slideshow widget

Friday, October 8, 2010

Is it good to give oxygen to a dying patient?

I occasionally check my statcounter to see what Google inquiries or searches lead someone to the RT Cave. If I think the landing page did not answer the question, I humbly try to provide the answer in this post.

1. is it good to give oxygen to a dying patient: Absolutely. A DNR patient should still be treated as any other patient. The only difference is if their heart stops, you don't make any heroic measures.

2. If i am non responsive, should my DNR come in effect: Yes. Although if your heart doesn't stop, you should still receive medical care. If you are responsive, this is when your advanced directives start if you have signed advanced directives. This is what allows your spouse or friend the right to make medical decisions for you, and it's also where you line out how you want to spend the remainder of your life, such as, do you want to be a DNR, do you want to be on a vent if necessary, do you want to live in a vegetative state, would you want to be in a nursing home, etc. For more information about advanced directives, click here.

3. inspiratory wheezing in the throat: This is usually indicative of cardiac asthma.

4. respiratory questions how to oxygenate a patient: A patient should be oxygenated by whatever method gets their spo2 or saturation greater or equal to 90%, or if you have a CO2 retainer in the high 80s. For neonates, check out this post.

5. WHAT IS LAVAGE THERAPY: This is where you have a patient who is intubated and needs to be suctioned, and yet you cannot suction it out. You insert 3-12 cc of normal saline down the ETT and bag the patient to try to loosen the junk up, and then you suction in out. This is also a good way to remove a mucus plug from the ETT. Doing this once a shift is also proven by some studies to prevent nosocomial infection. For more information about lavage and suctioning, click here.

6. refuse bipap: You have a Constitutional and God given right to refuse any medical treatment. However, doing so might mean you do not get better. Still, there are times when a doctor will order therapies that are not indicated, and it is your job as the patient to stop the doctor. To check out indications for bipap, click here.

If you have more questions please click on the contact button on the upper right corner of this blog.


Anonymous said...

The patient is elderly, has a DNR and with a clear mind says she is ready to go. How do your recommend handling a patient on oxygen who expresses a desire to stop the oxygen so she can die?

Rick Frea said...

I would think you'd have to respect those wishes.