Our January 27, 2009 Pattient Safety Tip of the Week “Oxygen Therapy: Everything You Wanted to Know and More!” summarized the new British Thoracic Society (BTS) guideline on oxygen therapy.
A 2-part series on implementation of these guidelines from a nursing perspective has appeared in Nursing Times in March 2009 (Smith et al 2009 Part 1, Smith et al 2009 Part 2). While this largely reiterates many of the key points in the BTS guideline, it does have some very practical tips. For example, it describes barriers to appropriate management, such as need for removal of nail polish to prevent inaccurate pulse oximetry readings or use of an ear probe in patients severely vasoconstricted peripherally. It also points out that oxygen therapy is intended to treat hypoxemia, not breathlessness. But it does discuss approaches to the breathless patient. In a discussion about mucus plugging, it notes that there is little evidence that humidification with high-flow oxygen is effective and the oxygen guideline recommends that a bubble bottle should not be used but that single doses of nebulised normal saline have been shown to help in sputum clearance and reduce breathlessness in patients with COPD
Smith, S.M.S. et al. Emergency oxygen delivery in adults 1: updating nursing practice. Nursing Times 2009; 105: 10, 16–18 March 13, 2009
Smith, S.M.S. et al. Emergency oxygen delivery 2: patients with asthma and COPD. Nursing Times 2009; 105: 11 March 24, 2009