If patient’s relative can arrange home oxygen and monitoring facilities at home then he can be shifted to home with oxygen therapy. This would involve inserting airway adjuncts and applying high-flow oxygen (15L/min) via bag-valve-mask ventilation. This recommendation is adapted from NICE's guidelines on intravenous fluid therapy in adults in hospital and intravenous fluid therapy in children and young people in hospital. A 'senior clinical decision maker' for children aged 5 to 11 years is a paediatric or emergency care doctor of grade ST4 or above or equivalent.

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They’re rarely used outside of an emergency department and should only be used under medical supervision. High-flow Nasal cannula consists of a specific machine and tubing used to deliver a very high flow of oxygen that is heated and humidified. The frequency of observations depends on how high the NEWS is (the higher the score, the more frequently it is measured). Patients who have had an episode of hypercapnic respiratory failure should be issued with an oxygen alert card for future use and a 24% or 28% Venturi mask.Humidified oxygen reduces this effect and can assist in breaking down a patient’s respiratory secretions, making them easier to clear. A non-rebreather mask can deliver between 60 percent to 80 percent oxygen at a flow rate of about 10 to 15 liters/minute (L/min).

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If platelet count <50x10 9/L consideration should be given as to whether the need to assess ABGs outweighs the risk of bleeding from arterial puncture. g. COPD patients who are known to be CO 2 retainers), it may be safer to start at a lower FiO 2 using a Venturi mask and up-titrate if required. The usual procedure for prescribing oxygen therapy in these areas should be adhered to, utilising the target saturation. The NICE British National Formulary for Children (BNFc) site is only available to users in the UK (England, Scotland, Wales and Northern Ireland).Use reservoir masks at 15L/minute O 2 flow initially in all patient groups pending arterial blood gas (ABG) analysis. Calculate the P/F ratio instead of the old-fashioned way of calculating an adequate PaO 2 for a patient on supplemental oxygen (subtracting 10 from the FiO 2).

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Oxygen saturations of less than 90%, with or without oxygen, laboured breathing or respiratory rate, or change in CEWS score outwith the expected range for the child should be reported immediately to the medical team. ensure review by a senior clinical decision maker within 3 hours of meeting 2 or more moderate to high risk criteria in an acute hospital setting for consideration of antibiotics. A non-rebreather mask may be used after traumatic injury, smoke inhalation, or carbon monoxide poisoning to keep blood oxygen levels within a normal range. Once patient has adequate and stable saturation on minimal oxygen dose, consider discontinuation of oxygen therapy. Patients with mild COPD (FEV1 % predicted ≥ 80%) are not necessarily at risk of hypercapnic respiratory failure.

Disadvantage of high oxygen support → tracheobronchitis, ARDS, pulmonary fibrosis • Try to reduce oxygen to maintain SpO2 ≥ 88.