Shouting at Elderly?

[EMTWintz]

although you are taught to never deny O2. If patient doesn't seem to need it, in you clinical judgement, ask if they would like to have a little. Most will say no thank you

 

[JPINFV]

^
Why is the person who is supposed to be deciding on a treatment plan based off of an assessment asking a patient if they want a treatment that the assessment doesn't make? Does a paramedic ask a patient who denies having any pain if they want morphine 'just in case?' I've always been perplexed on how supplemental oxygen has gotten this reputation as being a miracle cure all.

 

[MRE]

^
Why is the person who is supposed to be deciding on a treatment plan based off of an assessment asking a patient if they want a treatment that the assessment doesn't make? Does a paramedic ask a patient who denies having any pain if they want morphine 'just in case?' I've always been perplexed on how supplemental oxygen has gotten this reputation as being a miracle cure all.

If you have a CAOx4 pt, why not make them part of their own care. I'm not saying they should be telliing you what to do, but if you want to put them on a NC at 4L, tell them what you are doing if they have any questions or objections, talk to them about it instead of just shoving a tube under their nose.

In many cases, I think the O2 ends up being a placebo for the pt. If you are a basic truck and have a pt who you can't do anything for except transport, a little O2 might also keep them from thinking that they would have been better off driving themselves to the hospital (admittedly not always the message we want to send).

 

[JPINFV]

If you have a CAOx4 pt, why not make them part of their own care. I'm not saying they should be telliing you what to do, but if you want to put them on a NC at 4L, tell them what you are doing if they have any questions or objections, talk to them about it instead of just shoving a tube under their nose.

Of course informed consent is something completely different than:

If patient doesn't seem to need it, in you clinical judgement, ask if they would like to have a little.

 

[EMTinNEPA]

I've always been perplexed on how supplemental oxygen has gotten this reputation as being a miracle cure all.

Because they assume that every single person on the planet who doesn't have MD, DO, PhD, RN, LPN, CNA, PHRN, or EMT-P behind their name is a complete and total moron who doesn't know how to exercise clinical judgment and make a determination as to whether or not a patient needs supplemental oxygen?

 

[TexasEMTech]

Well JP,there's quite a bit of difference between the "hospital setting", and the "pre-hospital setting".It's always nice to know as much as you can about your patient,but as you probably know,you only get 100% of the story about 50% of the time.That's not necessarily because the patient deliberately withholds that information,but maybe he just doesn't think about everything, especially an 80 y/o person.So,when it's all said and done,it's the unknown that motivates a person,or at least that's what motivates me to take extra measures to prevent the unknown from taking hold,saying this,sometimes there are mistakes made,and sometimes there's really nothing that can be done in the pre-hosptal setting,especially by an emt-b.Do I give O2 to every patient I come in contact with? No.But ifIthink they will benefit from it I don't hesitate,or sometimes the best thing to do is simply ask them if they think oxygen would make them feel any better.Even though there is only one National Registry,some places from state to state just do things different,sometimes climate is a factor sometimes protocols take action.So until one knows how different places do things,it's really hard to criticize.

 

[JPINFV]

Well JP,there's quite a bit of difference between the "hospital setting", and the "pre-hospital setting".

So please tell me what magic quality supplemental oxygen possesses in the field that is immediately rendered useless upon moving the patient from the ambulance gurney to the hospital gurney? When the RN removes the NRB from the patient for a room air assessment and doesn't even put the patient back on oxygen you can't quite claim something as easy as lab values.

So,when it's all said and done,it's the unknown that motivates a person,or at least that's what motivates me to take extra measures to prevent the unknown from taking hold,

Do you call paramedics for all of your patients because of the unknowns?
Do you transport all of your patients emergently because of the unknowns?
After all, if unneeded treatments are started 'due to unknown factors' why stop at oxygen? Why not go all the way for every patient?

...or sometimes the best thing to do is simply ask them if they think oxygen would make them feel any better.Even though there is only one National Registry,some places from state to state just do things different,sometimes climate is a factor sometimes protocols take action.So until one knows how different places do things,it's really hard to criticize.

Again, why even go through class if it becomes the patient's choice on whether a treatment is needed or not (note: a patient deciding if a treatment is needed is not the same as a patient declining a treatment)? I'll ask it again, would it be appropriate for a paramedic to offer a patient who denies the presence of pain morphine (or any other narcotic) 'just in case?'

...and no, it's never hard to criticize protocols born from stupidity. As my signature says, "Tradition: Just because you've always done it that way doesn't mean it's not incredibly stupid."

 

[TexasEMTech]

First of all,we're not talking about a strong narcotic here,it's O2.I don't give every patient oxygen.But,Let's say an emt gives every patient oxygen,what would that hurt? Until you have M.D. behind your name,don't tell me what I do is wrong,I have yet to criticize you,so quit making every person that sees your posts think you're a paragod. Not everything about about emergency medicine is a science,so you may want to quit treating it as so. I have learned that putting things that I am currently learning in school to use in the medical field without having the experience or supervision to do so can be tricky. Don't ever get in over your head,always play on the safe side.