O2 at 3 lpm via Mask

We walk in the door and find the nursing home patient trying to pull the mask off his face. He is on oxygen at only 4 lpm(liters per minute) , which is more than the amount -- 3 lpm -- written on the W10 the nurse has handed me.

Oxygen by mask at 4 lpm is like putting a plastic bag over someone's head. You need at least 10 lpm to keep the patient from suffocating on his rebreathed carbon dioxide. 3 liters is obviously even worse.

I think about reaming out the nurse, but she seems flustered and there are many aides around her and patients. I hold my tongue because once you start...

This is not the first time I have seen this. This has been going on ever since I started in EMS back in 1989. Even before then as my EMT instructor warned me I would encounter this. I see it all the time.

The patient is, what else? lethargic, suffering from advanced cancer. His breathing is better once I take the mask off his face.

As we head out the front door, I am just about out when I hear someone say, "Where's his oxygen?"

I stop cold in my tracks. "Pardon me?"

"Where's his oxygen mask? He needs it, he keeps pulling it off."

That's when I lay into her. I use the plastic bag line.

"Don't blame me, I'm just an aide. I'm going to call the nurse and tell her you said that."

"Good, about time someone told her."

And she picks up the phone and starts dialing.

With a cannula the man's SAT is up to 95%.

I show the W10 to a nurse at the hospital. "It makes me embarrassed to be a nurse," she says. "They went through the same training I did, and they flush it down the toilet. But the sad thing is it's probably a doctor's order."

"For 3 liters by mask."

"They're not required to get continuing ed."

I glance at the doctor's name. I recognize it. I went to his office once for asthma and found a patient on a mask at 1 liter. Oh vey.

***

I imagine myself on Capitol Hill testifying before the legislature. "We need this bill to outlaw once and forever the practice of giving people oxygen by mask at less than ten liters of oxygen. Please join me today in ending this terrible suffocating abuse of our senior citizens, who deserve so much more for making this country great."

Ovation. American Flags.

***

Did a dsypnea, a woman feeling woozy after three days ago having an incident than left her with difficulty in using her fine motor skills of the fingers of her right hand, and a diabetic. The diabetic came in as a stroke, and the patient was gurgling and flaying about. His skin was very hot -- he had pnemonia. Blood glucose less than 20. I gave him two amps of D50. I wanted him to go because he'd never had a similar episode and was not an insulin dependent diabetic -- he took numerous diabetic pills, but he stubbornly refuused. Talked to his MD, who said it was okay he stayed home, provided his friend monitored him closely.