New A
East Anglian Ambulance NHS Trust, Hospital Lane, Hellesdon, Norwich NR6 5NA.
Emerg Med J. 2006 Feb;23(2):144-6. doi: 10.1136/emj.2005.027458.
High concentration oxygen therapy has long been a mainstay of prehospital treatment. Guidelines for its administration have for many years also cautioned its use with patients with chronic obstructive pulmonary disease (COPD). Successive guidelines and prehospital textbooks have advocated the use of 28% oxygen masks and re-emphasised the importance of the dangers of hyperoxia, often drawing upon the classic theory of hypoxic drive. Despite this, the reality remains that ambulance crews have tended to overoxygenate such patients. One study demonstrated that 80% of patients sampled with acute exacerbation of their COPD received oxygen in excess of 28% from the ambulance crew. Is this a worrying development or a reassuring sign that prehospital providers are rightly more concerned about the dangers of hypoxia than hyperoxia? And if the guidelines are right, then how are the hearts and minds of ambulance paramedics and technicians won?
高浓度氧疗长期以来一直是院前治疗的主要手段。多年来，关于其使用的指南也一直告诫要谨慎用于慢性阻塞性肺疾病（COPD）患者。后续的指南和院前急救教材都提倡使用28%氧面罩，并再次强调高氧血症危险的重要性，这往往借鉴了经典的低氧驱动理论。尽管如此，现实情况仍然是，救护人员往往会过度给这类患者吸氧。一项研究表明，80%的慢性阻塞性肺疾病急性加重期抽样患者从救护人员那里接受了超过28%的氧气。这是一个令人担忧的情况，还是一个令人安心的迹象，表明院前急救人员正确地更关注低氧血症而非高氧血症的危险呢？如果指南是正确的，那么如何才能让救护人员和技术人员信服呢？
