BTS has authored a number of Guidelines and Quality Standards addressing both emergency and home oxygen use, and these are supported by various tools to assist with implementation of the recommendations. 

Emergency Oxygen Guidelines

The 2017 BTS Guideline for oxygen use in adults in healthcare and emergency settings is available here. The new Guideline includes:

  • Teaching slide sets aimed at nursing and medical staff (Appendix 8) and doctors (Appendix 7) to aid dissemination of key recommendations.  
  • Key messages for primary care and hospital managers (Appendices 9 and 10)
  • Summaries for hospital and pre-hospital/ambulance settings (Appendices 3 and 5)
  • Oxygen policy template for prescription and administration of oxygen (Appendix 4)
  • Oxygen alert cards help to ensure that patients receive the correct level of oxygen in an emergency by setting out appropriate target saturation levels (see page 62 and Word version here). 

Home Oxygen Quality Standards

Quality Standards for Home Oxygen in Adults were published in September 2017 to support the BTS Guidelines in this area and are available here. Appendices include:

  • Risk mitigation and referral forms
  • Protocols for ambulatory and palliative oxygen 
  • NICE referral criteria

Department of Health commissioning toolkits are also available for home oxygen assessment and review.   

Updated National Early Warning Score (NEWS2)

NEWS2 was published in December 2017 and features a number of refinements including an improvement in recording of the use of oxygen and the scoring of recommended oxygen saturations in patients with hypercapnic respiratory failure (most often due to COPD). Read more on the RCP London website here: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2

Clinical Audit

BTS Emergency Oxygen Audits have run since 2008. Over this period significant improvements have been seen but there is still work to do, particularly in relation to prescription of oxygen with a target saturation range. Please see the 2015 audit report for details of where issues remain and recommendations for improvement. The audit tool is available outside of national audit periods for local re-audit. 

Respiratory Futures

The Respiratory Futures website features a dedicated Oxygen section which hosts a range of tools and information.  


October 2017