Oxygen is a drug, and too much carries risk as well as too little. Established practice is to prescribe a target saturation range for every patient who needs oxygen, and to reassess rather than leaving the flow rate unchanged for hours.
For most acutely ill adults a target of about 94% to 98% applies, and 88% to 92% for people at risk of hypercapnic respiratory failure, such as those with severe COPD.
- Prescribe a target range, not only a flow rate.
- Use a lower range (88% to 92%) in people at risk of hypercapnia.
- Turn the flow down when saturation sits above the range.
- Reassess after any change in flow and at every set of observations.
- Check arterial blood gases when a patient on oxygen becomes drowsy.
Why it matters
Over-oxygenation is the commonest way patients on oxygen are outside range, and it is easy to miss on a busy ward.
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