Years ago, when I was in Nursing school first time around, I was told that you do not administer O2 therapy of more than 2L/min to people with COPD. Second time around in Nursing school 3 years ago, We were told the hypoxic drive theory was all a misconception and has research to prove it.
Asked an MD, and he reckoned that when you take the O2 mask off a COPD patient, they miraculously wake up from their "sleep" - hypoxic drive theory at play???
Nonrebreathers at 2 -4 lpm? I dont' think that would even work.
About CO2 narcosis, I believe in it but I would like to see the research that the OP mentioned saying it was an old wives tale.
I do, however, think that people overestimate this reactiong with COPDers thinking that everyone is gonna crash if they get to much oxygen. And there's no hard and fast rule about not increasing the 02 above 2L for a c02 retainer. It is so patient specific. That's why ABGs are so important in this case. If he have a severely low PaO2 like an poster mentioned, why not use the non-rebreather...cuz like, he NEEDS 02 bad!!
A NRB at 2 to 4 l/m??? Talk about rebreathing CO2!! I was an RT for 18 years before I became and RN.....never and I mean never....use a NRB at less than 10 l/m!!
In all these years.......I have had maybe 3 or 4 pt's that had a TRUE hypoxic drive. If someone is hypoxic, struggling to breathe....give them O2.
SpO2 machines....are machines!! They show that "something" is bound to hemoglobin....it doesn't differentiate between oxyhemoglobin or carboxyhemoglobin...A pt with carbonmonoxide poisoning can have a 100% Spo2 reading!! It's a number. Assess the patient. Are they in distress?
I still use the OHD curve....there are conditions that shift the curve to the right....and shift the curve to the left.
zacarias, ASN, RN
1,338 Posts
Nonrebreathers at 2 -4 lpm? I dont' think that would even work.
About CO2 narcosis, I believe in it but I would like to see the research that the OP mentioned saying it was an old wives tale.
I do, however, think that people overestimate this reactiong with COPDers thinking that everyone is gonna crash if they get to much oxygen. And there's no hard and fast rule about not increasing the 02 above 2L for a c02 retainer. It is so patient specific. That's why ABGs are so important in this case. If he have a severely low PaO2 like an poster mentioned, why not use the non-rebreather...cuz like, he NEEDS 02 bad!!