Oxygen rate for Chest Pain?

[Richard B the EMT]

My interpretation of the thread was questioning "yes" or "no" to blindly following "cookie cutter" standing orders and/or protocols, allowing for national, state/provence, county, or departmental protocols and medical control interpretations, regarding oxygen flow rates for chest pain. I also thought the question was asked if less flow was possibly less hazardous to the patient, who might have additional problems that could be aggravated on the high flow.

That, I believe, is what the questions of the string were.

What were your interpretations of questions found within this string, if different from mine??

[AnthonyM83]

Well, the harm/helpfullness of O2 WAS the original question in the thread, but then it was explained several times why that thinking was wrong. I think that's why ccmedoc was banging his head. He had just finished explaining the true physiology of that for like the 4th time, with studies to back it up.

[Richard B the EMT]

Well, then, there will always be 1) those who try to follow the book, no matter what, 2) those who follow the book, but reach out if something seems "off" with any particular patient to their medical control, 3) those under directive to experiment within specified limits, and 4) under their protocols, carte blanque for experimentation, with suggested guidelines but no direct medical control, like areas where the trip to a hospital is measured in days, unless a medevac.

Put me in the second category.

[danielir]

there is NO contraindication to hi-con o2 in the field.

That being said, i think it is safe to say that CP gets 4lpm via NC. If they are SOB, have ANY s/s of shock, or are otherwise unstable for any other reason ie: ams, adventitious l/s, etc, slap on a nrb.

Dont be offended when the medic walks in the room and takes off the mask, replacing it with a NC, sometimes its just unnecessary.

[Dustdevil]

there is NO contraindication to hi-con o2 in the field.

Correction. There is no absolute contraindication to hi-con O[sub:b38e3f8bb1]2[/sub:b38e3f8bb1] in the field.

Dont be offended when the medic walks in the room and takes off the mask, replacing it with a NC, sometimes its just unnecessary.

Thanks for the quote of your protocols, but what we are trying to intelligently discuss here is scientific rationale. Can you tell us what yours is?

[tniuqs]

Doesn't everybody have New Unabridged Kanukistanian Dictionary in their repetoire?????

-steve

The cc means whatever you want it to mean, I'm flexible:lol:

Quote some duke:

Correcting the Correction. There is no absolute contraindication to hi-con O2 in the field, edit[/font:af197142a3] at this point in time, (hopefully) in the ongoing devlopment of EMS and evidence based medicine research will be applied some day.

I am beginning to believe that the New Unabridged Kanukistanian Dictionary is not currently available at most book stands at the 7/11 ? a sad commentary.

YET .... "How to Make Kookies" is a best seller.

cc could be critical care ? I'm just saying.....

cheers

[emt322632]

I've been slapped on the wrist multiple times for not following NYS BLS protocol when delivering O2 to my patients. The head of the CQI Committee in my organization believes if a pt gets O2 then they deserve a NRB at 15Lpm. If they can't tolerate it, they get a NC at 6Lpm...

They haven't really offered me any rationale other than "it's protocol..." I'll give them that...it is protocol...

But why should someone who is satting at 98% get O2? Why should someone satting at 94% get 15Lpm?

I really enjoyed that article by the way, felt like posting it at my squad for everyone's review :-)

[CBEMT]

But why should someone who is satting at 98% get O2? Why should someone satting at 94% get 15Lpm? /quote]

Because SPO2 is an awful, horrible, very bad decision tool for the administration or withholding of oxygen, and people who don't understand this shouldn't have their hands on a pulse oximiter or oxygen?

[emt322632]

Because SPO2 is an awful, horrible, very bad decision tool for the administration or withholding of oxygen, and people who don't understand this shouldn't have their hands on a pulse oximiter or oxygen?

Ok maybe I should clarify my post...why should a person who has no signs or symptoms of respiratory distress (no cyanosis, no accessory muscle use, clear lung sounds, A&0x3) receive oxygen at 15Lpm? I'm not talking only chest pain here...anybody...

As I said the head of the CQI committee will look at a PCR, see 98% SpO2 and ask why they weren't on a nrb...

[CBEMT]

As I said the head of the CQI committee will look at a PCR, see 98% SpO2 and ask why they weren't on a nrb...

Well, there you go. Someone who shouldn't have access to oxygen or pulse oximiters. Or other people's run reports.