Oxygen Therapy for Worsening Blood Oxygen Saturation in CoVid-19 Patients
SARS-CoV-2 infected patients should be vigilantly monitored in order to note the vitals down along with planning the future interventions according to the presentation. Exceptional emphasis should be placed on the parameters important for monitoring the function of respiratory system. Immediate hospitalization should be considered in patients with 1. Respiratory rate ≥30 per min 2. Oxygen saturation ≤ 95% 3. 50% increase in lung lesions over 48 hours on lung imaging 4. A quick sequential organ failure assessment (qSOFA) score of greater than 1 5. Signs and symptoms of community acquired pneumonia 6. Pneumothorax Oxygen therapy should be promptly started if individual is unable to maintain blood oxygen saturation above 90%, in case of males and 92% in case non-pregnant females. Blood oxygen saturation levels should be between 92% to 95% for pregnant women. Individuals with mild hypoxemia are given 5 L oxygen per minute via nasal cannula. If the individual does not response, high flow nasal cannula should be employed to deliver 20 L of oxygen per minute. The maximum oxygen that can be given in primary setting for severe hypoxemia is 50 to 60 L per minute. If the condition worsens, invasive ventilation might be the next step. Prone position is also recommended to improve lung function. Source Diagnosis and clinical management of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection: an operational recommendation of Peking Union Medical College Hospital (V2.0) https://www.tandfonline.com/doi/full/10.1080/22221751.2020.1735265 Image via https://www.unicef.org/supply/stories/fundamental-and-sustainable-response-covid-19-improving-local-oxygen-systems
