The administration of supplemental oxygen can be life saving for patients experiencing acute hypoxemia.

It is important for nurses to accurately assess the need for oxygen and that it is administered and managed appropriately across a range of clinical presentations. Patients presenting to the ED often have potentially life-threatening symptoms, so it may be necessary for nurses to initiate oxygen therapy.

This process carries great responsibility, as oxygen can be harmful. Oxygen should be considered a drug. Its administration should be focused on achieving a targeted oxygen saturation range. This range can be monitored by a patient’s response, such pulse oximetry or ABGs. The goal is to ensure haemodynamic sufficiency and minimise respiratory dysfunction.

As a nursing student, you will not be expected to initiate oxygen administration, however, it is essential that you are familiar with the fundamentals of oxygen therapy.

Within this module you will find resources that will provide guidance on the use of oxygen therapy, its benefits and potential complications.

Oxygen therapy in the Emergency Department

The dangers of oxygen therapy – hyperoxia and mortality
By measurement of the partial pressure of oxygen in arterial blood (pO2(a)) and oxygen saturation in arterial blood (sO2(a)), blood gas analysis provides the means for monitoring supplemental oxygen therapy.–hyperoxia-and-mortality

Liberal Use of Oxygen Increases Risk of Death for Acutely Ill
Researchers have found oxygen therapy increases risk of death when given liberally to patients with acute illness, such as heart attack, stroke, and trauma.

Oxygen delivery
The aim of this guideline is to describe the indications and procedure for the use of oxygen therapy, and its modes of delivery.

Cautions with Oxygen Therapy
Oxygen therapy supports life and supports combustion. While there are many benefits to inhaled oxygen, there are also hazards and side effects. Anyone involved in the administration of oxygen should be aware of potential hazards and side effects of this medication.

Allibone, E., Soares, T., & Wilson, A. (2018). Safe and effective use of supplemental oxygen therapy. Nursing Standard, 33(5), 43-50. doi:10.7748/ns.2018.e11227

Branson, R. D. (2018). Oxygen therapy in COPD. Respiratory Care, 63(6), 734-748. doi:10.4187/respcare.06312

Dobbe, A. S. M., Stolmeijer, R., ter Maaten, J. C., & Ligtenberg, J. J. M. (2018). Titration of oxygen therapy in critically ill Emergency Department patients: a feasibility study. BMC Emergency Medicine, 18(1), N.PAG-N.PAG. doi:10.1186/s12873-018-0169-2

Hofmann, R., James, S. K., Jernberg, T., Lindahl, B., Erlinge, D., Witt, N., . . . Pernow, J. (2017). Oxygen therapy in suspected acute myocardial infarction. New England Journal of Medicine, 377(13), 1240-1249. doi:10.1056/NEJMoa1706222

Myatt, R. (2017). Pulse oximetry: what the nurse needs to know. Nursing Standard, 31(31), 42-45. doi:10.7748/ns.2017.e9940

Raut, M. S., & Maheshwari, A. (2016). Oxygen supplementation in acute myocardial infarction: To be or not to be? Annals of Cardiac Anaesthesia, 19(2), 342-344. doi:10.4103/0971-9784.179594

Rolfe, S., & Paul, F. (2018). Oxygen therapy in adult patients. Part 1: understanding the relevant physiology and pathophysiology. British Journal of Nursing, 27(14), 798-804. doi:10.12968/bjon.2018.27.14.798

Siela, D. (2017). Oxygen requirements for acutely and critically ill patients. Critical Care Nurse, 37(4), 58-70. doi:10.4037/ccn2017627