Initial oxygen management in patients with an exacerbation of chronic obstructive pulmonary disease

Durrington, Hannah J.; Flubacher, M.; Ramsay, Crichton; Howard, Luke; Harrison, B. D.

doi:10.1093/qjmed/hci084

Cited by 44 publications

(32 citation statements)

References 11 publications

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“…This avoidable problem has occurred historically during the transfer to hospital, prior to measurement of ABGs or before a definitive diagnosis is known. Furthermore, ambulance staff are often not informed at present of a diagnosis of COPD and may not be aware of the presence of other high-risk conditions such as kyphoscoliosis or respiratory failure due to neuromuscular conditions 447. These patients should be issued with an oxygen alert card (example shown in figure 8) and a 24% or 28% Venturi mask based on previous blood gas results.…”

Section: Section 9: Emergency Use Of Oxygen In Ambulances Community mentioning

confidence: 99%

BTS guideline for oxygen use in adults in healthcare and emergency settings

O’Driscoll

Howard

Earis

et al. 2017

Thorax

507

376

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Section: Section 9: Emergency Use Of Oxygen In Ambulances Community mentioning

confidence: 99%

BTS guideline for oxygen use in adults in healthcare and emergency settings

O’Driscoll

Howard

Earis

et al. 2017

Thorax

507

376

View full text Add to dashboard Cite

“…Oxygen is commonly employed as the driving gas for jet nebulisers in patients with severe asthma or acute exacerbations of COPD. It is advisable to avoid the uncontrolled use of oxygen in patients with severe COPD because of the risk of hypercapnia with high doses of oxygen [109,110]. Such patients should be monitored for oxygen saturation and level of consciousness.…”

Section: Choice Of Drug-device Combinations To Use In the Emergency Rmentioning

confidence: 99%

What the pulmonary specialist should know about the new inhalation therapies

et al. 2011

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A collaboration of multidisciplinary experts on the delivery of pharmaceutical aerosols was facilitated by the European Respiratory Society (ERS) and the International Society for Aerosols in Medicine (ISAM), in order to draw up a consensus statement with clear, up-to-date recommendations that enable the pulmonary physician to choose the type of aerosol delivery device that is most suitable for their patient. The focus of the consensus statement is the patientuse aspect of the aerosol delivery devices that are currently available.The subject was divided into different topics, which were in turn assigned to at least two experts. The authors searched the literature according to their own strategies, with no central literature review being performed. To achieve consensus, draft reports and recommendations were reviewed and voted on by the entire panel.Specific recommendations for use of the devices can be found throughout the statement. Healthcare providers should ensure that their patients can and will use these devices correctly. This requires that the clinician: is aware of the devices that are currently available to deliver the prescribed drugs; knows the various techniques that are appropriate for each device; is able to evaluate the patient's inhalation technique to be sure they are using the devices properly; and ensures that the inhalation method is appropriate for each patient.

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“…Another possible approach to reduce the risk of high dose oxygen administration in patients with an acute exacerbation of COPD is to provide patients with severe COPD with an alert card and Venturi mask to show to paramedics in the setting of an acute exacerbation, reinforcing appropriate use of oxygen in this situation [64,65].…”

Section: Changing Clinical Practicementioning

confidence: 99%

Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease

Pilcher

Weatherall

Perrin

et al. 2015

Expert Review of Respiratory Medicine

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During the last decade, there have been major advances in knowledge of the effects of oxygen therapy in patients with acute exacerbations of chronic obstructive pulmonary disease. This includes a randomised controlled trial of oxygen therapy in the pre-hospital setting, which showed that high concentration oxygen therapy leads to a 2.4-fold increased risk of mortality compared with titrated oxygen therapy to maintain oxygen saturations (SpO2) within a target range of 88-92%. Professional guidelines now recommend the use of supplementary oxygen in acute exacerbations of chronic obstructive pulmonary disease only if the SpO2 is less than 88%, with titration to achieve an SpO2 of 88-92%, and the delivery of bronchodilators by air-driven nebulisation or metered dose inhaler with a spacer. The aim of this review is to provide an overview of the evidence base that underpins these recommendations. We suggest that their implementation will require important changes to current clinical practice in which there is an entrenched culture of the use of high concentration oxygen therapy.

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Initial oxygen management in patients with an exacerbation of chronic obstructive pulmonary disease

Cited by 44 publications

References 11 publications

BTS guideline for oxygen use in adults in healthcare and emergency settings

BTS guideline for oxygen use in adults in healthcare and emergency settings

What the pulmonary specialist should know about the new inhalation therapies

Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease

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