A breath of fresh air for acute oxygen treatment

Oxygen therapy given to acutely ill people is one of the commonest interventions used in modern medicine and has become part of the folklore of our times as a sick patient wearing an oxygen mask is pushed through the emergency department, both in real life and on television. Although the principles of oxygen treatment have been established by painstaking quantitative research over the past 60 years, in practice most people learn to use oxygen by following customary practice in their institution rather than considering rationally how it is best employed. A feeling that some oxygen is good, therefore more must be better, can be a dangerous precept to follow, whereas an unnecessary paranoia about inducing carbon dioxide retention can deny some people potentially life saving treatment. These uncertainties make the arrival of the new British Thoracic Society Guideline for Emergency Oxygen Use in Adults1 particularly welcome. This rather daunting document, which has been extensively endorsed by key professional societies and practitioner groups, provides a comprehensive and at times exhaustive review of the theory and practice of acute oxygen treatment. Its scope ranges from a detailed consideration of how oxygen therapy influences respiratory physiology and tissue oxygen delivery through to which mask should be chosen and how oxygen services should be developed. It is a major resource which answers almost any question about acute oxygen therapy but …