EMT student: how do I vent somebody with Hypoxia Drive?

[Knighthonor]

This is what I am confused about.How I handle this and COPD?If their breathing is driven by low oxygen, and venting them makes things worst, than what do I do if they having problems breathing?

[akulahawkRN, ADN, RN, EMT-P]

I would not worry too much about ventilating patients that are breathing on hypoxic drive. If you have a patient that has fairly advanced COPD, and you have to give them supplemental oxygen, have a bag valve mask device handy. You basically will just ventilate them just like anyone else that needs ventilation by BVM. You might have to slow things down a little bit, allow more time for expiration, but you should not worry about providing too much oxygen in the short term to a patient with COPD. That can be a problem in the long run, but in the short run, most COPD patients will do just fine even with breathing a high concentration of oxygen. If for some reason they slow down their breathing, all you must do is ventilate the patient mechanically. It's really not that big of a deal, and likely very rare overall. If we were discussing a patient that had been hospitalized, and you are taking care of that patient for several hours, or more, mechanically ventilating the COPD patient would be a little bit more problematic.

In short, if a COPD patient is complaining of shortness of breath, provide supplemental oxygen. Withholding oxygen from a COPD patient will be worse for the patient than providing it. Do not ever withhold oxygen, if the patient needs it.

Being that you are an EMT, I would expect that the amount of time that you would spend with the patient would be fairly minimal. You also do not have all of the equipment that would be needed to provide a COPD patient with optimal oxygenation. That can require arterial blood gas studies… Which is not something that you would do in the field at your level of certification.

[Esme12, ASN, BSN, RN]

Welcome to AN! The largest online nursing community!

You give them oxygen and monitor them closely. Just remember in the back of your mind that they are hypoxia driven if they begin to develop lethargy and get them to the ED ASAP.

Best practice: Emergency oxygen for respiratory patients | Practice | Nursing Times

High-Flow Oxygen and COPD: It's time to end this fear mongering. - JEMS Connect - EMS Emergency Medical Services

[LCinTraining]

I am an EMT. You are going to consult your protocol booklet. Ours states 15 L via non rebreather. A lot yes, but recognize this is very short term. You are also reassessing every 5 minutes. What's the pulse ox stating now? Is the breathing getting worse? Is he using accessory muscles still? Any improvement, you can titer down your O2. Regardless you are hauling ass to the ED with a COPD flair up. If it gets worse in spite of your efforts, you are calling in a paramedic. The other thing to note, is ask the patient or family members what his O2 saturation is at baseline. You can aim for that with your oxygen supplementation.I had a patient with COPD once. Arrived on scene to a pulse of of 72% and HR in 120s. Working very hard to breathe saying he was getting tired. Medic called on scene to start bipap. He administered a breathing treatment and was one step away from intubation because his O2 kept crashing when the meds finally kicked in. They reduced the O2 at that point.Your job is to know when you can handle it and when you need a medic. EMTs are very limited in situations like this and need to know when it's time to call the big guns in.