Clinical Case Database / Category: Clinical Care

Emergency oxygen use in adults

Publication details

Sarah Heikal MB, ChB, CT1, ACCS (Emergency Medicine)
Foundation Years Journal, volume 4, issue 2, p.44 (123Doc Education, London, February 2010)


Oxygen is perhaps the most commonly used and under recognised drug in patients presenting with medical emergencies. Most trainees who look after acutely unwell patients will have some experience of patients suffering the adverse effects of over or under use of oxygen, yet few of us ever prescribe it. Why then are we so poor at prescribing this particular drug, when we recognise the correct prescription of other therapeutic agents as one of "the essentials" of medical care? Despite its importance, the physiology of oxygen delivery (and consequently the pathophysiology of impaired oxygen delivery) is not always fully understood by many medical staff. As junior doctors we tend to receive conflicting advice from more senior colleagues (especially from differing specialties), who often have very strong ideas about the administration of oxygen, despite a relative lack of randomised controlled trials on which to base them.

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Sarah Heikal MB, ChB, CT1, ACCS (Emergency Medicine)

Emergency Medical Unit
Royal Devon and Exeter Hospital
Barrack Road


1. O'Driscoll BR, Howard LS, Davison AG (2008) British Thoracic Society guideline for emergency oxygen use in adults. Thorax, 63(suppl 6):vi1–68.
2. Beasley R, Aldington S, Weatherall M, et al. (2007) Oxygen therapy in myocardial infarction: an historical perspective. J R Soc Med, 100:130–133.
3. Rawles JM, Kenmure AC (1976) Controlled trial of oxygen in uncomplicated myocardial infarction. BMJ, 1:1121–1123.
4. Ronning OM, Guldvog B (1999) Should stroke victims routinely receive supplemental oxygen? A quasi-randomised controlled trial. Stroke, 30:2033–2037.
5. Berry RB, Mahutte CK, Kirsch JL, et al. (1993) Does the hypoxic ventilatory response predict the oxygen-induced falls in ventilation in COPD? Chest, 103:820–824.
6. Dick CR, Liu Z, Sassoon CS, et al. (1997) O2-induced change in ventilation and ventilator drive in COPD. Am J Respir Crit Care Med, 155:609–614.
7. Erbland ML, Ebert RV, Snow SL (1990) Interaction of hypoxia and hypercapnia on respiratory drive in patients with COPD. Chest, 97:1289–1294.
8. Feller-Kopman D, Schwartzstein R (2001) The role of hypoventilation and ventilation:perfusion redistribution in oxygen-induced hypercapnia during acute exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 163:1755.
9. Kern JW, Shoemaker WC (2002) Meta-analysis of hemodynamic optimization in high-risk patients. Crit Care Med, 30:1686–1692.
10. Forst H (1997) Maximising oxygen delivery in critically ill patients: a rational therapeutic approach (in German). Anaesthesist, 46:46–52.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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