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View oxygen as a drug

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VOL: 98, ISSUE: 12, PAGE NO: 47

Claire Kent

The delivery of oxygen needs to be taken more seriously than it is. I am not saying that just because I am involved in caring for many hypoxic patients. Nurses supply and administer oxygen to patients daily - in fact, you may have cared for someone using it today - but did you sign the relevant prescription sheet? Was there one?

The delivery of oxygen needs to be taken more seriously than it is. I am not saying that just because I am involved in caring for many hypoxic patients. Nurses supply and administer oxygen to patients daily - in fact, you may have cared for someone using it today - but did you sign the relevant prescription sheet? Was there one?

It can be argued that the doctor should have prescribed it in the first place, but nurses are responsible for their own practice and registration. Oxygen is just as much a drug as any other and is listed in the British National Formulary. It may be an odourless and colourless gas but, as any other drug, it has potential risks and side-effects. Be aware of how dangerous it can be to administer a high percentage of oxygen to hypercapnoeic patients with chronic obstructive pulmonary disease, who rely on their hypoxic drive to breathe.

Audits in several hospitals have confirmed that the standard of oxygen prescribing is poor. In order to improve standards, some areas have introduced separate charts for prescribing oxygen - as supplements to their standard drug charts. Prescriptions should include the flow rate and/or percentage of oxygen to be delivered and the route of delivery (such as nasal cannulae or venturi). And, as with any other drug, the prescription must be reviewed regularly and altered according to the patient's requirements.

Patient comfort must always be considered. If oxygen requirements can be met using nasal cannulae rather than a face mask patients can eat, drink and talk more easily. This may help to reduce the amount of money spent on delivering oxygen to foreheads! The prongs of some nasal cannulae are much softer than others, and small wraps of foam have been designed to prevent ear chafing that can sometimes occur.

Nurses need to be proactive regarding oxygen therapy. If oxygen saturation levels indicate, discuss reducing or even stopping the flow/percentage of oxygen with medical staff. If a patient is using oxygen in hospital and will not be having it at home, plan accordingly: give them time to adjust before you discharge them. When you are next caring for a patient using oxygen, make sure there is an appropriate prescription for you to sign or a patient group direction to work from. If there is not ask someone to write one.

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