Tuesday, December 4, 2012

How do you know what oxygen device to use?

Your question:  How do you decide what oxygen device to use?  I mean, do you use a nasal cannula, venturi mask, partial rebreather, a nonrebreather, or aerosol/ trach mask?

My humble answer:   Great question.  The answer to this question is:  it depends on the patient.  The main goal of oxygen therapy is to keep the patient's SAT (spo2) equal to or greater than 90 percent.  This will assure the PO2 is 60 or greater and assure adequate tissue oxygenation.  Ideally you'll want to use the least amount of oxygen (lowest FiO2) to maintain a SAT of 90%.

What are the exceptions to this rule:

1.  All patients with an acute episode of heart failure should be placed on 100% oxygen until the acute symptoms are under control.

2.  While you'll want to oxygenate them, you'll also want to make sure the SAT of COPD patients does not exceed 88-92%.

3.  It's a fallacy that patient's with chest pain need oxygen.  So long as their SpO2 is 90% or greater, there is no need for oxygen.  It's a recommendation by ACLS too. 

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