For most acutely ill adults, a target SpO2 of about 94 to 98%, or a narrower 92 to 96% in many units, is standard. For people at risk of hypercapnic respiratory failure, such as those with COPD, severe obesity, neuromuscular disease or chest wall disease, the target is 88 to 92%. Choosing the right one at admission and writing it down prevents both under- and over-oxygenation.
- Decide at admission whether the patient is at risk of hypercapnia.
- Use 88 to 92% for COPD, obesity hypoventilation, neuromuscular or chest wall disease.
- Use the standard local range for everyone else.
- Recheck a blood gas if a patient at risk of hypercapnia becomes drowsy on oxygen.
Why it matters
Most oxygen harm on the ward comes from no target being set, not from the wrong one.
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