Translations:Sauerstoff in der Notfallmedizin/6/en

Oxygen should be given to any patient with thoracic pain, suspected oxygen deficiency of any cause and cardiac arrest as an initial measure (Class I recommendation of the AHA and ERC). There are no toxic side effects of oxygen in the acute care of the patient. Damage caused by excessive oxygen intake can only be observed after more than three to five days. During resuscitation, there is no dosage other than 100% oxygen, regardless of the cause of clinical death. In still responsive patients with acute airway obstruction (exacerbated COPD, asthmatic status), there is a certain caution when applying too high doses of oxygen. Because the respiratory drive caused by hypoxia can be inhibited by too high doses of oxygen - usually only over two litres per minute - and CO₂anaesthesia results. However, it should also be borne in mind that severe hypoxia caused by acute obstruction of the respiratory tract (asthma, COPD) leads to an oxygen deficiency of the myocardium and thus to severe ischemia, which leads to circulatory shock and ultimately to the death of the patient. Therefore, even in severe asthma attacks with hemodynamic impairment, the administration of high doses of oxygen is necessary to counteract this mechanism. As a side effect, the patient can recover in the same way as he could become intubated, which is unavoidable in this situation. The dosage here ultimately depends only on the haemodynamic situation of the patient. Including oxygen even in this situation, the severe status of asthma, would therefore be a mistake due to ignorance - under the banal common idea that oxygen in high doses is contraindicated in acute respiratory obstruction.