Oxygen in advanced care

How often do you routinely use O2?

  • All the time, most of my patients get it

    Votes: 4 12.1%

  • Sometimes, even if they don't look like they need it

    Votes: 15 45.5%

  • Only in patients that have clear signs of hypoxia

    Votes: 13 39.4%

  • What's oxygen?

    Votes: 1 3.0%
  • Total voters
    33
Whoa.... didn't see that one coming.... interesting ( The MI study... )
 
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You know, I wonder if Veneficus has been on that strange Japanese game show called Ninja Warrior ..... :D
 
Veneficus said:
Intending absolutely no offense or smartass comment.

Logically, if the blood goes through the pulmonary circuit to the left ventrical, said ventrical contracts sending blood into the aorta, which during diastole back fills into the coronary arteries, how does the oxygenated blood get from the proximal end of the aertery through the thrombus/embolis, and to the distal part of the artery and capilay beds?

Unless there is some other disorder, there should be no problem with heme saturation until methylation or coboxy haemaglobin from pump failure, or an increase in PH.

Correcting even the pH will not push oxygen past a clot.
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In the words of the RN who taught the only EMT refresher I will ever attend said, "That science is too advanced for EMS."
 
JPINFV said:
In the words of the RN who taught the only EMT refresher I will ever attend said, "That science is too advanced for EMS."
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Shhhh! I am trying to help...

Actually MrBrown, I have a paper that says I am a ninja. :)

Dr.Tetsuya Higuchi signed it for me.
 
Veneficus said:
Logically, if the blood goes through the pulmonary circuit to the left ventrical, said ventrical contracts sending blood into the aorta, which during diastole back fills into the coronary arteries, how does the oxygenated blood get from the proximal end of the aertery through the thrombus/embolis, and to the distal part of the artery and capilay beds?

Unless there is some other disorder, there should be no problem with heme saturation until methylation or coboxy haemaglobin from pump failure, or an increase in PH.

Correcting even the pH will not push oxygen past a clot.
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Brown is gobsmacked!

That makes absolutely 100% certified natural, organic, pesticide, carconogen, additive, synthetic bovine growth hormone and artifical colour, sweetner and preservitive free sense!

Although most of those things were probably in the food you ate that caused your heart attack in the first place but sssssh Monsanto doesn't want you to know that :D
 
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MrBrown said:
Brown is gobsmacked!

That makes absolutely 100% certified natural, organic, pesticide, carconogen, additive, synthetic bovine growth hormone and artifical colour, sweetner and preservitive free sense!

Although most of those things were probably in the food you ate that caused your heart attack in the first place but sssssh Monsanto doesn't want you to know that :D
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Shhhhh!

I just stayed at a holiday inn express last night. :)
 
Just to play devil's advocate here, what if the pt doesn't have a complete blockage and a small amount of blood is getting through? Would it not be possibly beneficial to have that small amount of blood be hyperoxygenated? Not talking about 15 lpm via mask, but a cannula with a couple lpm.

I understand how more O2 does nada if it can't get past an embolism, and that too much oxygen can be bad, I'm just doing the "what if" thing.
 
Aidey said:
Just to play devil's advocate here, what if the pt doesn't have a complete blockage and a small amount of blood is getting through? Would it not be possibly beneficial to have that small amount of blood be hyperoxygenated? Not talking about 15 lpm via mask, but a cannula with a couple lpm.

I understand how more O2 does nada if it can't get past an embolism, and that too much oxygen can be bad, I'm just doing the "what if" thing.
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The problem is the amount of blood getting past the embolus to the myocardium, not the amount of oxygen in the haemoglobin of said blood.

Shoving more oxygen down this guy's gob doesn't mean it's going to bind to the haemoglobin and sneak past the clot the way Brown snuck back into bed after him and that Ninja fellow went out partying without waking Mrs Brown .... remember the oxyhaemoglobin dissassociation curve, once the Hb is fully oxygenated more oxygen is not going to do any good.
 
It is sort of a shame in my county - the schools teach to only apply oxygen for patients who are hypoxic or have increased oxygen demands, and mostly by NC. But the protocols for the area all state that general ALS should apply oxygen and the preferred method is by NRB. So most patients going to the hospital here will be on 15 by mask - regardless of whether it was indicated.
 
Aidey said:
Just to play devil's advocate here, what if the pt doesn't have a complete blockage and a small amount of blood is getting through? Would it not be possibly beneficial to have that small amount of blood be hyperoxygenated? Not talking about 15 lpm via mask, but a cannula with a couple lpm.

I understand how more O2 does nada if it can't get past an embolism, and that too much oxygen can be bad, I'm just doing the "what if" thing.
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Diffusion of oxygen from the blood into cell is caused by two things, plasma oxygen concentration (driving pressure) and time in contact with the cell. Oxygen is diffused into the cell out of blood plasma, not directly off the hemoglobin. So even with fully saturated hemoglobin you could theoretically increase driving pressure by hyperoxygenating a pt (ever heard of an AGB with a pO2 of >500mmHG? I did that to a patient early in my paramedic career). In reality, it does not move O2 into the cells any more effectively than O2 with a normal pO2 does.

These folk need a wire run over the lesion and a balloon inflated in the cath lab and/or CABG surgery. Anything you do before that is simply trying to support perfusion elsewhere and keep the infarct from extending. So it makes sense to focus on interventions that are proven to work, which right now includes only ASA and beta blockers in tachycardic and hypertensive patients.
 
im only an EMT and im sure you all know this but they teach and emphasize "All patients get oxygen, they have a stubbed toe, put them on oxygen" I think oxygen is helpful in patients who are clearly having trouble breathing but i also think it relaxes many patients cause they think they are breathing better even if they arent having any trouble breathing.
 
lampnyter said:
im only an EMT and im sure you all know this but they teach and emphasize "All patients get oxygen, they have a stubbed toe, put them on oxygen" I think oxygen is helpful in patients who are clearly having trouble breathing but i also think it relaxes many patients cause they think they are breathing better even if they arent having any trouble breathing.
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So does alcohol, but we don't hand that out like candy.
 
I hand out candy like candy... when I have candy... come to think about it, where is mine? :P
 
I honestly do give more morphine than oxygen to my patients.

I've probably put 3 people on oxygen in the past 2 months...all sob.
 
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