AIIMS Chief on Use of O2 Cylinders

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At a time when the need for medical oxygen has shot up across the country and people are rushing to the hospitals, AIIMS Director Dr Randeep Guleria on Thursday said oxygen saturation levels of 92 or 93 in Covid-19 patients should not be considered critical, but this is a buffer level which indicates that the patient needs medical help on time.

He also advised that judicious use of oxygen was the need of the hour. “Misuse of oxygen cylinders is a serious matter of concern these days. A few people stock oxygen cylinders at home, fearing that they may need it later. This is not advisable. If your oxygen saturation level is 94 per cent or above, it still means there is sufficient oxygen in the body. There is no need to panic. Misusing the same by a person with normal levels of oxygen can deprive someone whose saturation level is well below 90 or 80,” he said in a statement released by the Union Health Ministry.

“Previously when we used to do prolonged oxygen therapy for people with lung diseases, we have seen people doing fine in oxygen saturation of even 88 per cent. Oxygen saturation of 92 or 93 should not be considered critical. But this is a buffer level when you can seek medical help without panicking,” he added.

Speaking more on the use of medical oxygen to treat critical Covid-19 patients, he said, “Oxygen is crucial for the treatment of patients with severe Covid-19, since the disease affects lung functioning. Shortness of breath or difficulty of breathing is one of the most common symptoms in patients with severe Covid-19. It also hampers the supply of oxygen to various parts of the body. They hence need oxygen therapy, to be supplied through medical oxygen.”

As per the World Health Organisation (WHO), if the oxygen saturation level is 94 per cent or less, then the patient needs to be given a treatment quickly. A saturation level of lower than 90 per cent is considered as a clinical emergency.

The Health Ministry’s latest clinical guidance for management of adult Covid-19 patients stated that an oxygen concentration less than or equal to 93 per cent on room air requires hospital admission, while that below 90 per cent is classified as a severe disease, requiring admission in the ICU.

“However, given the prevalent situation in the wake of the second wave, we must do whatever we best can, in order to try and replenish our oxygen levels, in the event of delay or inability in getting hospital admission as per the clinical management protocol and people are now using oxygen concentrators while at home,” note experts.

On being asked whether one should buy oxygen cylinders for home usage, Guleria said people are wasting the oxygen cylinders by stocking them up at home without knowing its proper usage. “One common example of oxygen wastage is when patients are given food, they take the oxygen mask off and keep it at the side without switching off the connection,” he said.

Cautioning people that use of oxygen concentrator without medical guidance can be harmful, experts said that it can only be used in moderate Covid-19 cases where the oxygen requirement for a patient is a maximum of 5 litres per minute.

Speaking at a webinar on oxygen therapy for Covid-19 treatment, organised by AIIMS, Professor and Head of Department Anaesthesia, B J Medical College, Pune, Sanyogita Naik informed, “Oxygen concentrators are also very useful for patients experiencing post-Covid-19 complications which necessitate oxygen therapy.”

“There are also additional requirements and rules for medical oxygen, including requiring a person to have a prescription to order medical oxygen. It is important for citizens to ensure judicious use of the vital product, especially during a public health emergency. Misuse or overstocking of these will only lead to panic and black marketing,” the Ministry asserted.

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