Register for email alerts and news feeds:
This journal | BMJ Group
rss
Emergency Medicine Journal 2006;23:636-638; doi:10.1136/emj.2005.029991
© 2006 BMJ Publishing Group Ltd and the College of Emergency Medicine.

ORIGINAL ARTICLE

Oxygen alert cards and controlled oxygen: preventing emergency admissions at risk of hypercapnic acidosis receiving high inspired oxygen concentrations in ambulances and A&E departments

B Gooptu1, L Ward1, S O Ansari1, C D Eraut1, D Law2, A G Davison1

1 Southend Associated University Healthcare Trust, Prittlewell Chase, Southend-on-Sea, Essex, UK
2 Essex Ambulance Service, Broomfield, Essex, UK

Correspondence to:
Correspondence to:
A G Davison
Southend Associated University Healthcare Trust, Prittlewell Chase, Southend-on-Sea, Essex SS0 0RY, UK; adavison{at}southend.nhs.uk

Background: Appropriate resuscitation of hypoxic patients is fundamental in emergency admissions. To achieve this, it is standard practice of ambulance staff to administer high concentrations of oxygen to patients who may be in respiratory distress. A proportion of patients with chronic respiratory disease will become hypercapnic on this.

Objectives and methods: A scheme was agreed between the authors’ hospital and the local ambulance service, whereby patients with a history of previous hypercapnic acidosis with a PaO2 >10.0 kPa—indicating that oxygen may have worsened the hypercapnia—are issued with "O2 Alert" cards and a 24% Venturi mask. The patients are instructed to show these to ambulance and A&E staff who will then use the mask to avoid excessive oxygenation. The scheme was launched in 2001 and this paper present the results of an audit of the scheme in 2004.

Results: A total of 18 patients were issued with cards, and 14 were readmitted on 69 occasions. Sufficient documentation for auditing purposes was available for 52 of the 69 episodes. Of these audited admissions, 63% were managed in the ambulance, in line with card-holder protocol. This figure rose to 94% in the accident and emergency department.

Conclusion: These data support the usability of such a scheme to prevent iatrogenic hypercapnia in emergency admissions.

Abbreviations: A&E, accident and emergency; ABG, arterial blood gas; COPD, chronic obstructive pulmonary disease; FiO2, concentration of inspired oxygen; PaO2, arterial oxygen tension; PaCO2, arterial carbon dioxide tension

Keywords: oxygen; hypercapnia; acidosis; ambulances; emergency service; hospital


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?

Relevant Article

Primary Survey
Geoff Hughes
Emerg. Med. J. 2006 23: 587. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

  • Leach, R M, Davidson, A C (2009). Use of emergency oxygen in adults. BMJ 338: a2790-a2790 [Full Text]  
  • Hale, K E, Gavin, C, O'Driscoll, B R (2008). Audit of oxygen use in emergency ambulances and in a hospital emergency department. Emerg. Med. J. 25: 773-776 [Abstract] [Full Text]  
  • O'Driscoll, B R, Howard, L S, Davison, A G, on behalf of the British Thoracic Society, (2008). BTS guideline for emergency oxygen use in adult patients. Thorax 63: vi1-vi68 [Full Text]  

This Article

Services
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

 

The journal is co-owned by and the official journal of College of Emergency Medicine

Official journal of British Association for Immediate Care: BASICS, Faculty of Pre-Hospital Care, Irish Society for Immediate Care and Swedish Society for Emergency Medicine: SweSEM

Emergency Medicine Jobs

Emergency Medicine Jobs