Video Surveillance of Oxygen Administration by Mask in Postoperative Patients

Abstract

Patients may not receive prescribed oxygen because the oxygen face mask becomes displaced. Using video, we have observed the position of the face mask in 20 postoperative patients and recorded the timing and the events associated with mask displacement. Correct placement of the mask was confirmed at the start of the 8-h study period from 22:00 on the first night after operation. The mask remained on continuously and positioned correctly in only one patient. In the other 19 patients, it was removed 64 times (range 1-10 times per patient). The mask was removed 45 times for nursing tasks such as mouth care and temperature measurement and these represented 70% of the total number of times that the mask was not in position. Other reasons for removal were vomiting, retching and removal by the patient. The mask remained off a median time of 6 min 55 s per episode (range 46 s to 7 h 46 min 57 s) and per patient a median of 1 h 6 min 48 s (range 1 min to 7 h 46 min 57 s). Mask removal resulted in an average decrease in oxygen saturation of 4%. Oxygen by mask at 4 litre min-1 maintained an average saturation > or = 95% in most, but not all, of the patients.

Design of oxygen delivery systems influences both effectiveness and comfort in adult volunteers

“…The OxyArm had the best comfort score, independent of oxygen flow rate, presumably because of its oxygen premixing system. 5 Furthermore, Nolan et al 6 reported that a face mask is often removed for routine nursing tasks and that patients are frequently hypoxemic during these periods. It is also quite conceivable that the open-and microphone-type oxygen delivery systems tested in this study would have to be removed from the mouth/nose less frequently than would the other two devices tested.…”

Comparison of two different oxygen delivery methods in the early postoperative period: randomized trial

“…In others, difficulties encountered during the use of oxygen delivery methods were reported. However, the evaluation period in these studies covered only the first night following the surgery (Nolan et al. 1992, 1993).…”

Introducing the postoperative care team

“…Pulmonary exercises may decrease the incidence of respiratory complications. Oxygen therapy is effective at preventing hypoxaemia10 and would be titrated against oxygen saturation as measured by pulse oximetry. Continuous electrocardiographic monitoring, with computer assisted processing to detect abnormalities, would provide early warning of dysrhythmias and ischaemia.…”