China
Africa
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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
The patient with acute cardiovascular problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Acutely, patients presenting in AF required a detailed assessment to evaluate clinical status and deterioration risk. Triggering factors such as sepsis, anaemia, pulmonary embolism, electrolyte imbalance or hypoxaemia should be considered and addressed. Supplemental oxygenation may be necessary to maintain target oxygen saturation, treating hypoxaemia. Serum electrolytes should be replaced to keep within normal range, as they play a role in cardiac rhythm stability. Many patients present in AF with a tachycardia; NICE (2014) and ESC (2016b) have developed guidance, suggesting two essential treatment approaches: Rate control.Rhythm control.
A case of Hb Rothschild (HBB: c.112T>A) with low pulse oximetry: a first familial presentation in China
Published in Hematology, 2022
Diandian Li, Qunfang Wan, Chunyu Li, Hongbing Ma, Gang Wang
Pulse oximetry is a common non-invasive method for measuring oxygen saturation in clinical practice. However, this case highlights the limitations of pulse oximetry. ABG samples using modern blood gas analyzers can overcome these limitations to provide more reliable results. Typically, low oxygen affinity Hb variants have low SpO2 readings accompanied by low SaO2, with no evidence of cardiac or respiratory disease. P50 is one of the common metrics to quantify Hb oxygen affinity. When an altered oxygen affinity variant is suspected, P50 testing should be performed. Nevertheless, in some unusual Hb variants (eg, Hb Titusville and Hb Bonn), altered absorption spectra results in falsely low SpO2 and normal SaO2 [2,3], and P50 should be interpreted carefully since it relies on optical properties of Hb at a 560 nm wavelength.
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].
EEG signals during mouth breathing in a working memory task
Published in International Journal of Neuroscience, 2020
Kyung-Jin Lee, Chan-A Park, Yeong-Bae Lee, Hang-Keun Kim, Chang-Ki Kang
Generally, nose breathing changes the external air into warm and humid air in both the larynx and the nasal cavity, subsequently supplying it to the lungs. However, during mouth breathing, both dry and cold air is supplied to the lungs as it does not follow the above-mentioned pathway [1]. Consequently, dryness due to mouth breathing causes discomfort (Figure 2). In addition, changes in the respiratory muscles used during mouth breathing affect the lung capacity, leading to a less smooth gas exchange in the lungs than that observed during general nose breathing [10]. Further, the inability to supply oxygen smoothly in the abnormal gas exchange may result in low oxygen saturation. It has, in fact, been observed that children exercising mouth breathing have lower SpO2 and respiratory rates in the resting state than do children who breathe through their nose [10]. Subsequently, the lowered respiratory rate causes higher ETCO2 in healthy subjects [11]. In other words, the morphological deformation to facilitate mouth breathing seems to induce oxygen reduction in the body. These results were similar to the study on resting state mouth breathing showing SpO2 and AWRR to decrease and resulting in an increase in ETCO2 (Figure 3).