wow
When a patient is stressed out (as they likely are during transport, its a very scary thing), their vitals can skyrocket... surely, you're aware of this.
Could I respectfully ask what you consider "skyrocketing?"
At what level do you consider them dangerously high?
When the patient belives that the EMT is actively treating them instead of just kicking back and watching, they calm down and the vitals begin to return to a normal range (typically).
On medicine, no news is good news.
If you spend some time in a hospital, you will observe the most neglected patients are the least sick.
You know what is scary? Being the patient that is commanding everyone's attention.
However, I advocate always appearing calm and collected, it gives confidence to patients. When they see you have everything in control, they calm down.
Another thing that helps is explaining things to them. Like what is going to happen next, or the wait times, or what is going on with them.
As for potentially prevented complications... A pulse of 120 and BP of 150/100 (I have experienced this situation) places unnecesary strain on the cardiovascular system, which should be prevented, IF POSSIBLE, by the EMS crew.
Such vitals are not clinically significant in most patient populations.
This to me appears to be fear of the unknown influencing your judgement. You or your mentors do not know what scary looks like so it becomes fear of everything.
As for specific evidence, all I have to say is that my Captain (EMT-I, 20 years experience)
I am not impressed.
instructed me to do so and I have personally seen results.
Regretably, I doubt it. Correlation does not equal causation.
Keep in mind that its touch-and-go, and every patient reacts differently. Discontinue oxygen immediately if the patient isn't responding appropriately.
Have you considered the oxygen you apply today may take time off of a patient's life decades later? That it may reduce the quality of their life faster and increase their medical bills over time? Have you considered the stress involved with the elderly, particularly on a fixed income and immobile, and the negative health influences of trying to pay for and navigate the health system are?
Let me put it into perspective?
lets say a 65 year old male over the course of his life has lost X% of pulmonary function to age and various pathology.
Let's assume that you put them on 15l of NRB and drive them 30 minutes to the hospital. During this time, you observe them calm down.
3 or 4 months later they develop shortness of breath. They return to the hospital where they are now diagnosed with more advanced pulmonary deficency. They are now not able to carry on their daily routine and their quality of life and maybe even their income is reduced. Perhaps their renal function or liver function as well.
Perhaps that person could have gone another 2-3 maybe 5 years without such a decrease if you hadn't overdosed him on oxygen?
Just something to think about...
Above all, keep in mind that I am not an instructor, (I am) a doctor, (this too) or a renown scholar. (and this) It would be foolish to accept a new medical procedure based off of my statements.(I think I make some pretty good medical arguments and have some insight)
