O2 saturation question - page 2

My husbands grandfather was in the hospital today..and when the took his pulseox it was 95 - his breathing was labored- and noted as labored by the triage nurse, and upon listening to his lungs he was found to be congested. All... Read More

  1. 0
    He does have COPD but his baseline pulseox is 98. On the floor, they have him on 3 1/2 liters o2 which to me is strange because he does have COPD w/o any kind of heart problems that are making it impossible for the heart to supply the body with enough oxygenated blood. However, on 3 1/2 liters o2 he is having difficulty breathing with and without exertion. I guess it's just strange to me because I was always told in nursing school that COPD pts shouldnt have their o2 above 2 liters

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  2. 0
    I learned that COPD pts should never have their 02turned up > 6 lpm, but another nurse I know was taught 3 l.
    Anyone know what the standard is?
  3. 0
    I have never been able to get a straight answer on this. And policy DOES vary greatly from institution to institution. Perhaps I need to do a thorough search of the literature to find some evidence-based answers on this one... One respiratory therapist I knew and respected when I was working for a large teaching hospital told me that it is not the amount or delivery of oxygen that is important as is the oxygen saturation... For the COPD patient, should always be in the 88-92% range, regardless of the means to get the patient there. Some COPD patients in really bad shape require 100% nonrebreather just to keep them at 88%. That's how we did it at THAT facility in the critical care units and step downs. Anything over 92% saturation will generally knock out the COPD'ers hypoxic drive and their ventilations will go waay down. (Of course, if your patient is on a ventilator with any automated setting, than the ventilator is going to "breathe" for the patient, and the 88-92% range is irrelevant in this situation.)
  4. 0
    Our protocol is to start O2 if the sat falls below 92%. If the sat was 98% and his breathing was labored it was time for a resp tx. 98% is a result to be very happy about. Most smokers can't hold 98%.
  5. 0
    I had a hemodialysis pt w/ COPD experience acute chest pain while on tx. He was on 02 a 2 l,. One of my interventions was to turn his 02 up to 5. My nm got all hysterical saying "You'll kill him!"

    But, I've always been taught to turn up 02 during episodes of cp, and that this is ok for COPDers, as long as you don't give them more than 6 lpm.

    And.....when I worked hospice we had many COPDers on 15 lpm of 02, and they lived for months(AxO) like that.

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