Incorrect oxygen set up

Published

Specializes in BNAT instructor, ICU, Hospice,triage.

Have you ever walked in and found your patient on an 02 concentrator (which only goes up to 5 liters of O2) and on a 100% non-rebreather mask?

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

No....but I am sure it happends. Some people just don't use their heads....EVER:uhoh3:

Up Vote Up Vote ×
Specializes in ICU, Telemetry.

I've seen people on a regular cannula (not a high volume) turned all the way up to 15, I've seen people on a non-rebreather at 1.

Never underestimate the "whaaaa....?" factor in nursing. I actually had one coworker arguing to put a patient on a heparin drip for their very, very minor MI...who was also having a major, major GI bleed (hypotension probably led to the MI, her BP was so low she almost pumped dry). The other nurse couldn't get past the fact that you should anticoagulate an MI....if their hgb is 4...oh yes, let's put HIT into the mix.

Still makes me shudder to remember that night...

Up Vote Up Vote ×
Specializes in LTC, Memory loss, PDN.

Yes, that and a lot of other interesting set ups in LTC. Fortunately, most DME reps will gladly give or have their RT give inservices.

Up Vote Up Vote ×
Specializes in ICU.
I've seen people on a regular cannula (not a high volume) turned all the way up to 15, I've seen people on a non-rebreather at 1.

Never underestimate the "whaaaa....?" factor in nursing. I actually had one coworker arguing to put a patient on a heparin drip for their very, very minor MI...who was also having a major, major GI bleed (hypotension probably led to the MI, her BP was so low she almost pumped dry). The other nurse couldn't get past the fact that you should anticoagulate an MI....if their hgb is 4...oh yes, let's put HIT into the mix.

Still makes me shudder to remember that night...

That's scary. Heparin on a sever GI bleed? They actually argued this?

Up Vote Up Vote ×
Specializes in ICU, Telemetry.

Oh, yes....had the nerve to sit there and tell me about "A, B, C" and since heart was C we had to fix the heart first. Uh, honey, C's for Circulation, not cardiology.

She'd graduated 3 weeks before. Didn't know what HIT even was. Probably didn't even know that protamine was the antidote. She went around her preceptor, to ask me, I gave her the fish eye and said, "You sure you want to thin out the blood of someone who's hgb is so low their blood's transparent? You realize your patient would bleed out, right?" She immediately dismissed me as giving the wrong answer, and called the doc a 3 am. You could hear him yelling at her from 3 feet away.

She eventually transferred, since none of us knew what we were doing....:rolleyes:

Up Vote Up Vote ×
Specializes in LTC, Memory loss, PDN.

..... She eventually transferred, since none of us knew what we were doing....:rolleyes:

I hope you have since brushed up on your knowledge. :D

Up Vote Up Vote ×
Specializes in Intermediate care.

i've put a pt on a mask with 2L because they were a mouth breather. i tried NC but sats would drop immediately. tried reminding him to breath through his nose but he had dementia and retained nothing.

Talked with Respiratory and we just put a mask on him. it worked....

situation dependent i guess.

Up Vote Up Vote ×
Specializes in Med/Surg.
i've put a pt on a mask with 2L because they were a mouth breather. i tried NC but sats would drop immediately. tried reminding him to breath through his nose but he had dementia and retained nothing.

Talked with Respiratory and we just put a mask on him. it worked....

situation dependent i guess.

A mask is different than a non-rebreather. With a non-rebreather it is essential that the bag is inflated and it won't do that on 2L. Masks are great for mouth breathers! Our hospital has done away with masks though, apparently there were adverse patient outcomes from people putting masks on people and forgetting to hook up the oxygen. :uhoh3: I've seen everything from IVs to oxygen to PCAs to NG/chest tubes hooked up incorrectly. I'll always look everything over when I first assess the patient.

Up Vote Up Vote ×

Masks need a minimum of 4L or you're suffocating the patient. (It's not THAT much different from a NRB.) If you want to stick with 2L for a mouth breather, your best bet is to stick the cannula in their mouth.

Up Vote Up Vote ×
Specializes in Fall prevention.

Don't deal with concentrators much but did have a patient call ( not my patient by the way) and say they felt short of breath. When I walked in to assess the patient ( I was covering lunch for another nurse) I went to check the oxygen setting and noticed that the O2 tubing was connected to a suction head and it was turned onto low suction. Thank goodness sats were still in upper 80's. Corrected the error. To make things worse I found out that a respiratory therapy student had made the error. Patient was ok though. Situation was immediately report to my director. She is who found out who made the error. Goes to show you have to check everything every time you walk in a patients room

Up Vote Up Vote ×
+ Join the Discussion