Policy for the Prescription, Administration and Monitoring Of Oxygen ...

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• Where you think that the policy could have a negative impact on any of the equalitygroup(s) i.e. it could disadvantage them, tick the ‘Negative impact’ box.• Where you think that the policy has no impact on any of the equality group(s) listed belowi.e. it has no effect currently on equality groups, tick the ‘No impact’ box.Equality Positive Negative No Reasons for decisionGroupImpact Impact ImpactAgeXThis policy is applied irrespectiveof adult patient ageDisability X this policy is applied to patientsirrespective of any disability.Religion orbeliefX This policy describes activities notrelated to faith and beliefGender X This policy describes therapies notaffected by gender.Transgender X This policy describes therapies notaffected by transgender.Pregnancy/MaternityX This policy describes therapies notaffected by pregnancy/maternityRace X This policy describes therapies notaffected by pregnancy/maternitySexualOrientationX This policy describes therapies notaffected by sexual orientationMarriage / CivilPartnershipX This policy describes therapies notaffected by marriage or civilpartnershipYou will need to continue to a full Equality Impact Assessment if the following have beenhighlighted:• A negative impact and• No consultation (this excludes any policies which have been identified as notrequiring consultation).8. If there is no evidence that the policypromotes equality, equal opportunitiesor improved relations - could it beadapted so that it does? How?Full statement of commitment to policy ofequal opportunities is included in the policyPlease sign and date this form.Keep one copy and send a copy to Matron, Equality, Diversity and Human Rights, c/oRoyal Cornwall Hospitals NHS Trust, Human Resources Department, Chyvean House,Penventinnie Lane, Truro, Cornwall, TR1 3LJA summary of the results will be published on the Trust’s web site.Signed ________________________________________Date _________________________________________Policy for the prescription, administrationand monitoring of emergency oxygen in adultsPage 14 of 34
APPENDIX a. Indications for oxygen therapyThe British Thoracic Society divide patients into four different groups depending on theirdiagnosis and oxygen requirements:1. Critical illness requiring high levels of supplementary oxygen.2. Serious illness requiring moderate levels of supplemental oxygen is the patient ishypoxaemic.3. COPD and or other condition requiring controlled low-dose oxygen therapy.4. Conditions for which patients should be monitored closely but oxygen therapy is notrequired unless the patient is hypoxaemic.The following tables set out how oxygen should be administered and the grades of evidencesupporting oxygen use in these conditions.Table 1: Critical illnesses requiring high levels of supplemental oxygen‣ The initial oxygen therapy is a reservoir mask 15L/min‣ Once stable, reduce the oxygen dose and aim for target saturation range 94 - 98%‣ If oximetry is unavailable, continue to use reservoir mask until definitive treatment isavailable‣ Patients with COPD and other patients at risk of hypercapnia who develop critical illnessshould have the same initial target saturations as other critically ill patients pending theresults of blood gas measurements, after which these patients may need controlled oxygentherapy or supported ventilation if there is sever hypoxaemia and /or hypercapnia withrespiratory acidosis.Condition Additional comments Grade of recommendationCardiac arrest or resuscitation Use bag-valve mask during active Grade DresuscitationAim for maximum possible oxygensaturation until patient is stableShock, sepsis, major trauma, neardrowning,Also give specific treatment for the Grade Danaphylaxis, major underlying conditionpulmonary haemorrhageMajor head injury Early intubation and ventilation if Grade DcomatoseCarbon monoxide poisoning Give as much oxygen as possible using abag-valve mask or reservoir mask. Checkcarboxyhaemoglobin levels.A normal or high oximetry reading shouldbe disregarded because saturationmonitors cannot differentiate betweencarboxyhaemoglobin and oxyhaemoglobinowing to their similar absorbencies. theblood gas PaO2 will also be normal inthese cases (despite the presence oftissue hypoxia)Grade CPolicy for the prescription, administrationand monitoring of emergency oxygen in adultsPage 15 of 34
Page 2 and 3: Table of Contents1. Introduction ..
Page 5 and 6: provided for those administering ox
Page 7 and 8: 6.11 Transfer and transportation of
Page 9 and 10: well perfusedSaturation within targ
Page 11 and 12: Appendix 1. Governance InformationD
Page 13: Appendix 2.Initial Equality Impact
Page 17 and 18: Deterioration of lung fibrosisor ot
Page 19 and 20: CF (cystic fibrosis); COPD (chronic
Page 21 and 22: Poisoning with paraquat orbleomycin
Page 23 and 24: Appendix c. Administering oxygen th
Page 25 and 26: Venturi MasksDESCRIPTIONA mask inco
Page 27 and 28: Reservoir (non-rebreathe) maskDESCR
Page 29 and 30: Oxygen flow meterDESCRIPTIONDevice
Page 31 and 32: Appendix f Personnel who mayadminis
Page 33 and 34: Appendix (h)HEALTH AND SAFETYAction

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