During ACLS, how should supplementary oxygen be provided?

During ACLS, how should supplementary oxygen be provided?

• A. Titrate to SpO2 ≥ 94% by pulse oximetry in non-arrest victims
• B. Keep oxygen at 100% for all patients
• C. Only give oxygen if the patient is short of breath
• D. No supplemental oxygen is needed

Answer: (A)

The main idea is to use oxygen only as needed and base the amount on pulse oximetry to avoid both low oxygen and excessive oxygen. In non-arrest patients during ACLS, aim to keep the oxygen saturation at or above 94% by monitoring with a pulse oximeter, and adjust the inspired oxygen accordingly. If the SpO2 drops below 94%, increase FiO2 to raise it above that threshold, then titrate down to avoid unnecessary high oxygen levels. This approach minimizes oxygen toxicity and vasoconstriction risk while ensuring tissues aren’t hypoxic. In contrast, delivering 100% oxygen to everyone isn’t ideal because it can harm patients who don’t need that much oxygen, and no supplemental oxygen when it’s needed would risk hypoxemia. After return of spontaneous circulation, continue to titrate to a target saturation (generally around 94–99%) rather than maintaining 100%.

The main idea is to use oxygen only as needed and base the amount on pulse oximetry to avoid both low oxygen and excessive oxygen. In non-arrest patients during ACLS, aim to keep the oxygen saturation at or above 94% by monitoring with a pulse oximeter, and adjust the inspired oxygen accordingly. If the SpO2 drops below 94%, increase FiO2 to raise it above that threshold, then titrate down to avoid unnecessary high oxygen levels. This approach minimizes oxygen toxicity and vasoconstriction risk while ensuring tissues aren’t hypoxic. In contrast, delivering 100% oxygen to everyone isn’t ideal because it can harm patients who don’t need that much oxygen, and no supplemental oxygen when it’s needed would risk hypoxemia. After return of spontaneous circulation, continue to titrate to a target saturation (generally around 94–99%) rather than maintaining 100%.