GateWay CC



TITLE: Pulmonary Rehab: Oxygen Therapy during exercisePurpose/Expected Outcome:To maintain adequate oxygen saturation (SPO2) during exercise training and/or facilitate exercise endurance.Definitions: 6MWT – 6 Minute Walk TestExercise trainingPolicy:Oxygen saturation will be measured during exercise training sessions using pulse oximetry to assess the need for supplemental oxygen.Oxygen saturation should be maintained at a level greater than 88% during exercise unless otherwise ordered by provider.Supplemental oxygen therapy will be utilized on patients who are hypoxemic.Oxygen will be titrated to facilitate exercise training.Procedure/Interventions:Initial oxygen flow rate will be set according to what provider has prescribed for patient’s home use. Oxygen will be titrated in increments of 0.5 – 1 lpm up to maximum of 6 lpm per nasal cannula to maintain SpO2 greater than 88% or to facilitate exercise training. Need to use supplemental oxygen on patients who were not previously on oxygen, or to increase supplemental oxygen above previously prescribed flow rate will be reported to the referring provider. Procedural Documentation:Need to initiate or use supplemental oxygen will be documented in the daily session report and reflected on the plan of care. When supplemental oxygen is used during exercise, daily session notes will reflect the flow rate and SPO2.Additional Information:Oxygen saturation (SpO2) recorded post initial 6MWT may be considered when assessing need for supplemental oxygen. Bronchodilator therapy should be reviewed for optimization before and during the exercise program. Patient may need to take their short acting bronchodilator when indicated, before exercise to help maintain adequate oxygen saturation and minimize dyspnea.References:Guidelines for Pulmonary Rehabilitation Programs, Fourth Edition, AACVPR (2011).Clearance to ExerciseThe following patient is cleared to exercise and is directed to begin the Pulmonary Rehabilitation Program at the H.U.G. clinic. I understand that the Respiratory Care Practitioner will oversee the patient’s progress and titrate oxygen pet attached policy to safely exercise the patient per attached policy. My office will be a contact for the H.U.G. clinic pulmonary rehabilitation staff should alteration in the course of treatment be required. PATIENT NAME_______________________________________________________SPECIAL CONCERNS OR DIRECTION OF PHYSICIAN/PROVIDER: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Provider Name: _________________________________________Address: __________________________________________________Phone number: __________________________________________PHYSICIAN/PROVIDER SIGNATURE _________________________________________DATE______________Please mail signed document to: HUG Clinic 108 N. 40TH Street Phoenix, AZ 85034Or send Via email: hug@gatewaycc.edu ................
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