Question: Did Patient Need NRB?

[Akulahawk]

As a basic. Which I am. I would of placed her on 4lpm of o2 via NC. Per protocol.

Without the ETCO2 reading like the n7lxi said, you can't be entirely sure what is happening.

But her spo2 was good. Respirations were WNL. So I don't see anything that warrents high flow.

I have never personally put someone on a NRB. I usually go with a cannula first. Then if needed I would bump it up. But I have never needed to.

As a Basic, I have had to put someone on a NRB. Actually, more than a few times. However, I evaluate each patient for how much O2 is needed, with whatever tools I have on hand to help me decide that. In the OP's case, we have a patient with an SpO2 of 98% on room air. Great. Oxygenating well... but is the patient ventilating well? As a basic, I'll see if it appears that there's good chest rise/fall with each breath. If you're in pain and it hurts to breathe, you're going to breathe less often or you're going to breathe only as deeply as you can tolerate the pain. Shallow breathing doesn't lend itself well to good ventilation.

Would I have put the patient on an NRB? I doubt it. Nasal cannula? Possibly. Neither of those address ventilation. Would I have coached the patient to breathe as effectively as possible within the pain tolerance? Yep. Would I have attempted to use visualization/guided imagery to help increase pain tolerance? Probably. Certainly when we're in pain and we don't know why, we tend to get anxious and that can lead to the sensation of breathlessness/SOB. Anxiety can also lead to an increased perception of pain... which causes the cycle to worsen.

Each patient and situation is different. For this particular patient, I don't know exactly what I'd do... just that I'd do my best to reduce anxiety, and reduce the sensation of SOB, provide a nice, smooth ride...