Oxygen is being rationed to prevent hospitals running out due to the high demand from coronavirus patients. The Daily Telegraph reports that National Health Service (NHS) leaders have quietly instructed doctors to lower their targets for how much oxygen seriously ill patients should carry in their blood – a measure of fundamental health – to below levels regarded as “adequate”.
The report says the new guidance was sent to hospital bosses earlier this month, days after a trust near London declared a critical incident because the demand for oxygen from COVID-19 patients caused pressure to fail. Although NHS England subsequently dispatched engineers across the country to upgrade piping infrastructure, this has proved impossible in many older hospitals.
Low oxygen saturation, known as hypoxia, can lead to organ failure and brain damage. The normal target saturation range of 94% to 98% should be altered to 92% to 96% “in the first instance”, the guidance stated.
The report says British Thoracic Society (BTS) standing protocols state that patients with acute illness should have oxygen saturation of above 90%. Dr Graham Burns, BTS president elect, said that while 90% is not necessarily dangerous, the purpose of the traditional 94% threshold was to provide “head room”. “90% is when you start to approach the cliff face, so we prefer 94% because it’s a step away from that.”
The Daily Telegraph reports that prompted by the outbreaks in Wuhan and Northern Italy, UK planners have focused intensely on increasing the number of intensive care beds and accompanying mechanical ventilators. However, NHS doctors have found that a greater than expected proportion of COVID-19 patients who do not require a ventilator still need non-invasive oxygen therapy to fight off the virus.
[link url="https://www.telegraph.co.uk/news/2020/04/17/exclusive-nhs-rationing-oxygen-doctors-instructed-downgrade/?li_source=LI&li_medium=li-recommendation-widget"]Full report in The Daily Telegraph[/link]