Health facilities must consider issues of prehospital oxygen therapy and emergency room settings for oxygen delivery. The delivery of oxygen in prehospital emergency care is without indication and in variables and unknown concentrations. Pulse oximetry monitors oxygen delivery to reverse hypoxemia. However, most prehospital emergency care services rarely titrate oxygen after reversing hypoxemia. The only evidence-based indication for oxygen therapy is hypoxemia, confirmed by oximetry, blood gas analysis, or physical observation. Oxygen administration guidelines suggest oxygen delivery on the presumption of need based on disease state. This is to alleviate breathlessness and to prevent hypoxemia in sick patients at risk. However, oxygen delivery to patents without hypoxemia can lead to worsening outcomes in the presence of hyperoxia.
Read more of prehospital oxygen therapy and emergency room settings at
ADVERSE EVENTS IN PREHOSPITAL EMERGENCY CARE
Apart from prehospital oxygen therapy, patient safety in the prehospital setting is vital as well. There is a need for further research on providing patient safety before their arrival at the hospital. In recent years, we experienced the transformation of prehospital emergency care from a transport organization to an integrated part of the health-care system. Additionally, this transformation poses significant challenges for the involved organizations in terms of education, equipment, methods, and decision support. This necessitates the need for revised oxygen administration guidelines for prehospital emergency care. There have to be decisions made regarding staying at home with self-care advice, being transported to primary care, or being transported to the nearest emergency department.
Read more of adverse events in prehospital emergency care at
APPLYING AND TITRATING OXYGEN THERAPY
This section entails the oxygen administration guidelines. It is essential to initiate oxygen according to hospital protocols when patients with respiratory or cardiovascular conditions warrant its use. There is a need to develop prehospital emergency care to assess for underlying respiratory diseases. Patients with COPD are at risk for acute hypoventilation and carbon dioxide retention. Elevated CO2 levels increase the risk of respiratory failure or hyperventilation. During prehospital oxygen therapy, the first priority should be to prevent or treat hypoxia. Never withhold oxygen for COPD patients while waiting for additional medical interventions. Check all equipment for safety and function at least once per shift. Lastly, Check oxygen equipment more frequently if using a high-flow system, which requires higher oxygen concentration.
Read more of applying and titrating oxygen therapy at
Additional attachments
>> Download
