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Acute Oxygen Therapy on Hospital Wards in Low Middle-Income Country: Experience from a Referral Centre in Ilorin, Nigeria.

BACKGROUND
Oxygen is like any other medication that can cause severe consequences if administered inappropriately.


OBJECTIVE
To audit the pattern of acute oxygen therapy on regular hospital wards of a referral centre in Ilorin, Nigeria.


METHODS
We reviewed 150 patients that received or had a prescription for acute oxygen therapy in three months and extracted relevant information using a proforma.


RESULTS
About one-third of the patients (30%) were >65 years of age and the male to female ratio was 1:1. The commonest indication and medical condition for acute oxygen administration were hypoxemia (70.7%) and pneumonia (26.0%), respectively. Pneumonia accounted for most (41.2 %) of the oxygen therapy in childhood. The majority of patients (88.0%) had written order for oxygen prescription, 40.7% had a prescription to target oxygen saturation and only 31.3% achieved their target saturation. Oxygen prescription was adequate (documentation of delivery device, flow rate of oxygen, and target oxygen saturations) in 40.7% of patients. The assessment, monitoring and titration of oxygen therapy were adequate in 92.7%, 65.3% and 28 % of patients respectively. Overall mortality was 27.3% in patients receiving acute oxygen supplementation. Eleven patients had unstable COPD, and 63.6 %, 54.5 % and 45.6 % of them had adequate oxygen prescription, monitoring and titration respectively. The challenges to oxygen use were faulty delivery devices, emptied oxygen cylinders, inability to routinely do arterial blood gas analysis and lack of hospital oxygen protocol.


CONCLUSION
The current practice of acute oxygen therapy is not satisfactory and interventions are advocated to improve the healthcare providers' administration of oxygen.