Abstract
In trauma and orthopaedic surgery high flow oxygen can save lives by preventing severe hypoxaemia. Conversely, excessive oxygen can cause harm, and inadequate monitoring of its use has been reported in both pre-hospital and hospital audits. In 2008 the British Thoracic Society published guidelines on the use of emergency oxygen in adults. Data were collected before, 3 months after and 12 months after the introduction of an oxygen prescription chart and education of junior doctors and ward staff. A total of 84 patients were recorded in the first study, 76 in the second and 72 in the third. After education and introduction of an oxygen prescription section on the drug charts the number of oxygen treatments correctly prescribed increased from 10/84 (12%) to 56/76 patients (74%, P<0.001) at 3 months. Twelve months after education and introduction of an oxygen prescription section on the drug charts the number of oxygen treatments prescribed decreased to 37/72 (51%, P<0.001). Education and the use of oxygen prescribing charts significantly improved the prescription of oxygen. The effect of the intervention fell at 12 months, suggesting poor sustainability. Continued education and feedback to ward staff is vital to maintain change and improve sustainability.
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