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An audit of oxygen prescribing practices in a tertiary care hospital.

Introduction: Oxygen is the first drug that is administered to a sick child. However prescribing oxygen is not done like other drugs like antibiotics, anticonvulsants, etc. A background knowledge about the various oxygen delivery devices is required to give a proper prescription of oxygen.

Aims and objectives: To analyse the prescription of oxygen to inpatients by doctors in a tertiary care hospital and studied the prescribing practices.

Materials and methods: The audit was undertaken between October 2009-March 2010. Patients between 1 month to 18 years of age was randomly selected for chart review from the records section.

Results: A total of 300 in patients with principle diagnostic categories of respiratory, cardiovascular and neurological illness were included in the audit. Respiratory distress was the commonest indication for initiating oxygen therapy, 63.7% followed by seizures, 15.2%, shock in 13.7%, severe anemia in 2%, low GCS in 4.8%, sepsis and cyanosis in 0.3% each. Formal prescription of oxygen was found only in 43.5% whereas in 56.5% of children oxygen was administered without any prescription. The mean duration of oxygen administration was 24 h. The shortest duration of administration was 1 h and the longest was 16 days.

Conclusion: Oxygen prescription and/or delivery are associated with significantly greater error than that seen with antibiotics. Education of medical personnel should stress more prudent prescription and use of oxygen in hospitalized patients. Supplemental oxygen is actually detrimental to many of the patients who receive it. Supplemental oxygen is much overused and its use should be limited to the few conditions and situations in which it is truly effective, useful and non-detrimental.

Author(s): Janani Sankar