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Monday, April 3, 2017

Sigh! The hypoxic drive hoax lives on

It's a flat out fallacy, folks.
This is not true. 
Editors Note:  The following is a guest post from an anonymous therapist. He said it was okay to publish his name. I decided to hold it to make sure he doesn't get into trouble and lose his job for being honest.

I am soooooo tired of nurses taking patients off their oxygen because "they are retainers." The patient was wide awake and alert, and showed no signs of being lethargic, but based on a myth we are going to keep his sat at 85%. In the past I've tried to educate, but now I just roll my eyes and leave the room before I say something I might regret. This myth does not bode well, and never has, for patients.

Two days ago the patient had sats in the mid 80s, and the doctor (my favorite doctor) said to increase the oxygen. So, with his permission, I placed the patient on a high flow nasal cannula ad 15 lpm. The patient was happy that he didn't have to wear a mask, and we were happy that he felt better due to being oxygenated. He was happy on this for two days, and he showed no signs of any side effects to the high flow. But, then a night shift crew came on that believed in the hypoxic drive hoax, and the patient was taken off oxygen. 

So, I come on. I want to take the patient off his nighttime BiPAP. I go to hook up the patient to the high flow oxygen, and it is gone. "Where is it?" I chime to the patient's nurse.  The nurse says, ""Uh, the patient is a CO2 retainer. It was making the CO2 go up."  

Here is where I roll my eyes and...


I have explained about the hypoxic drive theory to nurses ad nauseum. I have written articles. My friends have written articles. I have even been interviewed for peer reviewed journals. And here I am ten years later and I still have to deal with it. And, to make matters worse, the nurses I'm dealing with is a nurse I've explained it to 100 times. It's as though I have wasted my time. And so, I just... 


I am going to start smoking. I have severe asthma. If I smoke, I will get COPD within a few days. If you have severe asthma, and you smoke, you can get a diagnosis of COPD real fast. I want to get COPD, and I want to need oxygen. And I want to be admitted. I want to be admitted for COPD. I want my oxygen.

And when a nurse puts me on a 2lpm nasal cannula, and my saturation is 85%, I'm going to demand more. and when they don't give it to me, I'm going to sue. I'm going to sue because I didn't get the oxygen I needed. This put me at risk of dying of a heart attack. Then maybe I will be heard.

And when they site their evidence, they will only have one study that was done way back in the late 1960s based on four COPD patients. I will have as my evidence over a hundred studies

I think this would give me a more credible voice, because no one listens to RTs -- obviously. If I were a doctor and championed for the abandonment of the hypoxic drive myth, then I'd be laughed at and mocked, like Rene Lenaec was when he invented the stethoscope. So, I think a COPD patient is a must. I think the only course of action here is through the law. We need to end the hypoxic drive hoax once and for all. 

And for you folks in Rio Linde, I'm joking about smoking. But, my point is still valid: the hypoxic drive theory is nothing more than a hoax that causes needless suffering and even kills. 

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