Oxygen use in acute myocardial infarction: an online survey of health professionals' practice and beliefs.
BACKGROUND
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.


RESULTS
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.


CONCLUSIONS
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.
Burls
Amanda
A
Division of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK.
Emparanza
José I
JI
Quinn
Tom
T
Cabello
Juan B
JB
D000208:Acute Disease; D000328:Adult; D001291:Attitude of Health Personnel; D002309:Cardiology; D003430:Cross-Sectional Studies; D004634:Emergency Medical Technicians; D004635:Emergency Medicine; D005240:Feasibility Studies; D005260:Female; D019538:Health Care Surveys / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D009203:Myocardial Infarction / Q000628:therapy*; D010102:Oxygen Inhalation Therapy / Q000401:mortality; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D006113:United Kingdom