A survey of emergency oxygen guideline implementation among all 15 UK Ambulance Services in early 2011
Davison, A.G. Smith, J. O'Driscoll, B. Ronan
Davison, A.G.
Smith, J.
O'Driscoll, B. Ronan
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Abstract
The British Thoracic Society (BTS), together with 21 other societies
published a UK guideline for emergency oxygen use in 2008. This
guideline was endorsed by the Joint Royal Colleges Ambulance
Liaison Committee (JRCALC) who produced new oxygen guidance
for ambulance crews in April 2009. We have conducted a survey of
implementation of this guidance among UK Ambulance Services in
early 2011. A questionnaire was sent to the Medical Directors of all
15 UK Ambulance Services and all, or their nominated deputies
responded. Eleven of fifteen respondents reported full implementation of the 2009 JRCALC oxygen guidance throughout their service
and ten of these reported that all relevant staff are trained in this
area of practice. However, an informal survey of about 100 front line
ambulance crews in one of these areas found that none were aware
of the 2009 JRCALC document so the above figures may be
aspirational and not yet achieved at operational level. Four services
reported that they have completed audits of guideline implementation and a further three services are planning audits. All 15
services reported that 81%e100% of response vehicles were
equipped with oximeters and the availability of oxygen masks was
as follows: 15/15 reservoir masks; 12/15 simple face masks, 12/15
28% Venturi masks, 6/15 24% Venturi masks, 10/15 nasal cannulae.
However, the informal survey of front-line staff from one ambulance service showed that Venturi masks were not actually available
at operational level although the Regional response indicated
universal availability. A separate survey found that no UK ambulance service has access to air cylinders, compressors or ultrasonic
nebulisers for COPD patients so all nebulised treatment is oxygendriven. Six of 15 services reported that they had protocols to limit
the duration of oxygen-driven nebuliser therapy for COPD patients.
Two services have a record of all patients in their area who have an
Oxygen Alert card. This survey suggests that UK Ambulance Services are taking steps to implement the BTS and JRCALC emergency
oxygen guidance but it is unclear how much advice and equipment
had been cascaded to front-line staff by Spring 2011.
https://thorax.bmj.com/content/thoraxjnl/66/Suppl_4/A108.2.full.pdf
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
http://dx.doi.org/10.1136/thoraxjnl-2011-201054c.101