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BTS guideline for oxygen use in adults in healthcare and emergency settings
  1. B R O'Driscoll1,2,
  2. L S Howard3,
  3. J Earis4,
  4. V Mak5
  5. on behalf of the British Thoracic Society Emergency Oxygen Guideline Group
    1. 1Respiratory Medicine, Salford Royal Foundation NHS Trust, Salford, UK
    2. 2Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
    3. 3Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
    4. 4University of Liverpool, Liverpool, UK
    5. 5Imperial College Healthcare NHS Trust, London, UK
    1. Correspondence to Dr BR O'Driscoll, Respiratory Medicine, Level 4 Brooke Building (Orange Area), Salford Royal Foundation NHS Trust, Stott Lane, Salford M6 8HD, UK; ronan.o@driscoll@srft.nhs.uk

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    Contents

    Abbreviations and symbols used in this guideline

    Executive summary

    Summary of recommendations

    • Critical illness requiring high levels of supplemental oxygen

    • Serious illnesses requiring moderate level of supplemental oxygen if the patient is hypoxaemic

    • Conditions for which patients should be monitored closely but oxygen therapy is not required unless the patient is hypoxaemic

    • COPD and other conditions requiring controlled or low-dose oxygen therapy

    • Abbreviations for oxygen devices for use on bedside charts.

    • Chart 1—oxygen prescription guidance for acutely hypoxaemic patients in hospital

    • Chart 2—flow chart for oxygen administration on general wards in hospitals

    Section 1 Introduction

    • Aim of the guideline

    • Intended users of the guideline and target patient populations

    • Areas covered by the guideline

    • Areas not covered by the guideline

    • Summary of changes since the 2008 guideline

    • Limitations of the guideline

    Section 2 Methodology of guideline production

    • Establishment of guideline team

    • Summary of key questions

    • How the evidence was assimilated into the guideline

    • Piloting, implementing and auditing the guideline

    • Planned review and updating of the guideline

    • Declarations of interest

    • SIGN levels of evidence

    • SIGN grades of recommendation

    Section 3 Normal values and definitions

    • Blood gas levels of oxygen and carbon dioxide in health and disease

    • Normal ranges for oxygen saturation (SaO2 and SpO2) and PO2 (PaO2) in the blood at sea level

    • Oxygen saturation in older adults

    • Oxygen saturation at altitude

    • Oxygen saturation in acute and chronic diseases

    • Variation in oxygen saturation during sleep

    • Normal range for arterial carbon dioxide tension

    • Definitions of hypoxaemia, hypoxia, type 1 respiratory failure and hyperoxaemia

    • Definition of hypercapnia and type 2 respiratory failure

    • Definition of acidosis (respiratory acidosis and metabolic acidosis)

    • Mean (SD) PaO2 (kPa and mmHg) and SaO2 (%) values (with range)

    • Ranges, mean, SD, median and IQR values for SpO2 (%) where measurements were made with the …

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