How many liters of O2 is really safe with COPD? - page 2

Hi this is my first time posting I tried to search my question but the search was not working. I'm a newly licensed RN and I'm not working yet so I'm a little unsure of my knowledge. Ok so some... Read More

  1. Visit  Iowa RN2006 profile page
    1
    WOW GRN TEA where were you when I was in nursing school, that was great! I have my grid all made up. THANKS
    GrnTea likes this.
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  3. Visit  VioletKaliLPN profile page
    2
    now in hospice she is still on 15 liters and going down hill quickly. just 6 months ago i was taught with copd 2-3 liters max. so my question is am i way off base are the hospitals doing something different now?

    i was taught that when on hospice or comfort measures, some copders will have a lot more o2 for 'comfort' reasons. they may feel better having all of that air blowing in, in a nutshell..

    when someone is on comfort measures, the idea is not heroic lifesaving measures, but comfort. if 15 l makes them feel comfortable, let them have it.
    leslie :-D and ProfRN4 like this.
  4. Visit  tothepointeLVN profile page
    0
    I need a cup of tea after reading all that but thanks
  5. Visit  snazzy-jazzy profile page
    0
    Thanks Grntea I have saved all of that, you are a legend.
  6. Visit  ZippyGBR profile page
    0
    Quote from Mardisb
    Thanks I was just really confused because that was just going against everything we were taught and since I'm not working yet I don't have any personal experience to draw from.
    unfortuantely you've been taught wrongly, titration of oxygen for someone with COPD has to be determined by their gasses and not by any simple blanket rule.
  7. Visit  Eldrad profile page
    1
    In an acute situation you can put a COPD pt on as much O2 as you need, contrary to what respiratory says or does. You just have to watch their CO2 levels and titrate the O2 down as soon as possible.
    nursenotamaid likes this.
  8. Visit  ObtundedRN profile page
    1
    Nursing school does a terrible job at teaching this and many instructors don't understand it well either. So they keep teaching the old rule of never give more then a few liters. It's wrong to apply a blanket rule like that. In ANY emergent situation you give ANYONE as much O2 as they need.

    And retaining CO2 is a ventilation problem. It has nothing to do with how much or how little O2 they are receiving.
    nursenotamaid likes this.
  9. Visit  Creamsoda profile page
    3
    From what i could infer from you post, they made her hospice. Im assuming she was a DNR/DNI. Bipap might help with the co2 in the short-term if she can tolerate it, but if she's retaining co2 that bad, next step is intubation and mechanical ventilation. Very hard with end stage COPD'ers to get them off that vent, hospice is often the best thing when its end stage.
    nursenotamaid, GrnTea, and leslie :-D like this.
  10. Visit  diva rn profile page
    0
    Greentea....your grid brought back memories of a similar one a R/T in PICU drew for me many, many years ago....I had forgotten about it...
    You are AWESOME!!!!
  11. Visit  GrnTea profile page
    0
    ::[color=pink]blushing:: aw shucks.

    seriously, though, thanks for the kind words.

    i remember so vividly what it was like to be totally clueless and have somebody tell me something in the same language that confused me in the first place, over and over. then i was blessed with some really good clinical teachers in my first critical care job, and once the light came on, it stayed on. i learned to explain things in plain english and to keep trying other ways if i wasn't getting those "aha!" looks from my students. but i stand on the shoulders of giants.

    i knew i was getting ok at some of this when driving home one night with my kids, aged 5 and 8, from a class i taught on f&e that i had to take them to, having no babysitter that evening.

    my 8-yr-old said, "mom, what's kay?" "oh," said i, "that's k, the abbreviation nurses use for potassium." "ok," she said. "now i get it."

    (now she's a college physics professor, but still.:d)
  12. Visit  srichardson profile page
    0
    I just saw your post. I'm on 2 liters myself for COPD. My mother just went on Hospice for a severe heart condition. They have her on 15 liters of oxygen. I did learn in Pulmonary Rehab that you have to be careful when you increase the oxygen as the brain does tend to tell the body that it's getting enough. I know some have to be on more, but then you need to watch the extremities of the body as they may not really be getting the proper oxygen reguired. She has 3 arteries in her heart totally blocked and one that they could only get a balloon in so the blood is only dripping slowly to the two lower chambers in her heart.
  13. Visit  TiffyRN profile page
    0
    To the OP,

    I'm so sorry your family is going through this tough time. We have no way to determine all that has gone into the decision to place your grandmother on hospice care. Even if we did, it is not within the scope of this board to advise you on that.

    As for the hypoxic drive theory and COPD patients, I have learned recently that this is more a theory but not so much based on science. I found a great blog site from an RT that provides multiple scholarly references explaining how the hypoxic drive theory has fallen out of favor as it does not hold up to rigorously controlled trials (but continues to be taught to students).

    Regardless of the current science, if your grandmother is on hospice care, the focus there is comfort and oxygen is very comforting to a hypoxic patient regardless of their CO2 retaining status. I don't know how aware your grandmother is, but even minimally aware people can be comforted by the presence of their loved ones and that would be my advice to you.

    Respiratory Therapy Cave: Hypoxic Drive Theory: A history of the myth
  14. Visit  Poochiewoochie profile page
    0
    Quote from TiffyRN
    To the OP,

    I'm so sorry your family is going through this tough time. We have no way to determine all that has gone into the decision to place your grandmother on hospice care.
    The OP posted this in 2011-I'm sure her grandmother is no longer on hospice.


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