- Subscribe
- Log In More
Log in via Institution
Log in via OpenAthens
Log in using your username and password
- Basket
- Search More
Advanced search
- Latest content
- Current issue
- Archive
- Authors
- Podcasts
- About
Advanced search
- CloseMore
Main menu
- Latest content
- Current issue
- Archive
- Authors
- Podcasts
- About
- Subscribe
- Log in More
Log in via Institution
Log in via OpenAthens
Log in using your username and password
- BMJ Journals
You are here
- Home
- Archive
- Volume 63,Issue Suppl 6
- BTS guideline for emergency oxygen use in adult patients
Email alerts
Article Text
Article menu
- Article Text
- Article info
- Citation Tools
- Share
- Rapid Responses
- Article metrics
- Alerts
This article has corrections. Please see:
- Corrections - January 01, 2009
- Corrections - January 01, 2009
BTS guideline
BTS guideline for emergency oxygen use in adult patients
- B R O’Driscoll1,
- L S Howard2,
- A G Davison3
- 1Department of Respiratory Medicine, Salford Royal University Hospital, Salford, UK
- 2Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
- 3Southend University Hospital, Westcliff on Sea, Essex, UK
- Dr B R O’Driscoll, Department of Respiratory Medicine, Salford Royal University Hospital, Stott Lane, Salford M6 8HD, UK; ronan.o'driscoll{at}srft.nhs.uk
Statistics from Altmetric.com
Request Permissions
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
EXECUTIVE SUMMARY OF THE GUIDELINE
Philosophy of the guideline
Oxygen is a treatment for hypoxaemia, not breathlessness. (Oxygen has not been shown to have any effect on the sensation of breathlessness in non-hypoxaemic patients.)
The essence of this guideline can be summarised simply as a requirement for oxygen to be prescribed according to a target saturation range and for those who administer oxygen therapy to monitor the patient and keep within the target saturation range.
The guideline suggests aiming to achieve normal or near-normal oxygen saturation for all acutely ill patients apart from those at risk of hypercapnic respiratory failure or those receiving terminal palliative care.
Assessing patients
For critically ill patients, high concentration oxygen should be administered immediately (table 1 and fig 1) and this should be recorded afterwards in the patient’s health record.
Oxygen saturation, “the fifth vital sign”, should be checked by pulse oximetry in all breathless and acutely ill patients (supplemented by blood gases when necessary) and the inspired oxygen concentration should be recorded on the observation chart with the oximetry result. (The other vital signs are pulse, blood pressure, temperature and respiratory rate).
Pulse oximetry must be available in all locations where emergency oxygen is used.
All critically ill patients should be assessed and monitored using a recognised physiological track and trigger system.
Figure 1 Chart 1: Oxygen prescription for acutely hypoxaemic patients in hospital. ABG, arterial blood gas; COPD, chronic obstructive pulmonary disease; Fio2, fraction of inspired oxygen; ICU, intensive care unit; NIV, non-invasive ventilation; Pco2, carbon dioxide tension; Spo2, arterial oxygen saturation measured by pulse oximetry.
View this table:
- In this window
- In a new window
Table 1 Critical illnesses requiring high levels of supplemental oxygen (see section 8.10)
Oxygen prescription
Oxygen should be prescribed to achieve a target saturation of 94–98% for most acutely ill patients or 88–92% for those at risk of hypercapnic respiratory failure (tables 1–3).
The target saturation should be written (or ringed) on the drug chart (guidance in fig 1).
View this table:
- In this window
- In a new window
Table 2 Serious illnesses requiring moderate levels of supplemental oxygen if the patient is hypoxaemic (section 8.11)
View this table:
- In this window
- In a new window
Table 3 COPD and other conditions requiring controlled or low-dose oxygen therapy (section 8.12)
Oxygen administration
Oxygen should be administered by staff who are trained in oxygen administration.
These staff should use appropriate devices and flow rates in order to achieve the target saturation range (fig 2).
Figure 2 Chart 2: Flow chart for oxygen administration on general wards in hospitals. ABG, arterial blood gas; EPR, electronic patient record; EWS, Early Warning Score; Spo2, arterial oxygen saturation measured by pulse oximetry.
Monitoring and maintenance of target saturation
Oxygen saturation and delivery system should be recorded on the patient’s monitoring chart …
View Full Text
Footnotes
No member of the Guideline Development Group is aware of any competing interests. In particular, no member of the group has any financial involvement with any company that is involved in oxygen therapy.
Linked Articles
- Correction
Corrections
BMJ Publishing Group Ltd and British Thoracic Society
Thorax 2008; 64 91-91 Published Online First: 22 Dec 2008.
- Correction
Corrections
BMJ Publishing Group Ltd and British Thoracic Society
Thorax 2008; 64 91-91 Published Online First: 22 Dec 2008. doi: 10.1136/thx.2008.102947corr1
Read the full text or download the PDF:
Subscribe
Log in via Institution
Log in via OpenAthens
Log in using your username and password
Read the full text or download the PDF:
Subscribe
Log in via Institution
Log in via OpenAthens