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New emergency oxygen guideline

Tagged In:  Allied Health, Nursing

Doctors, nurses, midwives and other health professionals are being encouraged to follow the latest advice from the British Thoracic Society (BTS).

Oxygen is a life-saving drug for hypoxaemic patients ie those whose oxygen levels are too low. However, it's vital that oxygen is administered carefully and appropriately. It cannot be stored in the body, so too much can be dangerous.

First published in 2008, the BTS Guideline for Oxygen Use in Adults in Healthcare and Emergency Settings has recently been updated. The revised guideline document includes guidance on several new areas, including endoscopy and other procedures requiring sedation, care before, during and after operations (including patient-controlled analgesia) and oxygen use in palliative care settings such as hospices. There is also new guidance on the use of oxygen mixtures (such as Entonox) and high-flow humidified nasal cannulae, as well as advice for oxygen use in patients' homes, for example by community nurses, and by voluntary rescue organisations and other non-NHS first responders.

“Oxygen is a very important drug and should always be prescribed and monitored like any other medication, " said Dr Ronan O'Driscoll, Consultant Respiratory Specialist at Salford Royal NHS Foundation Trust and lead author of the guideline.  "It is very beneficial to many patients, but can be harmful if misused. We urge all clinicians to adopt the updated BTS Guideline so that emergency oxygen is always used in an optimal and safe way."

In April the BTS issued its latest Emergency Oxygen Audit Report, covering the period 15 August to 1 November 2015. It found that one in seven patients in UK hospitals receives oxygen therapy on any given day. However, over 40% of those patients are receiving that oxygen with no prescription or formal written order to help ensure that healthcare staff deliver and monitor oxygen use safely and effectively. The audit also found that over half of hospitals don't provide adequate training in oxygen provision and monitoring for doctors and nurses.

The updated BTS oxygen use guideline has been endorsed by many organisations representing healthcare staff, including the Association of Chartered Physiotherapists in Respiratory Care, the  Association of Respiratory Nurse Specialists, the British Association of Stroke Physicians, the Royal College of Anaesthetists, the Royal College of Emergency Medicine, the Royal College of General Practitioners and the Royal College of Nursing.

To support the new guideline, BTS offers a range of downloadable resources for doctors, nurses and other health professionals, as well as for hospital managers, including teaching slides, key points and a local oxygen policy template.

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