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Emergency Medical Training 2019 – Part 3 – Oxygen Administration

February 25, 2019

Too much oxygen in the lungs overwhelms the blood’s ability to carry the oxygen away. The results in the excess oxygen forming free radicals that binds to the surface proteins of the lungs. Theses free radicals interfere with the central nervous system and attack the retina in the eye. Effectively it’s a form of chemical burning of tissue.

Oxygen administration is now viewed as giving a drug, and therefore needs to be recorded. In the past we gave 100% oxygen for long periods of time and thought it was safe. Now we have found that this unregulated use has led to permanent damage of parts of the body.

This means we need to give oxygen with a finger pulse oximeter. The oximeter is a portable non-invasive, spot check of oxygen saturation via a finger of arterial haemoglobin and pulse rate of an adult and paediatric patients at home and in hospital. Tip-if the patient has false nails, then turn the finger side on for accurate readings.

A healthy patient: Pulse rate should sit between 60-100 per minute for an adult, and a child between (9-15 years) should be 80-100 per min.

A healthy patient: SpO2 (oxygen saturation) for an adult, and a child from (9-15years), should be also 95%-98%.

Finger Pulse Oximeter - oxygen saturation number on left and pulse on right

Oxygen Administration – Adult

SpO2 below 92%

  • Oxygen via nasal prongs at 2-4 litres/minute, until target 92-96% is reached.
  • If target not reached then use a mask and increase flow to 8 litres/minute, until target 92-94% is reached.

Keep SpO2 below 96% – turn down or stop oxygen if target exceeded.

Oxygen Administration – Children

SpO2 below 92%

  • Oxygen, via nasal prongs, at 2-4 litres/minute until target 94-98% is reached.
  • If target not reached then use a mask and increase flow to 8 litres/minute until target 94-98% is reached.

Keep SpO2 below 98% – turn down or stop oxygen if target exceeded

There are other conditions where the oxygen saturations need to be lower, than above, as it may cause respiratory arrest. Additional measures such as a bronchodilator may be needed.

Green Oxygen Bag, Oxygen Tank, Red Bag - Medication & Equipment

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Next week

How Often Do We Need to Review – Children Development and Bite – Part 4 – Lower Jaw Development