Oxygen Log
Baby’s name: Alarm limits: Hospital: Hospital number:
Date
Shift
Ventilation/nCPAP*
Supplementary
oxygen†
Vent
All
nCPAP Neither
Study number: % Lower Upper while in oxygen
ONLY when oxygen was given for PART of the shift,
draw lines on the ruler to show every period when
oxygen was given for more than 20 minutes
Part None
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
0800 - 2000
08
09
10
11
12
13
14
15
16
17
18
19
20
2000 - 0800
20
21
22
23
00
01
02
03
04
05
06
07
08
*Tick one or both of the first two boxes or the third box in this column for each shift (see back page for an example)
†
%
Tick one (and only one) box in this column for each shift
Version 2 February 2008
Instructions
Definitions
Report the baby as ventilated if there was an endotracheal tube in place for more than 30 minutes and/or as
having nasal CPAP if any other form of respiratory support was used for more than 30 minutes in any given
12 hour shift.
Nasal CPAP includes: vapotherm; other humidified high flow nasal cannula devices where flow is ≥2l/min;
nasal IPPV and nasal BiPAP.
Completing the log
Ventilation/nCPAP:
• If the baby was ventilated during a shift, tick the box in the Vent column
• If the baby was on nCPAP during a shift, tick the box in the nCPAP column
• If the baby received ventilation and nCPAP during a shift, tick the boxes in the Vent and nCPAP columns
• If the baby did not receive ventilation or nCPAP during a shift, tick the box in the Neither column
Please ensure you tick at least one box
Supplemental oxygen:
• If the baby was on supplemental oxygen for the whole of a 12 hour shift, tick the box in the All column
• If the baby was in air for the whole of a 12 hour shift, tick the box in the None column
• If the baby was in supplemental oxygen for only part of the shift, tick the box in the Part column and draw
lines on the ruler to show every period when oxygen was given for more than 20 minutes
Please ensure you tick one and only one box
Note: It is only necessary to complete the ruler for periods when the baby is in supplemental oxygen for part
of the time. It is not necessary to complete the ruler if the baby was not in supplementary oxygen but was still
receiving ventilation or nCPAP.
Example:
Oxygen Log
This chart summarises the care given to a baby entered into the trial at 13:00 onStudy
3rd January
and0 was ventilated
number:
and in oxygen for the next 15 hours. This baby came out of oxygen at 04:00, was extubated and given nasal
CPAP
11:40. Oxygen was given for two periods,
30 limits:
minutes atUpper
21:00 and 65
at 22:40 on%4th
Baby'sfrom
name:
% minutes
Lower
Alarm
while in oxygen
January.
Nasal CPAP was stopped at 10:00 on 5th January.
Hospital:
Hospital number:
Date
Shift
Ventilation/nCPAP*
Vent
03/01/08
04/01/08
05/01/08
0800 - 2000
2000 - 0800
0800 - 2000
2000 - 0800
0800 - 2000
2000 - 0800
nCPAP Neither
Supplementary
oxygen†
All
ONLY when oxygen was given for PART of the shift,
draw lines on the ruler to show every period when
oxygen was given for more than 20 minutes
Part None
08
09
10
11
12
13
14
15
16
17
18
19
20
20
21
22
23
00
01
02
03
04
05
06
07
08
08
09
10
11
12
13
14
15
16
17
18
19
20
20
21
22
23
00
01
02
03
04
05
06
07
08
08
09
10
11
12
13
14
15
16
17
18
19
20
20
21
22
23
00
01
02
03
04
05
06
07
08
What to do when you receive a replacement oximeter
When you receive a replacement oximeter you will be instructed to take a photocopy of the current oxygen
log and enclose this with the replaced oximeter and return to the Co-ordinating Centre using the FREEPOST
envelope and box provided.
What to do when the baby reaches 36 weeks’ PMA
When the baby reaches 36 weeks’ postmenstrual age and having completed the 36 week form, the
interventional part of the study will end and the baby can, if still oxygen dependent, be managed on any
of the unit’s oximeters. At this point you will be asked to return the baby’s study oximeter and enclose the
completed oxygen log.
Version 2 February 2008