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Oxygen Therapy (CPG A0001)

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  • This CPG relies on accurate pulse oximetry reading

  • CPG should only be applied to Pts ≥ 12 years

  • High concentration O2 may be harmful for patients at risk of hypercapnic resp failure

  • Suspect COPD if Pt > 40+ smoker / ex-smoker with ↑ dyspnoea (esp. on exertion), chronic cough / sputum or family Hx of COPD

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Adequate SpO2 (≥ 92%)

  • No O2 required

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Mild - moderate hypoxaemia (SpO2 85-91%)

  • Titrate O2 to SpO2 92-96% with:

    • nasal cannula (2-6 L/min)

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Severe hypoxaemia (SpO2 < 85%) OR Critical illness

  • Critical illness includes:

    • Cardiac arrest or resuscitation

    • Major trauma/head injury

    • Shock

    • Severe sepsis

    • Anaphylaxis

    • Status epilepticus

    • Ketamine sedation

  • Initial Mx:

    • Non rebreather mask (10-15 L/min)

    • Consider BVM/IPPV/LMA or ETT (MICA only) as req'd

  • Once hemodynamically stable:

    • Titrate O2 to SpO2 92 - 96%

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Chronic hypoxaemia

  • Conditions include:

    • COPD

    • Neuromuscular disorders

    • Cystic Fibrosis

    • Bronchiectasis

    • Severe kyphoscoliosis

    • Obesity

  • Titrate O2 to SpO2 88-92% with cannula or mask

  • Treat as per severe hypoxaemia if deterioration or SpO2 < 85%

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Regardless of SpO2

  • Pt presents with:

    • Toxic inhalation exposure

    • Decompression Illness

    • Cord prolapse

    • Postpartum haemorrhage

    • Shoulder dystocia

    • Cluster headache

  • O2 via nonrebreather mask (10 - 15 L/min)

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Flow Chart

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