O2 protocol 89 vs 90%

JustBeachyNurse, LPN · Sep 5, 2015

Your coworkers are correct with their interpretation of the current standard of care especially if COPD b

Susie2310 · Sep 5, 2015

"O2 to maintain sats > 90%", means to me that if O2 sats drop to 90% or less, then oxygen is to be administered per protocol to maintain sats > 90%.

man23SN · Sep 5, 2015

Any other takes?

JustBeachyNurse, LPN · Sep 5, 2015

Medicare rules are pretty specific regarding qualifying for oxygen. If they were satting at 90% upon transfer they are stable. If the heart rate parameters were 60-100 would you not transfer of their HR was 60 consistently?

MunoRN, RN · Sep 5, 2015

Ongoing (home) supplemental O2 is really only recommended for saturations of 88% or less, and this is also the requirement that must be met in order to qualify for most home O2 coverage. So if you aren't going to discharge a patient who is at 90% without first arranging for home O2 then they will never be able to leave the hospital.

Caffeine_IV · Sep 5, 2015

That's pretty standard from what I've seen. Our wording may differ somewhat...ex: supplemental O2 up to 4L/NC for saturations less than 90%.

vanilla bean · Sep 6, 2015

My facility's O2 protocol reads "O2 to maintain sats >90%". Do you see any potential liability in discharging a patient home (in this case nrsg home) while right at 90% while on room air? Several of my cohorts think O2 need only be applied if the pt drops below 90%.

I can't speak to the liability issue, but if your facility's protocol is for "O2 to maintain sats >90%," then that means that oxygen is applied when sats are 90% or less. Of course, it's reasonable to attempt other interventions as well - reposition, instruct to deep breathe and cough, etc. to see if sats can be brought up without supplemental oxygen.

As another poster mentioned, qualifying for home O2 is a different animal than following an oxygen protocol for an admitted resident/patient.