Practice Therapeutics

Emergency oxygen use

BMJ 2012; 345 doi: (Published 18 October 2012) Cite this as: BMJ 2012;345:e6856

Re: Emergency oxygen use

Dear Sir,

O’Driscolls’ otherwise helpful, thoughtful and comprehensive review of emergency oxygen administration makes no mention of High Flow Nasal Oxygen delivery devices [1]. These devices deliver humidified oxygen at between 40 -70 l/min, and the achieved FiO2 (around 0.9) is substantially more than traditional ‘high flow’ methods such as non-rebreathing (‘trauma’) masks, at around 0.7 [2]. They may also provide a small amount of continuous positive airway pressure.

This method of oxygen administration is very well tolerated. In patients with severe hypoxaemia, who are not hypercapnic or exhausted, these devices may avoid the need for mechanical ventilation.

Yours sincerely,

Pamela Dean, Martin Hughes and Prof. John Kinsella.

1. O’Driscoll R. Emergency oxygen use. BMJ 2012;345:e6856
2. Sim MA, Dean P, Kinsella J, Black R, Carter R, Hughes M. Performance of oxygen delivery devices when the breathing pattern of respiratory failure is simulated. Anaesthesia 2008;63(9):938-40.

Competing interests: No competing interests

16 December 2012
Pamela A Dean
Dr Martin Hughes, Prof. John Kinsella
Glasgow Royal Infirmary
Castle Street Glasgow G3 0SF