O2 administration

[rock_shoes]

Straight from my class: never withhold O2

I've always been under the impression that cardiac pts get 15 lpm nrb. That's what they aught me in basic.

I'm going to be blunt because I think you can take it. Your class was wrong in that respect.

Oxygen must be treated like any other drug. Only use it when indicated, and titrate it to effect.

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[Bieber]

An addendum to Rock's post for Dilaudid, since you mentioned it in your post about oxygen usage per your class: the AHA does not recommend routine use of oxygen in uncomplicated MI's. Theres evidence that it increases the size of the infarct and increases mortality.

Edited July 29, 2012 by Bieber

[Arctickat]

Just back from watching my beloved football team, (soccer for you Europeans I think) blow an 18 point lead in the last 5 minutes of the game; I'm reading this and think I might be misunderstood. As Kiwi states, judicious use of O₂ would be indicated in the COPD patient. Ideally maintaining the sats in the low 90s where the non COPD patient you'd be trying to get 100%. My comment regarding the Hypoxic drive was simply in response to the concept of withholding O₂ entirely for the COPD patient.

[EMTDenny]

I did not read every reply but I was I was told during my training you can never go wrong with administering o2.

Not that I use it with every PT. LOL

[emtdennis]

Has anyone had a service change its O2 protocol due to the finding that it can be harmful to patients in the long run?

I understand New York DOH is supposed to be changing their protocols later this year, to the extent of using venturi type masks, also reducing the requirements for NRMs.

Edited July 31, 2012 by djdudley

[DFIB]

If I remember correctly the EMT text mentions that "every patient can benefit from O2"

Research shows that hyperventilation produces free radicals particularly in ischemic tissues, making the previous statement debatable to say the least.

[Vorenus]

I did not read every reply but I was I was told during my training you can never go wrong with administering o2.

Not that I use it with every PT. LOL

Was told the same in training, with the exception of COPD and propable problems with ventilation drive (although grandly exxagerated).

But most studies concerning the propable harmfulness of hyperoxaemia are of newer origin, hence why the recommendation of careful use in ACS only made it into the 2010 AHA/ERC guidelines.

Another example why it`s important to stay up-to-date in this business.

[emtdennis]

We were taught that when transporting a COPD pt, we were to use humidified O2 only in the event of a long ride >20 mins, otherwise normal O2 at a reduced rate (6 LPM) only if the pt required it.

[Vorenus]

We were taught that when transporting a COPD pt, we were to use humidified O2 only in the event of a long ride >20 mins, otherwise normal O2 at a reduced rate (6 LPM) only if the pt required it.

Guess that`s one of the major regional differences - since we never had standing protocols like 15 lpm for most pt. (like I seem to remember exist/existed in the US), we were always a tad more selective about usage of O2 anyways,

[rock_shoes]

We were taught that when transporting a COPD pt, we were to use humidified O2 only in the event of a long ride >20 mins, otherwise normal O2 at a reduced rate (6 LPM) only if the pt required it.

So no titration of O2 to maintain something resembling physiologic norms for a patient's pathology? Just 6 LPM or nothing?

I know educational practices are due for some serious revamping but we need to stop doing things that harm patients the instant we find out the practice is harmful.

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