Oxygen for a patient who has become more breathless
NMC OSCE practice station
Clinical skills · 1 min to read · 8 min to perform
Harjit Singh, aged 69, has known chronic lung disease and has become more breathless.
Harjit SinghI cannot get my breath. It is like last time.
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You are the nurse on a respiratory ward. Harjit Singh, aged 69, has known chronic lung disease and has become more breathless. A healthcare assistant is available and the on-call doctor can be reached by phone. Introduce yourself and assess him. Decide what oxygen therapy is needed, set it up, and check and adjust it. Say aloud what you are checking and why. Record your choices and monitoring on the form provided and act on what you find.
What this station tests
- Know the target saturation before giving oxygen: 94 to 98 % for most patients, 88 to 92 % if at risk of raised carbon dioxide.
- A history of drowsiness on oxygen is a warning sign; use controlled oxygen, not high flow.
- A Venturi mask gives a fixed percentage; set the flow rate marked on the valve.
- Recheck saturation and alertness soon after starting and after each change.
- Do not wait for drowsiness: a NEWS2 of 5 or more needs an urgent review, and a patient who becomes drowsy on oxygen is an emergency.
Sources for the clinical content
- British Thoracic Society: Emergency oxygen guideline
- RCP: National Early Warning Score (NEWS2)
- NMC: The Code
An original practice scenario with invented patients. Not an exam question.