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Discussion in 'Internship' started by gretel, Apr 26, 2007.
how do I calculate the oxigen amount for oxigentherapy in a COPD patient????
whut's this oxigen thing? oxygen wit an electron removed?? If you using oxygen mebbe try turning it up until he not turning blue...
What's to calculate?
Awww....c'mon now...it appears the OP is in Ecuador and English is probably not her first language.
There is no one right number to set the FIO2 for a COPD patient, but they likely survive daily at lower oxygen sats than the rest of us...turn it up too high and they lose their drive to breathe.
Room oxygen fiO2 is appox. 21%. If nasal canula used, add approx. 3% for each additional Liter. Nasal canula maximum is 40%. The same applies to face mask (maximum 55%) and CPAP (up to 80%). Endotracheal incubation maximum is 100%
Also check out www.floeos.com it is in it's beta version, but it is free.
Not everybody believes in the losing-the-drive-to-breathe-story, but who wants to be the one messing up? If things get serious, your patient will be more likely to die from hypoxia than low CO2 (yes, if the promoters of the story are correct, you may need to bag mask ventilate or intubate them, but at least the patient survives).
So, watch your patient carefully. With nasal cannulas and face masks, it is hard to get a really accurate measurement of O2 supply anyway, you can just use the numbers to follow a given patient over time.
Please correct me if I`m wrong.
I'm one who certainly believes the story, because I've seen it happen on more than one occasion.
Generally, patients with severe enough COPD to require oxygen are accustomed to a lower oxygen tension in their blood and walk around on a day-to-day basis with a SpO2 in the low to mid 80s.
On an inpatient, I will usually aim to keep a COPD patient's SpO2 between 88 and 92%. The nurses don't like that, though, so when one goes into the room to examine the patient, make sure the O2 hasn't been turned up too high.
Outpatients who are on O2 at home (whether continuous or intermittent or nightly) obviously do not get monitored. In the US, in order for medicare to pay for O2 at home, the patient must have a resting or exercise SpO2 < 88%, which must be demonstrated and documented. Again, usually the goal with oxygen is to keep the SpO2 above 88%.
Hope this helps.
I'm sure you know this, but it really doesn't have anything to do with what the patient's usual O2 level is. It's their usual CO2 level that requires keeping their O2 saturation lower than in a healthy person.
As a patient becomes more hypercapnic, the respiratory centers become accustomed to higher CO2 levels and the drive to breathe is regulated by lower O2 levels, rather than CO2. However, it is still important to maintain adequate oxygen levels - it just so happens that "adequate" is adjusted downward a bit in those with chronic hypoxic lung disease...
just in case the OP was talking about this is:
RA is 21%,every 1 liter of o2 via Nasal cannula adds 3%. Only calculation as far as i can see.