Oxygen. . . Can that drug by itself save lives?

[akroeze]

The use of O2 in a prehospital setting has been proven many times to be beneficial to the patient.

If it wasn't it wouldn't be in the text books.

There are many things wrong with this kind of statement.

[ERDoc]

The use of O2 in a prehospital setting has been proven many times to be beneficial to the patient.

If it wasn't it wouldn't be in the text books.

Does every patient need it ?

No, of course not but you take one patient into an ED anywhere that should have been on 02 and you chose not to put them on 02 because your "experience" told you not to and see how fast you get chewed a new one.

Statements like this require evidence. "It's in my EMT book," is not evidence. I've seen old EMT books that say you should apply cervical spine traction in neck injuries. Do you still do that? While you may be right, you need to back up your statement with evidence for it to be a worthwhile arguement.

[MTNMANMEDIC]

Doc you just reaffirmed my statement.

Yes, older textbooks do say to hold traction on the C-spine but medical science has progressed and we now know that was the wrong thing to do.

Older texbooks also said to give O2 as do the newer textbooks.

Giving O2 has not been proven to be the wrong thing to do.

If anything it has progressed and we have taken the humidifiers off the trucks along with the on demand valves and straight 02 masks and replaced them with NRB's.

Remember the explosion scare of the early 90's ?

We didn't take 02 off the trucks, we switched the trucks to diesel from gas.

I could show you dozens of examples, what are we playing here I'll show you mine if you show me yours ?

I actually saw a Medic bring in a COPD patient to the ED, with no O2 on her.

He cited the hypoxic drive therory as his reason.

Now mind you the patient was on 3 liters O2 at home by way of NC.

The pt. was stating at around 89%, the family was addament that her doctor told them to maintain her stats at 94%.

What was the first thing done once she reached the ED ?

3 liters O2 by NC, lasix.....etc.

She was discharged the same evening.

The Medic was discharged 3 weeks later after a board of review.

I hear self educated medics citing studies that say withhold 02 from stroke patients but

At present, stroke patients receive variable amounts of oxygen in the ambulance and current guidelines do not support the routine use of in-hospital oxygen.18 An observational study found worse 1-year survival in patients with mild-to-moderate stroke who received oxygen.30 However, in that study, a substantial proportion of "treated" patients did not receive oxygen, low doses (3 L/min) of oxygen were administered for as long as 24 hours, the time to therapy was relatively late, and 12.7% had primary brain hemorrhage. In light of our preclinical and clinical experiences, we believe that further studies are promptly needed to investigate the utility of high-flow oxygen in acute ischemic stroke (both in the prehospital setting and as an adjunctive therapy with tPA), and to determine the optimum duration of therapy. NBO may ultimately prove to be a simple, widely accessible, and potentially cost-effective therapeutic strategy that improves stroke outcomes around the world.

[akroeze]

Doc you just reaffirmed my statement.

Yes, older textbooks do say to hold traction on the C-spine but medical science has progressed and we now know that was the wrong thing to do.

Older texbooks also said to give O2 as do the newer textbooks.

Giving O2 has not been proven to be the wrong thing to do.

If anything it has progressed and we have taken the humidifiers off the trucks along with the on demand valves and straight 02 masks and replaced them with NRB's.

Remember the explosion scare of the early 90's ?

We didn't take 02 off the trucks, we switched the trucks to diesel from gas.

I could show you dozens of examples, what are we playing here I'll show you mine if you show me yours ?

I actually saw a Medic bring in a COPD patient to the ED, with no O2 on her.

He cited the hypoxic drive therory as his reason.

Now mind you the patient was on 3 liters O2 at home by way of NC.

The pt. was stating at around 89%, the family was addament that her doctor told them to maintain her stats at 94%.

What was the first thing done once she reached the ED ?

3 liters O2 by NC, lasix.....etc.

She was discharged the same evening.

The Medic was discharged 3 weeks later after a board of review.

I hear self educated medics citing studies that say withhold 02 from stroke patients but

At present, stroke patients receive variable amounts of oxygen in the ambulance and current guidelines do not support the routine use of in-hospital oxygen.18 An observational study found worse 1-year survival in patients with mild-to-moderate stroke who received oxygen.30 However, in that study, a substantial proportion of "treated" patients did not receive oxygen, low doses (3 L/min) of oxygen were administered for as long as 24 hours, the time to therapy was relatively late, and 12.7% had primary brain hemorrhage. In light of our preclinical and clinical experiences, we believe that further studies are promptly needed to investigate the utility of high-flow oxygen in acute ischemic stroke (both in the prehospital setting and as an adjunctive therapy with tPA), and to determine the optimum duration of therapy. NBO may ultimately prove to be a simple, widely accessible, and potentially cost-effective therapeutic strategy that improves stroke outcomes around the world.

You know what else we have been doing for years and has "always" been in the text books? Back boards.

Now we're starting to think that maybe they aren't so great afterall.

Just because something has always been there, doesn't mean it is right. They always used to think the world was flat....

Also just as a note, it's considered good practice to provide a link to your source when you quote studies

[sledogg1]

O2 is the strongest drug in your kitbag, without it all others are worthless.

[JPINFV]

O2 is the strongest drug in your kitbag, without it all others are worthless.

Are you putting forth that without supplemental O2, then your epi, lasix, morphine, and any other drug you have will not work?

[AnthonyM83]

MtnMedic, in reference to "Giving O2 has not been proven to be the wrong thing to do.":

in medicine you don't just want proof that it's not harmful to patient, but that it's actually the right thing to do. It's fine if you're just pointing out that it's not harmful (thought people will bring up studies against that in certain cases), but you're trying to justify the use of O2 not based on proof/support/evidence, but based on convention and the fact we've used it for awhile.

ERDoc didn't actually reaffirm your statement which was "O2 in a prehospital setting has been proven many times to be beneficial to the patient". Rather he pointed out that you were not using "proof", rather "convention" and historical acceptance of O2 in medicine. "That's the way everyone's been doing it for years, so it must be right" doesn't work in these discussions in medicine, because you have to build only on evidence...otherwise if 1 out of 1,000 things you accept as true without proof turns out to be false, then every development after that is also based on a false theory and the pyramid might crumble eventually and people won't know where they went wrong.

I hear self educated medics citing studies that say withhold 02 from stroke patients but

Heh, that's actually a good point. I made that mistake after hearing stuff about shock position on this forum, then actually re-reviewed the studies and realized they were far from conclusive.

[JPINFV]

Heh, that's actually a good point. I made that mistake after hearing stuff about shock position on this forum, then actually re-reviewed the studies and realized they were far from conclusive.

But is there conclusive proof that it works?

[sledogg1]

If there is not any o2 in the ol system then the drugs don't circulate and then they become useless cause u are dead. Pink good blue bad

[JPINFV]

If there is not any o2 in the ol system then the drugs don't circulate and then they become useless cause u are dead. Pink good blue bad

Err, so again, are we talking about room air oxygen (i.e. not a drug) or supplemental oxygen (i.e. a drug)? Yes, if you are dead then the drugs probably won't work (i.e. cardiac arrest + ACLS drugs), but the vast majority of the world's population does not need supplemental oxygen to survive. We can survive just well on room air oxygen.