Stop giving oxygen.
You heard me.
Sometimes it seems like every patient in the emergency room is wearing a nasal cannula. Sometimes they're wearing it like a headband, or a necklace, or sometimes it's just spewing gas next to the stretcher. (Pause for laughter.)
But oxygen, for those who do not *need* it, may be harmful.
ACS
The folks at UpToDate suggest only giving oxygen if O2 is <90% on room air.
AHA also says only if room air sat <90%.
In the UK, oxygen is only recommended if the room air saturation is < 94%.
This amazing post from Dr. Salim Rezaie shows there is no convincing data that oxygen helps patients who aren't hypoxic, and there is some signal of harm with increased troponin/CK in patients given O2! Are we worsening their MIs?
STROKE
AHA says no oxygen unless saturation < 94%.
Journal Feed talked about this RCT of 8,000 patients, those getting supplemental O2 had no benefit.
ACUTE & CRITICAL CARE
REBEL podcast talking all about the IOTA trial, which showed increased mortality with unnecessary oxygen in acutely ill patients. INCREASED. MORTALITY. FROM OXYGEN.
(Systematic review, meta-analysis including only RCTs)
(Or read the JournalFeed on it.)
The title of this article speaks for itself.
Are you not convinced? Turn down the friggen oxygen.
So what's the ideal saturation?
In our critically ill patients, it's reasonable to aim for a sat of 94-98% based on a huge retrospective study in Chest.