Monday, May 04, 2015

Trends in pre-hospital oxygen administration for chest pain patients

From a recent study:

Objectives. The purpose of this study was to examine trends in oxygen administration following the 2010 American Heart Association guidelines recommendation to withhold oxygen therapy for patients with uncomplicated presentations of ACS whose SpO2 is 94% or higher...

Results. 10,552 patient encounters by 2,447 paramedic students from 195 paramedic programs representing 49 states were included for analysis. Prior to release of the new guidelines (2010), 71.9% (95% CI 69.8–74.0%) of patients with SpO2 greater then or equal to 94% received supplemental O2. Rates of O2 administration were significantly lower in 2011 (64%; 95% CI 62.7–65.3%) and in 2012 (53.1%; 95% CI 51.5–54.7). The odds of a hemodynamically stable chest pain patient with SpO2 greater than or equal to 94% receiving supplemental oxygen in 2011 were 1.4 times lower compared to patients in 2010 (95% CI 1.3–1.6). Similarly, the odds of patients in 2012 receiving supplemental oxygen were 2.3 times lower compared to patients in 2010 (95% CI 2.0–2.6). The odds of receiving supplemental oxygen decreased by 4% for each 1% increase in SpO2 beyond the 94% threshold (OR = 0.96; 95% CI 0.94–0.98). Conclusions. The prehospital administration of supplemental O2 decreased significantly following release of the 2010 updated guidelines; however, our data revealed that 50% of patients not meeting criteria for administration still received supplemental O2.

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