Monday, March 25, 2013

Myth busted: Chest Pain patients need 2-4lpm

Patients with chest pain require 2-4lpm to make sure the heart is oxygenated: As with most of the myths above, this myth was created because it sounded like a good idea, and was based on no evidence.  Common sense suggests, however, that if the patient has an SpO2 of 90 or above the patient's heart is receiving plenty of oxygen.  In 2010, the new ACLS Guidelines recognize this fact, and implemented the following change:  "Oxygen supplementation for uncomplicated acute coronary syndrome is no longer routinely indicated and should only be applied only if the oxyhemoglobin saturation (SpO2) is less than or equal to 94 percent."  Of course this change was only made because CMS is always looking for ways of saving money, but we'll take good changes any way we can get them.  The problem with this is most nurses and physicians and respiratory therapists had the old myth inculcated into their cranium, so the change is usually not accepted and ignored.  So if you land in the ER with chest pain, expect prongs to be stuffed into your nares for no good reason. (See "ACLS New Guidelines," www.studentblock.com, http://www.studentdoc.com/acls-guidelines.html, accessed 3/24/13)

For more respiratory therapy myths check out the 15 biggest myths of respiratory therapy.  

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