After working for several days on the medical floors I have made a list of Do’s and Don’t for oxygen therapy. This list is for the highly intelligent and skilled nurses of the Sunny Flats CardioPulmonary Floor, though I suspect it would apply to many other nurses and floors out there. Ready? Here we gooooo!!!
DO: Call the respiratory therapist when your patient’s O2 sats are 85% on a nonrebreathing mask.
DON’T: Plug the nonrebreathing mask into the air flowmeter and then argue that “there’s oxygen in the air.”
DO: Titrate the oxygen to the patient’s SPO2.
DON’T: Wean the patient to a 2-liter-a-minute venturi mask.
DO: Humidify oxygen at high flows.
DON’T: Plug the 15-liter-a-minute nonrebreather into the nasal cannula bubbler. That whistling noise means it’s going to pop…
DO: give the ambulatory oxygen-dependent patient an oxygen cylinder.
DON’T: give them an empty one.
DO: change the unresponsive mouth-breathing patient to mask oxygen.
DON’T: forget to plug the mask in.
DO: monitor the COPD patient who has chronic hypoxemia and hypercarbemia
DON’T: allow them to turn gray around the lips, fingernails, and ears simply because you fear putting oxygen on them.
DO: ambu the patient who stops breathing and call the respiratory therapist STAT
DON’T: ask the respiratory therapist to give the apneic, unresponsive patient an albuterol treatment.
This list should give you a pretty good idea how my weekend here at the hospital has been. It’s like a circus, except the clowns wear scrubs and I’m only laughing so I don’t scream at people.