Landmark guidance issued on oxygen use

Respiratory nurses have said that national guidance on emergency oxygen use will result in a more consistent approach to its delivery and better patient safety.

The landmark guideline on the emergency use of oxygen in adults, published by the British Thoracic Society, says that oxygen should only be used to treat hypoxaemia or in critically ill patients.

According to the BTS, there is no evidence that administering oxygen relieves breathlessness in patients whose blood oxygen level is normal, and giving too much oxygen to patients with chronic lung conditions can be harmful.

The guideline recommends that nurses should administer oxygen only to patients whose oxygen saturation levels fall below target ranges – 94–98% for most critically ill patients and 88–92% for those at risk of type 2 respiratory failure.

Patients should be monitored closely using pulse oximetry – which the BTS says should be available wherever emergency oxygen is used – and oxygen therapy adjusted to stay within the specified ranges.

The guidelines also recommend that oxygen should only be administered with a prescription, except in the immediate management of critical illness, and should be delivered via nasal cannulae rather than masks.

Susan Perrott, respiratory specialist nurse practitioner at Brookfields Hospital in Cambridge, said: 'Nurses receive conflicting advice about oxygen use and many of us are confused about the entire area of oxygen prescription and delivery.

'The guidelines will help us standardise oxygen therapy in the emergency situation and improve the consistency of administration.'

Jane Scullion, consultant nurse in respiratory medicine at University Hospitals of Leicester NHS Trust, said the guidelines would help improve patient safety.

'Oxygen administration has been done very badly in the past with no prescriptions or target saturations,' she said.

'These timely guidelines will ensure that the right patient receives the right dose using the right equipment.' 

The BTS is auditing the oxygen administration practices of all UK acute trusts.