NREMT Paramedic Cognitive ExamAirway, Respiration & VentilationMedium
A 60-year-old male with a history of COPD is receiving oxygen via nasal cannula at 2 L/min. His current SpO2 is 92%, and he is alert and oriented. He reports feeling 'a little more breathless' than usual. What is the most appropriate initial action regarding his oxygen therapy?
- ASwitch to a Venturi mask to deliver 28% oxygen.
- BMaintain current oxygen therapy and reassess frequently.
- CIncrease oxygen to 4 L/min via nasal cannula.
- DSwitch to a non-rebreather mask at 10 L/min.
Show answer & explanationAnswer & explanation
Correct answer: B. Maintain current oxygen therapy and reassess frequently.
For COPD patients, the goal is to maintain an SpO2 between 88% and 92%. This patient is within the target range. Increasing oxygen unnecessarily can depress the respiratory drive in some COPD patients. The appropriate action is to monitor his condition and maintain the current therapy as it is meeting the saturation goal.
Why the other options are wrong
- A. Switching to a Venturi mask for 28% oxygen might be considered if the nasal cannula was insufficient, but the current SpO2 is adequate.
- C. Increasing oxygen beyond the target SpO2 of 88-92% for COPD patients can suppress their hypoxic drive.
- D. A non-rebreather mask delivers high concentrations of oxygen, which is generally not indicated for stable COPD patients meeting their target SpO2.
Controlled Oxygen in COPD
Administering oxygen to COPD patients requires careful titration to maintain an SpO2 between 88-92% to avoid suppressing their hypoxic respiratory drive.
- Target SpO2: 88-92%.
- Avoid excessive oxygen.
- Monitor respiratory drive.
Memory trick: For COPD, 'Keep the Oxygen Calm, 88-92 is the Golden Balm'.