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You can Reverse Hypercapnia, you can’t Reverse Death

Matt B

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“You should never give oxygen to a patient with Chronic Obstructive Pulmonary Disease (COPD)”. It’s an age-old myth and more than anything it is wrong and endangering the lives of patients everyday.

When I was a Student Nurse I explicitly remember being told by many, many Nurses, that putting oxygen onto a patient with COPD will cause them to retain carbon dioxide (CO2), remove their hypoxic drive and promptly send them into irreversible type 2 respiratory failure. This is partly true, but it is missing several pieces of information.

RELATED: THE 10 RIGHTS OF MEDICATION ADMINISTRATION

Let me start by saying, that not all COPD patients are CO2 retainers and chronic CO2 retention only stands at around 20% of patients with a chronic respiratory disease. Even then only a marginal PC02 increase can be detected with know retainers on 100% O2 for 20 minutes (Wilson, 2012). Acute CO2 retention is a possibility for ALL patients not just those with COPD.

I cannot stress to you enough – If your patient has low saturations – give them oxygen! In an emergency situation when your patient is acutely unwell, and/or their oxygen saturations are below any specified values for that individual patient, start at 15L via a non-rebreathable mask and titrate downwards as able, the saturations you are aiming for should be specified by a medic. You should never withhold oxygen from any patient when they urgently need it, as emergency Patient Group Directives (PGD’s) are in place to implement this treatment, and guide your patient/oxygen management with support from the Resuscitation Council guidelines. You should ensure medics are made aware ASAP and an arterial blood gas (ABG) is completed, this is to assess for adequate oxygen saturation and to monitor for hypercapnia.

Ultimately it falls down to this – low oxygen saturations are going to cause multi-organ damage and cardiac arrest through hypoxic damage much, much faster than CO2 retention. Plus CO2 retention is, in most cases, reversible.

“You can reverse hypercapnia, you can’t reverse death” is something that should be taught to Nurses and Students around the world in order to prevent unnecessary deaths. A fantastic fact sheet about COPD and CO2 retention can be found here.

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Lucozade is no longer as effective at treating hypoglycemia

James M

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Due to changes in its recipe and a significant reduction in glucose, Lucozade will not be as effective as a treatment for hypoglycemic patients.

Recipe changes to Lucozade Original Energy product line mean it will no longer be as effective at treating hypoglycemic patients – this is due to a 50% reduction in glucose based carbohydrates. Healthcare Professionals should seek guidance from their local specialist team on alternative treatment protocols.

This change applies to all Lucozade Energy Flavours. New products started appearing on shelves in April 2017. However, for a short time, both the new and old recipe will be available.

Previously, 100ml of Lucozade Original contained 17g of carbohydrate; this was reduced to 8.9g in April 2017.

According to Diabietes.co.uk, patients who experience a hypoglycemic episode are advised to consume 15-20g of sugar when treating low blood sugar, but this will no longer be equivalent to 100ml of Lucozade.

Lucozade Ribena Suntory, which also makes Ribena and Orangina, among other drinks, is lowering its sugar content by replacing these sugars with low-calorie sweeteners, such as aspartame.

You can also visit www.lrsuntory.com/health for more information on Lucozade’s changing nutritional values or speak to your local diabetes specialist team.

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Shift Planner for Nurses, Students & Support Staff

Matt B

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Shift planning is essential for safe care, some people using a piece of paper others have their thoughts well arranged in their head, either way everybody does it.

This shift planner has been designed with newly qualified nurses and student nurses in mind but would be suitable for anybody to use.

You can download our Shift Planner for FREE. You are free to download, print and distribute our shift planner as you wish. You will need a PDF reader on your PC to download. 

The planner has been created with two primary columns, one for your main nursing priorities and one to remind you to hand over jobs to the next shift. It also features a small key and area for general notes. Due to limited space we have only included enough room to plan up to eight patients, if you need more we encourage you print doublesided.

We encourage you to make comments or suggestions in the comments section below. The most popular will be implemented in a version 2.

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