segunda-feira, 3 de setembro de 2007

Oxigenoterapia, mais artigos

Utilizar os seguintes links para os artigos com o seguinte título (abrem no hospital):

Oxygen therapy for older people.

Caring for patients receiving oxygen therapy.

Artigo: "Emergency oxygen therapy for the breathless patient. Guidelines prepared by North West Oxygen Group" através do link

"Acute care: Treatment with oxygen" in STUDENTBMJ VOLUME 12 FEBRUARY2004 págs. 56-58

sexta-feira, 27 de julho de 2007

Development, dissemination, implementation and evaluation of a clinical pathway for oxygen therapy.

CMAJ. 2000; 162(1):29-33 (ISSN: 0820-3946)

Wong C; Visram F; Cook D; Griffith L; Randall J; O'Brien B; Higgins D
Department of Medicine, McMaster University, Hamilton, Ont.

BACKGROUND: Oxygen is commonly administered to patients in hospital, but prescribing and monitoring of such therapy may be suboptimal. The objective of this study was to develop, disseminate, implement and evaluate a multidisciplinary clinical pathway for the administration of oxygen. METHODS: The authors developed a clinical pathway for the ordering, titration and discontinuation of oxygen, which was disseminated through teaching sessions, in-service training sessions and information posters in a medical clinical teaching unit (CTU). Implementation of the pathway was ensured by means of reminders and patient-centred audit and feedback to CTU nurses and house staff. During a 3-month intervention phase, consecutive patients requiring supplemental oxygen were treated according to the pathway. During a 1-month "wash-out" phase followed by a 3-month non-intervention phase, patients were treated at the discretion of the CTU team. Clinical and economic data were collected in both phases. RESULTS: In the 2 phases, patient characteristics, the concentration and duration of oxygen prescribed, the frequency of oxygen saturation monitoring, the frequency of arterial blood gas testing and the clinical outcomes were similar. However, there were more discontinuation orders in the intervention phase (p < p =" 0.048)" p =" 0.02).">

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Pattern of non-ICU inpatient supplemental oxygen utilization in a university hospital.

Chest. 1992; 102(6):1672-5 (ISSN: 0012-3692)

Albin RJ; Criner GJ; Thomas S; Abou-Jaoude S
Department of Medicine, University of Maryland School of Medicine and Hospital, Baltimore.

Random assessments of SaO2 were performed via pulse oximetry in 274 hospitalized non-ICU patients prescribed supplemental O2 in a large tertiary care university hospital. In 507 assessments performed in patients inspiring the prescribed O2, 426 were receiving excessive amounts of O2 to maintain a SaO2 > or = 92 percent. In 233 of these assessments, SaO2 was > or = 92 percent while breathing ambient air. In an additional 193 assessments, the concentration of inspired supplemental O2 was excessive to maintain a SaO2 > or = 92 percent. However, in 81 assessments performed in patients inspiring O2, the prescribed amount was insufficient to maintain SaO2 > or = 92 percent. These results indicate that O2 prescription in hospitalized non-ICU patients is excessive or not required in the majority of cases. Furthermore, routine use of pulse oximetry in hospitalized patients prescribed O2 may be useful in determining the continued need for supplemental O2 and adjusting the proper concentration needed to avoid hypoxemia.

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AARC Clinical Practice Guideline: oxygen therapy for adults in the acute care facility--2002 revision & update.

Respir Care. 2002; 47(6):717-20 (ISSN: 0020-1324)

Kallstrom TJ;
Fairview Hospital, Cleveland, OH, USA.

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Oxygen and inhalers.

BMJ. 2006; 333(7557):34-6 (ISSN: 1468-5833)

Currie GP; Douglas JG
Respiratory Unit, Aberdeen Royal Infirmary, Aberdeen.

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Audit of oxygen prescribing before and after the introduction of a prescription chart.

BMJ. 2000; 321(7265):864-5 (ISSN: 0959-8138)

Dodd ME; Kellet F; Davis A; Simpson JC; Webb AK; Haworth CS; Niven RM
North West Lung Centre, South Manchester University Hospitals Trust, Manchester M23 9LT.

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ABC of oxygen. Acute oxygen therapy.

BMJ. 1998; 317(7161):798-801 (ISSN: 0959-8138)

Bateman NT; Leach RM

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Prescribing oxygen therapy. An audit of oxygen prescribing pratices on medical wards at North Shore Hospital, Auckland, New Zealand

N Z Med J. 2006; 119(1238):U2080 (ISSN: 1175-8716)

Boyle M; Wong J
General Medicine, North Shore Hospital, Takapuna, Auckland.

AIM: To assess the frequency and accuracy of inpatient oxygen prescription at North Shore Hospital, Auckland. METHOD: Between 14 April 2005 and 14 May 2005, 100 medical inpatients receiving oxygen therapy were randomly selected for chart review. For each patient, the clinical diagnosis, oxygen prescription (if present), and initial medical plan were analysed in conjunction with the oxygen flow rate and oxygen saturations (as documented in the observation chart). RESULTS: Only 8% of patients receiving oxygen had it prescribed in their medication chart. The majority (75%) of oxygen prescriptions were inadequate. CONCLUSION: Current rates of oxygen prescription on medical wards at North Shore Hospital, Auckland, are unsatisfactory. This poor oxygen prescription rate carries serious potential consequences.

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