Oxygen Administration

1. Administer oxygen to any seriously ill or injured patient with potential respiratory insufficiency, even if pulse-oximetry readings are normal, and to any mildly to moderately ill child whose readings are low (< 93%).

2. Use caution in children whose respiratory drive is dependent on hypoxia, such as an infant with ductal-dependent congenital heart lesion (eg, hypoplastic left heart syndrome) or a child with chronic respiratory illness.

3. Use best-tolerated method of oxygen delivery that effectively maintains adequate oxygenation. For example, consider risk of increased agitation and respiratory distress when attempting to attach a cannula or mask to child. Humidified oxygen is preferred, when possible, to avoid drying mucosa.

4. Allow alert children to assume preferred position, as they will naturally optimize their air entry and minimize work of breathing.

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