Oxygen for the Critically Ill

2. Oxygen for the Critically Ill Oxygen for the Acutely unwell Oxygen for COPD Patients

3. 2 Important Messages • Oxygen is a treatment for HypoxianotBreathlessness • Oxygen saturations should be checked and recordedalong with the concentration of inspired oxygen

4. Critically Ill Allcritically ill patients receive high flow Oxygen 15L/min via reservoir mask

5. Critically Ill? When stabilised manage as per Guidelines for the acutely unwell

6. Acutely Unwell? Examples:- If unsure give 15L via reservoir mask and complete initial assessment.

7. Acutely Unwell • Need to achieve saturations 94-98% • Give whatever is needed to achieve these saturations • IfSats <85%give 15L/min via reservoir mask Otherwise • Start with 10L/min via Hudson mask (but reassess and give more if needed)

8. Acutely Unwell Remember If in doubt… Give 15L via Reservoir mask And complete initial assessment

9. COPD Patients (And others at risk of retaining CO2) • Need to achieve saturations of 88-92% • Give 28% Oxygen via venturi mask (If unable to achieve desired saturations try higher concentration Venturi masks) • Perform Arterial Blood Gas • Perform Blood gas analysis 30-60 mins after every change in oxygen concentration

10. ABG in COPD Patients • If pCO2 is <6.0kPa It is safe to aim for saturations of 94-98% • If developing hypercapnia (pCO2 >6KPa) along with ongoing hypoxia – • Do NOT Decrease Oxygen! • Consider need for assisted ventilation – NIV or Intubation.

11. Oxygen Guidelines • More detailed guidance from the British Thoracic Society • www.brit-thoracic.org.uk/ • NHS Tayside Oxygen Prescribing chart is derived From these Guidelines