To Give or Not To Give - Is that the Question?: The Changing Face of Emergency Oxygen Therapy.

Oxygen's image, together with its reputation, is changing. No longer is it regarded as a benign panacea for all clinical presentations; indeed it is now increasingly evident that oxygen has the potential to contribute to clinical deterioration and mortality. There is an emerging recognition that oxygen is a drug when administered as a therapeutic intervention and should be used with caution. Contemporary guidelines offer criteria and directives for administration and prescription of oxygen, dependant on the patient's condition, acuity and care setting, yet clinical audit and gathering evidence repeatedly demonstrates that poor practice persists. There is a need to raise awareness of the importance of maintaining normal oxygen levels and be aware of the detrimental effects of both over and under oxygenation. Clearly more research is needed but in the meantime titration to normal or near normal levels seems a pragmatic solution.