New oxygen guidelines from The British Thoracic Society

Have you seen the updated guidance by The British Thoracic Society published this week regarding the use of Oxygen in Adults in Healthcare and Emergency Settings? The guidelines, which were first published in 2008 and endorsed by over 20 clinical societies and colleges, is based on new evidence in prescribing and the delivery of emergency oxygen to ensure oxygen is always used in a safe and optimal way.

The guidance advises health practitioners when prescribing oxygen to always specify a safe ‘target range’ of oxygen in the blood, which can then be monitored. This vital action is designed to ensure that patients are not given too little, or too much, oxygen which can result in greater illness and, in rare cases, even death.

Our use of oxygen has changed over the years, one example is patients with heart attacks. Until recently, oxygen was given to almost every patient suspected of a heart attack. However, evidence has spotlighted this probably increases the size of the heart attack due to constriction of the blood vessels in the heart in response to high doses of oxygen. Current guidance is for patients to be monitored closely but oxygen therapy is not required unless the patient is hypoxaemic.

Some of the key points for Primary Care from the new guidance includes:

  • Oxygen should be available where patients may become acutely unwell.
  • Oximeters must be available whenever emergency oxygen is used.
  • The recommended delivery systems should be available and staff should be trained in the range of different devices. It is recommended that the following delivery devices should be available in prehospital settings where oxygen is administered:
    • High-concentration reservoir mask (non-rebreathe mask) for high- concentration oxygen therapy
    • Nasal cannulae (preferably) or a simple face mask for medium-concentration oxygen therapy
    • Twenty-eight per cent Venturi mask for patients with definite or likely COPD (patients who have an oxygen alert card may have their own 24% or 28% Venturi mask)
    • Tracheostomy masks for patients with tracheostomy or previous laryngectomy.
  • Primary care and secondary care staff and ambulance control teams in each district should cooperate in establishing a list of all patients who are known to be sensitive to high‐dose oxygen therapy
  • Oxygen should be administered by staff who are trained in oxygen administration.

The guidance, available on The British Thoracic Society’s website, gives the full details. If you’d like to know more about the use of emergency oxygen within your area of work, give our office a call. Many of our courses include the use of oxygen, and we can ensure you have the up to date information and training you need.

Written by Sophie McCracken 19th May 2017