My protocol in the ambulance service states that I should give an FiO2 of
0.98 to acute COPD.
I recently had a patient on my bus who had a high lateral infarct with CCF -
ONF very poor. NO evidence of COPD.
At the receiving hospital I was asked to take the patient off high flow O2
and reduce to 24% for COPD even though there was no PMH of this. This has
bothered me ever since as there was no obvious indication of COPD at the
time.
The questions I must ask - as I must be assume ignorance are -
How does COPD present as an acute and new onset as opposed to CCF with AMI.
All the paramedic manuals state COPD in an emergent situation should be
given high flow O2. Is there a change of thinking here or are the ambulance
services ahead of AEU.
I thought I was right and unless you chaps can produce evidence to the
contrary I shall assume the evidence I have to hand is correct and the doc
wrong.
High flow or not - that is the question.
Mike Bjarkoy
Paramedic
Sussex
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