O2 therapy

O2 therapy..... I always thought of it as something that was prescribed by the doctors and would remain as it was till they decided was was ideal for the patient.
I had a pt that’d come in with as Exacerbation of COPD increased cough, sputum production and SOB over the last 3/7. At the ED department his SpO2 levels were 83% on RA therefore he was given O2 of 3L via NP and thereafter his SpO2 was 90%. Doctors wanted his sats to remain 90% and above. Once he was brought onto the ward in his notes it stated he was to be on 2L O2 on exertion and 1L O2 at rest.

I was to do an initial assessment with this pt and from his subjective found out that he had been prescribed with domiciliary O2 about a year and a half before but this has since been ceased 6 mts ago by his GP.He reports his COPD is well managed and he is usually pretty active and only of the last weeks has been unwell and thus this admission. After completing my subject and object assessment with this pt decided that his main problems were impaired airway clearance, impaired gas exchange, decreased ex tolerance and dyspnoea.

I decided to begin by taking him for a walk on O2 to help mobilise his secreations, increase his tidal vol and improve the gas exchange. Just as I was about to carry out my treatment, I was caught off guard when my supervisor asked me if I wanted to modify my treatment. Dumbfounded, I had no reply. Upon probing from my supervisor, she suggested thinking about discharge planning and looking at things as a big picture. If the patient come into hospital without home O2, we need to be thinking about sending home either without home O2 or if there is a need for them to be receiving home O2.

Therefore it was brought to my attention that it’s a great idea to ambulate him on RA and see how he maintains his sats on exertion. From this experience, it is evident that as a physio, it is important to carry out a sound assessment looking at things not just related to physio but as a whole with other health care professionals. We should look into other factors as they affect the patient and knowing the history of the patient takes us a long way as it enables us to get them back into their ‘normal’ standard of living which in turn improves their quality of life resulting in less hospital admissions.