A Prehospital Apneic Oxygenation Protocol Correlates with Fewer Desaturations

Prior small studies have demonstrated that paralyzed patients desaturate less rapidly when high-flow oxygen is provided via a nasal cannula, which supports the concept that oxygen passively circulates through the glottis and into the alveoli. A paramedic system in Australia instituted such an apneic oxygenation protocol, and investigators retrospectively compared the frequency of desaturation (defined as oxygen saturation <93%) before and after.

During the baseline period, in which apneic oxygenation was used at provider discretion, 22.6% of 310 patients desaturated. During the intervention period, in which apneic oxygenation was required by protocol but compliance was not monitored, 16.5% of 418 patients desaturated.