Oxygen rate for Chest Pain?

[Dustdevil]

I would say stick to the book on this one, more O2 can hardly hurt them, unless they are COPD (am i thinking of the right illness?)...

Rule #1: To avoid looking really silly and/or clueless, always read the entire thread before posting in it. :wink:

[tniuqs]

Yes ageed there dust or in teaching RTFQ...tater dude yes thats the whole point of this thread....High FiO2s CAN hurt the patient! your new so follow the whole thread...k?

Ok now in "medic land" the application of a NRB is often called hi-flow, unfortunatly in Respiratory speek HI FLOW is defined as exceding the INSPIRATORY DEMAND of the patient x 4, this means inspiration, that is variable and dependant upon that patients needs, and can exceed 40 liters per minute !

RR (a biggy), the depth of breathing, = minute volume, sooo the if the I:E ratio is say 1:4, and the patients minute volume is say 10 lpm (typically someone who is in respiratory extremus) then do the math.

No matter how high you twist that "thorpe tube" flow control (and it will deliver ~ 23 lpm on average) now even if the NRB baggy is reinflating with every breath, AND the mask is a good seal one is NOT I repeat NOT delivering 100% O2...sorry to tell you this but its true!this is a means of teaching in school, a very idealistic approach, but your not in school no more.

OMG...don't tell me that your using really using these high flows on a bagger (ps This will deliver 100% and due to the resevour size not flows)

BUT hear me loud and clear....YOU COULD BE AUTO PEEPING the patient, with hi flows going into the bagger then exhalation can be impaired resulting in IATROGENIC AUTO PEEP.....this can lead to a relative hypovolemia.....or as commonly called a PEA. If this occures in the comprimized patient ie lowered BP or no BP.....SLOW freaking down and allow for equilibration, like take your hand off the bagger for up to 90 full seconds...that said back to the originally sheduled programming.

AntonyM83 : ...I like the way you think, nerdy logic LMFAO! but if your not getting decient Sats on 15 lpm with a NRB...time for da tube or CPAP or BIPAP 10 more lpm aint going to do it....although is is kewl to refill all those tanks or change out your Ds enroute to the gut wagon..... your not helping the patient if your delivering 25 one minute and room air the next.

ps not spell checked off to work!

cheers

pppss...GETTO CPAP.....te he he.

[Richard B the EMT]

If possible, can you replace that ball in tube style regulator? Get one with a click to flow level type, or at least a round gauge type?

Unless my memory has gone (more), the ball in tube style is in disfavor, as with the tilt to lay it down can cause the tech to inaccurately read it.

[AnthonyM83]

I'll ask about ordering different ones. The main problem we have with them, is the ball getting stuck. We endup doing it by how inflated the reservoir bag is. Smaller patients who take small rapid breaths might keep the reservoir bag inflated, but be rebreathing a good amount of exhaled air.

[Dustdevil]

I'll ask about ordering different ones. The main problem we have with them, is the ball getting stuck. We endup doing it by how inflated the reservoir bag is. Smaller patients who take small rapid breaths might keep the reservoir bag inflated, but be rebreathing a good amount of exhaled air.

Bourdon gauges are notoriously inaccurate. That's why they are not used in the hospitals. And not all Bourdons flow any higher than a Thorpe tube. Rates vary from manufacturer to manufacturer, and from model to model. And, so long as you set the rate while the tube is upright, it doesn't matter what it reads while lying down. But Thorpe tubes are pretty delicate and pretty expensive. I certainly wouldn't choose one for my portable O[sub:bd8a996316]2[/sub:bd8a996316] setup. And really, are you going to have anybody on portable O's long enough to make a difference anyhow?

That said, what difference does it make? Either the flow is adequate for NRB function or it isn't. As stated above, the number is completely irrelevant. It is not even necessary to chart a flow rate when utilising an NRB. You should be able to do it without a gauge or tube.

[BushyFromOz]

[tniuqs]

Is this "renegadism" rearing its ugly head once again?

cheers

[AnthonyM83]

Well, our portables use the dial with specific flow rates you can click to, but the house O2 uses the floating ball and tube regulator.

My concern with the ball/tube regulator that sticks is that smaller patients with low tidal volumes with quick respiratory rates might be rebreathing their same exhaled air from the mask and not even using the pure O2 from the reservoir bag.

If it's working, I just make sure it's above 8lpm or so, THEN adjust flow rate to patient without really looking at the number. If it's lower than that (or meter not working correctly), you might end up with a flow rate too low to mostly displace patient's exhaled air from mask.

Or so, I think.