NDLI: Smoking and home oxygen therapy--a preventable public health hazard.

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Smoking and home oxygen therapy--a preventable public health hazard.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Edelman, David A. Maleyko-Jacobs, Sharron White, Michael T. Lucas, Charles E. Ledgerwood, Anna M.
Description	Country affiliation: United States Author Affiliation: Edelman DA ( Wayne State University/Detroit Medical Center, Detroit, Michigan 48201, USA.)
Abstract	Patients who continue to smoke while on home oxygen therapy endanger themselves, family members, neighbors, and firefighters and create an expense to society for their medical care. This phenomenon was studied in our burn center. Fourteen patients were identified prospectively during the last 2 years. All were smoking while on nasal oxygen. The 14 patients (10 males) were 45 to 87 years of age. All suffered facial burns. Only one patient had a significant burn (30% TBSA, 20% 3rd degree), but all suffered from an exacerbation of chronic obstructive pulmonary disease. Two patients gave a history of stage IV lung cancer and four patients had newly found squamous cell cancer seen on bronchoscopy. All six patients with lung cancer and one with severe chronic obstructive pulmonary disease died. Of the seven survivors, only one patient quit smoking. Total charges were \$2,861,526 and total costs were \$938,311. All patients had Medicare or Medicaid on admission. Hospital loss (\$432,561) was incurred in those patients admitted more than 4 days whereas a profit (\$33,285) was realized in patients admitted less than 4 days. These deaths and financial loss could be reduced by better testing and more precise guidelines as to which patients can safely receive home oxygen. Patients can have their saliva tested for the nicotine breakdown product of cotinine; the test takes 10 minutes. The American Burn Association, in conjunction with the American College of Chest Physicians, should address this issue and develop guidelines for physicians who order home oxygen therapy and for state departments of public health who should regulate the companies that deliver home oxygen.
File Format	HTM / HTML
ISSN	1559047X
Issue Number	1
Volume Number	29
e-ISSN	15590488
Journal	Journal of Burn Care & Research
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2008-01-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Traumatology Burns Etiology Explosions Home Care Services Oxygen Inhalation Therapy Adverse Effects Public Health Safety Smoking Aged Aged, 80 And Over Burn Units Prevention & Control Emergency Service, Hospital Female Humans Male Middle Aged Prospective Studies Risk Assessment Journal Article
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine Rehabilitation Surgery

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