Who does this guideline apply to?

This guideline applies to adults, children and infants.

Who is the audience for this guideline?

This guideline is for use by bystanders, first aiders and first aid training providers.

Recommendations

The Australian and New Zealand Committee on Resuscitation (ANZCOR) makes the following recommendations:

1. Basic Life Support measures should never be delayed whilst waiting for oxygen or other equipment. [Good Practice Statement]
2. The administration of supplemental oxygen should be limited to individuals with specific training in oxygen administration.^1,2 [Good Practice Statement]
3. When bag-valve-mask oxygen resuscitation is used by trained but occasional operators, a minimum of two trained rescuers are required to provide ventilation for a non-breathing person. [Good Practice Statement]
4. Persons who require supplemental oxygen in a first aid setting be further evaluated by a health care professional. [Good Practice Statement].

Abbreviations

Administration of supplemental oxygen is traditionally considered essential for individuals presenting with shortness of breath, difficulty breathing, or hypoxemia (low oxygen level in the blood). In certain circumstances, oxygen supplementation might have adverse effects that complicate the disease course or even worsen clinical outcomes.¹ The administration of supplemental oxygen should be limited to individuals with specific training in oxygen administration.^1,2 [Good practice statement]

There is evidence to support the use of oxygen as part of first aid management of decompression illness¹ and for shortness of breath (dyspnoea) in cancer patients with hypoxaemia.¹

The use of oxygen delivery devices, such as bag-valve-mask equipment and oxygen powered resuscitation equipment, should also only be undertaken by those who are trained in their use (with current training and certification). [Good Practice Statement]

There are many types of oxygen delivery devices available, ranging from the simple oxygen mask, which can be used with very little training, to the more complex bag-valve-mask ventilation equipment.

It is recommended that when bag-valve-mask oxygen resuscitation is used, a minimum of two trained people are required to provide ventilation for a non-breathing person: one to manage the airway, mask and seal, and the second to operate the bag.³ [Good Practice Statement]

If two trained people are not available to provide ventilation for a non-breathing person then mouth-to-mask breathing using a resuscitation face mask with supplemental oxygen will provide adequate oxygenation and ventilation.⁴ [Refer to ANZCOR Guideline 5].

Basic Life Support measures should never be delayed whilst waiting for oxygen or other equipment.⁶ [Good Practice Statement]

In the non-breathing person, oxygen may be used if available by mouth-to-mask, bag-valve- mask or positive pressure oxygen delivery system, if the appropriate equipment and personnel with current training and certification in its use are available. [Good Practice Statement]

A person who requires supplemental oxygen in a first aid setting requires further assessment by a health care professional so an ambulance must always be sent for. 

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8. National Stroke Foundation. Clinical Guidelines for Stroke Management 2017. Chapter 3 of 8: Acute medical and surgical management. Melbourne. Retrieved 20 November 2020 from https://informme.org.au/en/Guidelines/Clinical-Guidelines-for-Stroke-Management-2017: National Stroke Foundation, 2017.
9. Chew D, Scott I, Cullen L, et al. National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of acute coronary syndromes 2016. Med J Aust 2016; 205(3): 128.
10. Stub D, Smith K, Bernard S, et al. Air versus oxygen in ST-segment–elevation myocardial infarction. Circulation. 2015 Jun 16;131(24):2143-50.
11. Singletary EM, Zideman DA, Bendall JC, et al. 2020 International Consensus on First Aid Science With Treatment Recommendations. Circulation 2020; 142(16_suppl_1): S284-S334.
12. Singletary EM, Zideman DA, Bendall JC, et al. 2020 International Consensus on First Aid Science With Treatment Recommendations. Resuscitation 2020; 156: A240-A82.
13. Nikolaou NI, Welsford M, Beygui F, et al. Part 5: Acute coronary syndromes 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2015; 95: e121-e46.