Guideline alert: British thoracic society emergency oxygen use in adult patients

In June 2008 the British Thoracic Society (BTS) produced the frst national emergency oxygen guideline (O’Driscoll et al, 2008). This was endorsed by 21 professional bodies and associations, including the British Paramedic Association, the Joint Royal Colleges’ Ambulance Liaison Committee and the Resuscitation Council (UK).

The emergency use of oxygen is an area where there is a lack of clinical trial evidence, with controversy surrounding both risks and benefts, as well as some strongly held beliefs and it is in this context that this guideline was produced. National audit has suggested that guideline uptake has been encouraging in the inpatient setting, but also highlights the diffculties inherent in changing established practice (O’Driscoll et al, 2011). Our own data suggest that uptake in the Emergency Department (ED) has been less impressive (Wallace et al, 2010) despite widespread guideline awareness among ED physicians (unpublished observation of ED trainees at regional training sessions). While the guideline predominantly covers the use of oxygen in the inpatient setting a section specifcally devoted to pre-hospital care is included and many of the points covered are also applicable to the pre-hospital environment.