Peter

We use way too much oxygen. If studies show that we ventilate cardiac arrest patients too rapidly with oxygen, then on strategy might be to decrease the amount of oxygen we use when we ventilate.

We know that Oxygen not only doesn’t help, but might be harmful to stroke patients, yet most EMTs still persist in giving high concentration Oxygen to them. I’ve developed quite a reputation among the BLS crews for arriving on scenes and directing them to switch out from a non rebreather to a cannula. To the point that some of them are using cannulas routinely now. Plus, I don’t see nurses taking patients off cannulas as I do NRB.

A lot of the responsibility for this falls on system medical directors and training staff who maintain what I call the “Chicken Soup” approach to some medications. “Can’t hurt, might help.” is the thought process here. Only it can hurt. That and the 1994 revision of the BLS curriculum that determined that BLS (and by extension ALS) patients were too dumb to know how much oxygen a patient might need.

Yes it’s counter intuitive to not give Oxygen. After all it’s something we are taught to do almost from Day One of EMT training. One of the hardest things to do in medicine, and probably most fields, is unlearn old untruths and replace them with new ones.

Here, http://tinyurl.com/yeq8h3n is a blog post on the subject I put up in January.

Good post.

I also agreed, we definitely need a large scale randomized study looking at 02. The problem is there isn’t a lot of money to be made proving oxygen is overused. All the big studies are funded by drug companies or medical device makers trying to prove their products make a difference.