Oxygen delivery systems and training needs in pediatric and adult settings- a call to action beyond COVID-19 era

Abstract

Oxygen was first used to manage a young patient with pneumonia in 1885, and by 1907 nasal catheter devices for oxygen delivery were introduced. [1] Since then oxygen use, its modes of administration, best oxygen prescription practices, and interfaces for oxygen administration have continued to evolve: for example, oxygen cylinder versus. piped oxygen or use of oxygen concentrators; high-flow nasal oxygen, nasal cannula, nasal prongs, nasal masks, simple face masks, rebreather/non-rebreather masks, venturi masks, masks with reservoir bag, oxygen hoods and tents, non-invasive and invasive mechanical ventilators. The way these equipment are used in pediatric and adult patients are sometimes different, such as the interfaces applicable and the rate of oxygen flow prescribed. Up to 12% of hospitalized patients may require oxygen during their admission in the hospital. [2] Every year globally, at least 1.4 million deaths occur due to the lack of supplemental oxygen therapy and inappropriate administration of oxygen. [3] In one study, 40.7% of patients had a prescription to target oxygen saturation SP02 and only 31.1% achieved their target saturation. [4] This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Assessment of knowledge, attitude and practice for oxygen therapy among medical staff at the Colonial War Memorial Hospital in Fiji

“…[5][6][7][8][9][10][11] The COVID-19 pandemic highlighted the importance of ongoing monitoring and evaluation of OT administration worldwide. 12 As a result of its universal presence in hospital settings worldwide, the adverse effects of inappropriate OT supplementation may be underestimated by health professionals. The current trend towards conservative oxygen administration is based on the evidence that excessive oxygen blood levels may lead to poor health outcomes among hospitalised patients, including newborns.…”

“…Given the complexities associated with the wide range of OT applications across the lifespan of age groups, evidence‐based clinical guidelines and technical specifications are essential to ensure best practice and optimal patient outcomes 5–11 . The COVID‐19 pandemic highlighted the importance of ongoing monitoring and evaluation of OT administration worldwide 12 …”

Oxygen as a drug and scarce commodity: Do we use it rationally?

“…2,5 Medical grade oxygen is classified as a drug given to patients in a clinical setting to treat various medical conditions 2,5 and needs to be prescribed by a qualified physician who has in-depth knowledge related to oxygen therapy. 6,7 A patient needs oxygen therapy when the measured oxygen is below a certain level (hypoxemia). 2 This level can be measured directly from blood or indirectly by using a pulse oximeter (a peripheral blood oxygen saturation below 92%).…”

“… 2 , 5 Medical grade oxygen is classified as a drug given to patients in a clinical setting to treat various medical conditions 2 , 5 and needs to be prescribed by a qualified physician who has in-depth knowledge related to oxygen therapy. 6 , 7 …”

“…It is not always available or affordable for all facilities. 5 , 7 , 11 Ugandan researchers found that even before the COVID-19 pandemic, many African countries battled with shortages of oxygen and oxygen equipment. 12 The additional need for oxygen was emphasised in a study from China, where 41.3% of admitted COVID-19 patients needed supplemental oxygen.…”