?
Pulse oximetry is likely to be inaccurate in the patient with carbon monoxide poisoning. Carbon monoxide preferentially binds to haemoglobin in the place of oxygen. This reduces haemoglobin oxygen carrying capacity despite normal levels of oxygen in the lungs and blood. The term ‘toxic inhalation exposure’ was used in the guideline in preference to naming specific toxic agents as the precise agent involved may not be known upon initial attendance at scene.
