Prehospital High Flow Oxygen Increases Risk of Death

By Mike McEvoy
EMS Editor

Prehospital oxygen titrated with pulse oximetry lowered risk of death compared to high flow oxygen in a large Australian study. Researchers randomized 405 patients with difficulty breathing into treatment with high flow oxygen (n=226) and nasal oxygen titrated to maintain oxygen saturations between 88 and 92% (n=179). Titrated oxygen significantly reduced both pre-hospital and in-hospital mortality in all patients by 58%. In patients with confirmed COPD, titrated oxygen reduced risk of death by 78%. Long standing tradition of administering high flow oxygen has been difficult to change, probably due to lack of any clear benefits of titrating oxygen therapy. This relatively large study provides strong evidence that titrated oxygen improves outcomes in prehospital difficulty breathing patients.

Source: Austin MA, et al. Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial. BMJ 2010;341:c5462.

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