title: Improving the safety of oxygen therapy in the treatment of acute myocardial infarctions.
abstract: OBJECTIVE
  The article examines the evidence for giving oxygen routinely to patients with suspected myocardial infarction, and addresses the challenges in changing practice.
  
  
  BACKGROUND
  It has been thought that administering oxygen to patients suffering from acute myocardial infarctions may be beneficial, but there is a lack of supporting evidence. Furthermore there is evidence that the use of oxygen in some circumstances may not improve clinical outcome. Despite conflicting evidence, guidelines in the past have recommended supplementary oxygen as part of treatment. Therefore it was necessary to understand and identify best practice.
  
  
  METHODS
  Evidence was collated using electronic databases. Search terms included 'acute myocardial infarction' 'acute coronary syndrome' 'oxygen' and 'hypoxia', 'hyperoxaemia'.
  
  
  CONCLUSIONS
  A systematic review of studies did not confirm that the use of routine oxygen in the acute stages of a myocardial infarction reduces myocardial ischemia. In reality, some evidence suggests that oxygen may even increase myocardial ischemia. Therefore it is crucial that emergency care nurses/practitioners across the world use observation skills and monitoring such as pulse oximetry to recognise the clinical need for supplementary oxygen to be given to a patient.
authors.affiliation: Emergency Department, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8HW, United Kingdom. Maria.Britton@uhbristol.nhs.uk
authors.forename: Maria
authors.initials: M
authors.lastname: Metcalfe
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D010092:Oximetry; D010102:Oxygen Inhalation Therapy