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Guideline

BTS guideline for oxygen use in adults in healthcare and emergency settings

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Last updated:18th Jun 2018

The key aim of this guideline is to make oxygen use in emergency and healthcare settings safer, simpler and more effective. Oxygen is probably the commonest drug used in the care of patients who present with medical emergencies. Prior to the publication of the first BTS guideline for emergency oxygen use in adult patients in 2008,2 ambulance teams and emergency department teams were likely to give oxygen to virtually all breathless or seriously ill patients and also to a large number of non-hypoxaemic patients with conditions such as ischaemic heart disease or stroke based on custom and practice. About 34% of UK ambulance journeys in 2007 involved oxygen use.3 This translated to about two million instances of emergency oxygen use per annum by all UK ambulance services, with further use in patients’ homes, GP surgeries and in hospitals. Audits of oxygen use and oxygen prescription have shown consistently poor performance in many countries and most clinicians who deal with medical emergencies have encountered adverse incidents and occasional deaths due to underuse and overuse of oxygen.4–10

The guideline addresses the use of oxygen in three main categories of adult patients in the prehospital and hospital setting and in other settings such as palliative care:

  • Critically ill patients,
  • Hypoxaemic patients and patients at risk of hypoxaemia,
  • Non-hypoxaemic patients who may benefit from oxygen (eg, carbon monoxide poisoning).

 

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