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Oxygen use in acute myocardial infarction: an online survey of health professionals' practice and beliefs
  1. Amanda Burls1,
  2. José I Emparanza2,
  3. Tom Quinn3,
  4. Juan B Cabello4
  1. 1Centre for Evidence-Based Medicine, Department of Primary Health Care, University of Oxford, Old Road Campus, Oxford, UK
  2. 2Unidad de Epidemiología Clínica e Investigación, CASPe, CIBER-ESP, Hospital Donostia, San Sebastián, Spain
  3. 3Division of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
  4. 4Centro coordinador CASPe & Cardiology Department, Hospital General Universitario de Alicante, Alicante, Spain
  1. Correspondence to Professor Tom Quinn, Division of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK; t.quinn{at}surrey.ac.uk

Abstract

Introduction There is growing interest in the safety of oxygen therapy in emergency patients. A Cochrane review of oxygen versus air for patients with acute myocardial infarction (AMI) showed a potentially important, but statistically non-significant, increase in mortality (RR 3.03 (95% CI 0.93 to 9.83)) and concluded a definitive randomised controlled trial (RCT) was needed.

Objective To explore the feasibility of conducting an RCT of oxygen versus air in AMI, by exploring the beliefs of UK professionals who treat patients with AMI about oxygen's benefits, and to establish a baseline of reported practice by asking about their use of oxygen.

Method A cross-sectional online survey of UK emergency department, cardiology and ambulance staff.

Result 524 responses were received. All specialities had over 100 respondents. 98.3% said they always or usually use oxygen. 80% reported having local guidelines that recommended the routine use of oxygen. 55% believed oxygen definitely or probably significantly reduces the risk of death, while only 1.3% reported that they thought ‘it may even increase the risk of death.’ There were only minor differences across specialities and grades.

Conclusion Widespread belief in the benefit of oxygen in AMI may make it difficult to persuade funders of the importance of this issue and health professionals to participate in enrolling patients into a trial in which oxygen would be withheld from half their patients.

  • Acute myocardial infarction
  • oxygen inhalation therapy
  • uncertainty
  • cardiac care
  • treatment
  • nursing
  • prehospital
  • emergency departments

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; not externally peer reviewed.