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Measuring and monitoring vital signs
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
The normal value of oxygen saturation is 96–100%, so hopefully your reading was within that range. This figure refers to the percentage of Hb molecules that are fully saturated with oxygen. RCP (2017) suggests that the recommended target saturation range for those acutely ill and not at risk of hypercapnic respiratory failure is 96–98%. However, some people, especially if aged 70 years, may have oxygen saturation measurements below 96% and do not require oxygen therapy when clinically stable. Repositioning the person to a more upright position, if not contraindicated, may provide significant improvement. Pulse oximeters have alarm systems that sound if the measurement falls below a normal level.
Chest
Published in Henry J. Woodford, Essential Geriatrics, 2022
Aspiration pneumonitis is inflammation of the lungs in response to the inhalation of acidic gastric contents. The event is often witnessed. It is most likely to occur in people with reduced consciousness (e.g. post-operative, drug overdose or major stroke). These contents cause a chemical injury but are typically sterile. It is believed that 20 mls or more of liquid with a pH < 2.5 is required to trigger a significant reaction.17 This is unlikely to occur in people on acid-suppressing medications. Presenting symptoms may range from acute respiratory distress syndrome and shock to mild cough with low oxygen saturation. The symptoms usually commence soon after the aspiration event. A late complication of pneumonitis may be secondary infection. Following witnessed aspiration, upper airway suction is recommended. In this situation, a sterile pneumonitis is likely and antibiotics are probably unnecessary unless symptoms last beyond 24 hours.18
Thoracic Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
As already described, thoracic trauma may result in hypoxia, reduced cardiac output or both. The consequence of this is a reduction in the delivery of oxygen to the tissues (DO2) which, if uncorrected, may result in secondary organ damage and subsequent complications such as acute renal failure. Tissue oxygen delivery may be calculated from the equation: DO2= Cardiac output (CO) × Haemoglobin concentration (Hb) × Oxygen saturation (SaO2) × 1.34 Thus, haemoglobin concentration and cardiac output are major determinants of DO2. Preload optimization by replacement of the circulating blood volume is the most efficient way of increasing cardiac output.6 Maximal oxygen saturation must be maintained during management by ensuring effective ventilation and supplementary oxygen therapy.
A survey of the physiotherapy treatment methods for infants hospitalised with acute airway infections in Sweden
Published in European Journal of Physiotherapy, 2021
Sonja Andersson-Marforio, Christine Hansen, Eva Ekvall Hansson, Annika Lundkvist Josenby
Bronchiolitis is a lower respiratory tract infection and the most common cause of hospitalisation for infants younger than 2 years [1] and involves a high cost for families and health care organisations around the world [2]. In a population based study [3] 20% of the children under 2 years of age were diagnosed with bronchiolitis, and 3% were hospitalised. In bronchiolitis the airways are thickened due to inflammation with oedema, and increased mucus production leads to occlusion or narrowing of the airways [4,5]. The infants often have an increased work of breathing and difficulties to maintain fluid balance and nutrition status. The oxygen saturation is often low. Different medical treatments have been used, and there is no definite consensus about the best practice [6,7]. Antibiotics, corticosteroids, bronchodilators and antivirals are not generally recommended. Supporting treatment such as oxygen therapy, fluid/nourishment supplement is common [8].
Acute oxygen therapy: a cross-sectional study of prescribing practices at an English hospital immediately before COVID-19 pandemic
Published in Expert Review of Respiratory Medicine, 2021
Ravina Barrett, Eugene Catangui, Railton Scott
Our study presents authentic real-world data in an English hospital that represents practice in naturalistic settings. A limitation of our study is its modest sample size, coupled with potential subjectivity when interpreting clinical notes. COPD patients should initially be maintained within a target SpO2 range of 88–92%, which can be adjusted to 94–98% following ABG analysis that subsequently confirms the absence of hypercapnia [1]. Due to absent ABG data, all COPD patients were assumed to be maintained within a target SpO2 range of 88–92%. Where thresholds deviated for COPD patients, they may not have truly been at risk of iatrogenic hypercapnia. Conversely, due to low portion of target SpO2 ranges documented, this assumption was necessary. We can therefore not be certain if patients were truly at risk of adverse events. Moreover, a retrospective observation of the oxygen saturations was not conducted, only a single oxygen saturation measurement by pulse oximetry was taken. Therefore, ‘under-shoots’ and ‘over-shoots’ may have only been short-lived. The sampling window also gives an indication of recent practice, which may not be representative of year-round practice.
Risk factors for disease progression in hospitalized patients with COVID-19: a retrospective cohort study
Published in Infectious Diseases, 2020
Wei Hou, Wei Zhang, Ronghua Jin, Lianchun Liang, Bin Xu, Zhongjie Hu
Patients’ pharyngeal swab specimens were collected for the SARS-CoV-2 viral nucleic acid detection using real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay. Influenza A virus, influenza B virus, respiratory syncytial virus, adenovirus, parainfluenza virus, enterovirus, human metapneumovirus, coxsackievirus, chlamydia, and mycoplasma were detected by collecting body fluid (nasopharyngeal swabs and sputum) samples. Laboratory variables were tested with conventional methods, including (i) routine blood tests: the numbers of leukocytes, lymphocytes, and neutrophil, haemoglobin, platelet; (ii) blood biochemistry: alanine transaminase, aspartate aminotransferase, total bilirubin, albumin, creatinine, creatine kinase, myoglobin, troponin; (iii) partial pressure of oxygen and oxygen saturation of blood; (iv) infection indices: procalcitonin and CRP.