British Thoracic Society Oxygen Guidelines: another clinical brick in the wall

The world's first evidence-based guideline for emergency oxygen therapy was published by the British Thoracic Society (BTS) in 2008 and endorsed by 21 other societies and colleges.1 The key message in the guideline was very simple: clinicians were advised to avoid hypoxaemia and hyperoxaemia by prescribing a normal or near-normal target oxygen saturation of 94%–98% for most acutely unwell patients and to prescribe a lower range (usually 88%–92%) for patients at risk of hypercapnia, and to use high-concentration oxygen for some conditions such as carbon monoxide poisoning or the immediate management of critical illness. This guidance has informed worldwide clinical practice and research since 2008 and is cited by more than 500 publications. The guideline is now updated and extended with the support of 22 colleges and societies.2 Readers will want to know what is new in the 2017 update of the BTS emergency oxygen guideline, published as a supplement to this edition of Thorax .2 A concise version of the guideline is available in BMJ Open Respiratory Research.3 The evidence review methodology and grading of recommendations follows the National Institute for Health and Care Excellence accredited BTS guideline production process which is based on Scottish Intercollegiate Guidelines Network (SIGN) methodology and adheres to the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument.4 The evidence base for the guideline has been updated to August 2013 with bespoke literature searches (and extended to late 2016 for key references). The remit of the guideline is wider now than in 2008. The new guideline covers emergency …