Oxygen rate for Chest Pain?

[Richard B the EMT]

OK, I am not a researcher. If a researcher wants to use data I normally generate from a response, fine and good. If my On Line Medical Control Physician tells me to use a different protocol for an AUTHORIZED test, I will follow the different protocol, noting on all appropriate paperwork that I am doing so, and why, along with whatever results I do or do not achieve.

Cookie cutter? Perhaps. I am not in any position to go outside existing protocols without it biting me in the ass, but, as I have stated in other postings on this string, when the APPROVED ALTERNATE protocol is taught me, and I am advised to use it fulltime, let us say, I then have a new cookie cutter.

Now, would someone advise me what is Godwin's Law?

[Richard B the EMT]

OK, I am not a researcher. If a researcher wants to use data I normally generate from a response, fine and good. If my On Line Medical Control Physician tells me to use a different protocol for an AUTHORIZED test, I will follow the different protocol, noting on all appropriate paperwork that I am doing so, and why, along with whatever results I do or do not achieve.

Cookie cutter? Perhaps. I am not in any position to go outside existing protocols without it biting me in the ass, but, as I have stated in other postings on this string, when the APPROVED ALTERNATE protocol is taught me, and I am advised to use it fulltime, let us say, I then have a new cookie cutter.

Now, would someone advise me what is Godwin's Law?

[JPINFV]

http://en.wikipedia.org/wiki/Godwin's_Law

I'll have to remember that one.

[Dustdevil]

Minus 15 for quadruple posting. :?

[Richard B the EMT]

Thanks for the link to Godwin's Law.

As to the multiple postings, sorry, frozen screen lead to accidental multi-postings. Most here know I would not usually do that.

[iMac]

I think it's a case by case thing. Some patients will present with very obvious signs and symptoms that warrant high flow O2. Having said that in some patients I will use a NC to keep them calm thus reducing some of the symptoms they are complaining of.

When it comes down to it high flow O2 won't hurt them and all you have to do is change the tank after the call if need be which is also something thats easy to do. If you arent sure just go with high flow.

[AnthonyM83]

When it comes down to it high flow O2 won't hurt them and all you have to do is change the tank after the call if need be which is also something thats easy to do. If you arent sure just go with high flow.

Uhh...that's the whole discussion we're having about how it actually could be hurting them...

Also, do people have studies on how high flow O2 increases cardiac output...?

[ccmedoc]

Uhh...that's the whole discussion we're having about how it actually could be hurting them...

Also, do people have studies on how high flow O2 increases cardiac output...?

Comanche should read the research article and perhaps the first few pages of post.

I doubt you will find any articles indicating increase in cardiac output with high FiO2 oxygen administration. Mostly due to the increase in peripheral vascular resistance, lowering of heart rate, and the probability of a weak heart, as noted in the article and comments in the first couple of pages of posts. Some studies may downplay the potential cardiac ischemia from increased O2 administration.. Debateable at best. If vasoconstriction is present, central and peripheral, cardiac ischemia is obviously an issue to be strongly considered. I think the biggest argument can be made as to how fast the resultant vasoconstriction comes about, but this is largely case by case and dependant on the health and Hx of the patient in question.

I was not advocating going against protocol in my post, only questioning them to the appropriate officials when they are potentially harmful. It seems that most are not seeing the difference in trying to enhance treatment for patients and defying med control..

[AnthonyM83]

I was actually thinking about that at work the other day. How long the vasoconstriction takes. This is extremely important, because the patient could be missing out on a good deal of oxygen. I think saying it's largely case by case is sidestepping the issue, though. What factors does the onset of vasoconstrction depend on?

[canadian_ghost]

My protocol is for 10 lmp on a NRB for any chest pains, obviously think outside the box and adjust accordingly to the nature of the call and the way the patient responds to treatment. Is it really necessary to have a patient on 10 lmp via NRB when 4 lmp NC will do ? I guess it all depends on the situation at hand and the attending medic ?