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Respiratory critical care
P74 Emergency oxygen usage observed by a medical emergency team
  1. J Carr,
  2. J Rodrigues,
  3. N Duffy,
  4. J Earis
  1. University Hospital Aintree, Liverpool, UK

Abstract

Introduction Aintree University Hospital was one of the first acute Trusts to develop a multidisciplinary MET team in the UK. It was created in 2009 to manage acutely ill and deteriorating patients safely in keeping with the NICE 50 (2007) guidance. The MET team records data on each callout and this study analyses the use of oxygen in this cohort of patients.

Methods The MET team records (1) any patient who is not on O2 with an SpO2 below 94% and (2) patients already on oxygen with a low SpO2 necessitating a change in flow rates. Following the experience of the first 6 months a simple laminated sheet outlining the actions needed before the MET team is called was prepared for all wards. This clearly states the BTS target ranges for SpO2 and oxygen prescription. This aide memoire was in use for 12 months before the second 6-month analysis period.

Results In the 19 months of its existence the MET has responded to 1717 calls. Of these 536 patients needed O2 initiating (32%) because of low SpO2 and a further 685 had the O2 flows changes (38%). The Abstract P74 table 1 shows comparison between the first 6 months with the 6 months to April 2011 (post educational intervention). The number of calls has increased between these two time blocks from an average of 2.44 to 3.33 per day and the number of patients who needed oxygen starting decreased from 38% to 29%.

Abstract P74 Table 1

Conclusions This study confirms the results of the BTS National Audits 2008 and 2010 and the NPSA Rapid response Report September 2009 that emergency oxygen is poorly administered in the NHS. The simple intervention of providing an aide memoire on the wards has improved the situation but it still remains unsatisfactory. Because of this UHA has now introduced a new Patient Group Direction for the administration of O2 by first level registered nurses. This will empower nurses to initiate oxygen in deteriorating patients with a low SpO2 while waiting for assistance from the MET team.

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