Oxygen rate for Chest Pain?

[AnthonyM83]

Now, if your assessment shows all vitals in normal range and the pain is not radiating I feel a NC would be sufficient.

Why would that matter? If you already believe the CP to be cardiac in nature based on asking all those questions, why would non-radiating get low flow and radiating high flow?

Obviously any SOB/resp. distress would make you reevaluate your low flow decision, but for purposes of this discussion we're assuming non SOB so it doesn't taint the cardiac discussion.

[ccmedoc]

Yeah, oxygen is considered a drug for a reason ----Anthony, you are correct in your assumptions--this article should do fine by you. --Steve

[katbemeEMT-B]

Why would that matter? If you already believe the CP to be cardiac in nature based on asking all those questions, why would non-radiating get low flow and radiating high flow?

Obviously any SOB/resp. distress would make you reevaluate your low flow decision, but for purposes of this discussion we're assuming non SOB so it doesn't taint the cardiac discussion.

Let me start by saying sorry for what appears to be not finishing my statement earlier or maybe even leaving misleading words. The kids were bugging me and the phone was ringing. As I also missed that this is a definite cardiac issue. I did not mean radiating gets high flow and non-radiating gets low flow. My point was supposed to be if vitals are stable than NC should do. I was taught you start small and go bigger as need.

Once again, sorry.

[akroeze]

Go big or go home. That's why I tube all my chest pain patients. I was taught that the only definitive airway is an ETT and obviously without A you can't go on to B or C so I first secure A.

[tniuqs]

Go big or go home. That's why I tube all my chest pain patients. I was taught that the only definitive airway is an ETT and obviously without A you can't go on to B or C so I first secure A.

Straight up...Your scaring me man, just because one "can" shoot a tube doesn'tt mean that blanket statement "get a tube" have you been following the CPAP vs PEEP thread...maybe you should?

Now first off you identify yourself as a PCP...is ETT even an option for you out there in Ontario... cause it aint here and over my dead body will that happen, without drugs to keep a tube in, one is not doing the best thing for the patient. AND when a tube goes in then it must come out, Ventilator aquired nosocomial infections, excessive costs +++ look at the intubated patients "discharge to door" vs non-intubated patients...hmmmm, i need say no more. The mark of an good Paramedic is do no harm first..!

Back to the regular sheduled topic, nicely done there ccmedoc I to believe that the "paradigm buster" that you included to support your opinion is well founded and appears a very valid study....only in Britian you say? Yes, we sometimes just follow wrote protocol for years without raising the question is Hi flow O2 the BEST for the patient ? Lots of studies are pointing to the fact that this may NOT be the optimal treatment, that said follow ones protocols and present the studies to the Topside Director for review.

cheers

[JPINFV]

^

I get the feeling that he was being sarcastic. that said, I also go for the trache. Better for long term care and less chance at dislodgeing it.

[ccmedoc]

Thank you and all I can say is please, PLEASE, people think outside the box and ask questions. If it doesnt seem correct, ask questions. If you need more studies on this subject dont hesitate to ask...."times they are a changin'"-Steve

[AnthonyM83]

I rather love paradigm busters...

Thanks for the paper. Still reading through it.

[Jon_E]

Well, if you follow ACLS protocol, CP Pt. should get 4lpm NC. Also I read somewhere that high flow O2 'increases free radicals' in the bloodstream, have been meaning to research that last one there, but havent had time yet. I know free radicals have been linked to cancer. Anyway, they tell ya in basic class to give high flow o2, but I think 4lpm would suffice. Also, remember that your pulse ox really isnt that accurate, takes 3-4 minutes for it to register a drop in O2 sat. ETCO2 is the way to go.

[AZCEP]

ACLS is not a protocol. AHA will not tell providers that they have to do anything. They will only recommend, based on the evidence they have.

The current recommendation is to provide the lowest possible flow rate to maintain an SpO2 >90%. If there are signs of respiratory distress, you can increase as needed. This has already been mentioned several times in this, and many other threads.