Abstract
Oxygen therapy is an essential medicine and core component of effective hospital systems. However, many hospitals in low- and middle-income countries lack reliable oxygen access-a deficiency highlighted and exacerbated by the coronavirus disease (COVID-19) pandemic. Oxygen access can be challenged by equipment that is low quality and poorly maintained, lack of clinical and technical training and protocols, and deficiencies in local infrastructure and policy environment. We share learnings from 2 decades of oxygen systems work with hospitals in Africa and the Asia-Pacific regions, highlighting practical actions that hospitals can take to immediately expand oxygen access. These include strategies to: (1) improve pulse oximetry and oxygen use, (2) support biomedical engineers to optimize existing oxygen supplies, and (3) expand on existing oxygen systems with robust equipment and smart design. We make all our resources freely available for use and local adaptation.
Highlights
Oxygen therapy is an essential medicine and core component of hospital systems that has been a standard of care for more than 100 years.[1]
Access to oxygen therapy is limited in many low-resource settings, where the majority of hypoxemic patients who are admitted to the hospital will not receive oxygen, resulting in an increased risk of death.[2]
This experience has informed the development of clinical and technical guidance by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF)[14,15,16] and is informing oxygen scale-up for COVID- We show how to
Summary
Oxygen therapy is an essential medicine and core component of hospital systems that has been a standard of care for more than 100 years.[1]. Achieving reliable supply and appropriate use is challenging, with major barriers due to equipment that is low quality and poorly maintained, lack of clinical and technical training and protocols, and deficiencies in local infrastructure and sociopolitical context.[6]. Our work has shown lack of clinical and how to combine quality equipment and training technical training to achieve context-appropriate and sustainable improvement in oxygen systems and improve clinical and protocols. To complement existing technical guidance on equipment and COVID-19 response from WHO17 and others, we of- training to achieve fer practical suggestions based on our on-the- sustainable ground experience to help policy makers, adminis- improvement in trators, technicians, and health care workers seeking oxygen systems to rapidly improve their hospital oxygen systems. We have created practical resources to assist biomedical engineers/technicians to build and maintain reliable, user-friendly
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