FiO2

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Revision as of 14:37, 2017 May 7 by Ttenbergen (talk | contribs) (Question, likely for Laura, to confirm before I roll out change to dropdown to include "Flush")
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Data Element (edit)
Field Name: Ap_FIO2
CCMDB Label: FIO2
CCMDB tab: Apache
Table: L_Log
Data type: number
Length: single
Program: CC
Created/Raw: Raw
Start Date: 1988-07-11
End Date: 2300-01-01
Sort Index: 67

FIO2 is the fraction of inspired oxygen[1] in the gas mixture breathed by the patient.

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Legacy implementation right in the table

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It is an element of the Arterial blood gas (APACHE).

See http://en.wikipedia.org/wiki/FiO2

Collection Instructions

There are special collection instructions for Arterial blood gas (APACHE), refer there for further info. FIO2 collection is impacted by this.

Enter the FiO2 by choosing the type and LPM in the drop-down in CCMDB.mdb.

Once entered, your choice will translate into a number. If you go back to the dropdown later to check what you have entered, the type/LPM may not be what you entered, but they will be something that corresponds to the same percentage FiO2. In other words, you can not go back to this field later to see the type or LPM you entered originally.


Apache Physiological Variable
variable name fraction of inspired oxygen
unit percentage
absolute max allowed 100
warning max 100
high score 4
high score 3
high score 2
high score 1
score 0 as per AaDO2
low score 1
low score 2
low score 3
low score 4
AP phys warnMin 20
AP phys absMin 20

APACHE Score

This value is used to generate the APACHE Score.

Collecting Apache physiological variables

There are some specific rules to follow in choosing which one of several lab results to collect.

See APACHE physiological variable collection for details.

Cross Chcks

Rules described in APACHE_physiological_variable_collection#Exceptionally_high_or_low_values are implemented by Check APACHE physiological variable high low.

FiO2 dropdown

See drop-down in CCMDB.mdb.

These FIO2's are estimates only that we use for the collection of arterial blood gas (ABG's) data for APACHE II scoring]] purposes. The actual FiO2 that a patient gets varies due to a number of factors that are not accounted for in these estimates. (breath rate and depth, distance of O2 diffuser from face, resistance to flow etc.)

"Flush" for non-BiPAPs

  • I have posted the link below for an article that deals with the relationship between FiO2 and flow rate. It does help to understand this concept but there would have to be a decision made as to how the data collectors should deal with "flush" as this means that the flow is at maximum which is not a precise flow rate. --LKolesar 07:42, 2017 May 5 (CDT)
  • I emailed Dr. Garland about this issue and he suggested for "practicality reasons" we should just use the highest value on the O2 flowmeter which is 15L. This clears up this question.--LKolesar 11:48, 2017 May 5 (CDT)
    • Template:Discussion I have added a line to the dropdown for the following, is that the correct interpretation for what you said above?
      • type = Flush
      • code = 15L
      • percent = 70

OptiFlow

  • The FiO2 should be indicated on the optiflow or "high flow" when initiated by respiratory. Use this FiO2 in your apache ABG. --LKolesar 07:15, 2017 May 5 (CDT)

Implementation

The field draws its values from the S_FIO2 table.