Results: One retrospective study presents very-low-quality evidence that there is no benefit of supplemental oxygen administration for reducing death, the need for assisted ventilation, and respiratory failure for patients with acute exacerbation of chronic obstructive pulmonary disease. One randomized controlled trial presents low-quality evidence showing the benefit of supplementary oxygen administration for treatment of shortness of breath in cancer patients with dyspnea and hypoxemia. A meta-analysis and four randomized controlled trials present low-quality evidence of no benefit for advanced cancer patients with dyspnea without hypoxemia for shortness of breath. Oxygen administration was found to have a positive effect on oxygen saturation.

Outcomes: No evidence was found for or against routine administration of supplemental oxygen by first-aid providers. Supplemental oxygen administration has been found to be of some benefit in specific circumstances, including advanced cancer patients with dyspnea and hypoxia as well as individuals with decompression injuries. Oxygen provided to patients with hypoxemia helped them reach normal oxygen levels.

Discussion: There is no recommendation for the use of supplemental oxygen as the evidence is conflicting and too low quality to recommend a change to current practice. The use of supplemental oxygen should be limited to individuals with specific training in oxygen administration.

Recommendation: No recommendation.

Note from Dr. Mell: Providing supplemental oxygen does not appear to improve outcomes for patients with dyspnea. Emergency physicians do not need to routinely carry oxygen as part of first-aid kits.