Episode #11 – Are we harming patients with oxygen?

EMS 12-Lead podcast – Episode #11 – Are we harming patients with oxygen?

In this episode of the EMS 12-Lead podcast we're joined by Kelly Arashin, ACNP, CCNS and Mike McEvoy, PhD, RN, CCRN, REMT-P at EMS Today 2013 in Washington D.C. We discuss the benefits and dangers of oxygen administration. 

Kelly is a dual boarded advanced practice nurse and Chair of the Hypothermia Steering Committee at Hilton Head Hospital in Hilton Head Island, SC.

Mike describes himself as a nurse, paramedic, firefighter, and medical college professor. He is also Chair of the Resuscitation Committee for University Teaching Hospital in Albany, NY.

Mike is the author of the article Can Oxygen Hurt? and taught an educational session at Physio-Control University entitled To Give Oxygen or Not: That is the Question. 

*** Update ***

Thanks to Brooks Walsh, M.D. for bringing this article to our attention:

Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality

Tom Bouthillet, Kelly Arashin, Mike McEvoy at EMS Today 2013

Special thanks to Physio-Control, JEMS, PennWell, and the ProMed Network

You can also watch the video version.

See also:

Follow Kelly Arashin on Twitter at @BarefootNurse24

Visit Kelly's blog

Follow Mike McEvoy on Twitter at @McEvoyMike

Visit Mike's website

Subscribe to the EMS 12-Lead podcast on iTunes

6 Comments

  • PJ says:

    Really interesting podcast.
    Appreciated the issue about ventilating to End Tidal Co2 values
    Thanks

  • Jon Kavanagh says:

    It is all a bit mind-blowing (for those of us shifting our practices).  We hold these truths to be evident, yet can't quite walk out on the ledge and be confident in the studies.  Perhaps as the agencies that tell us what to do (AHA/ILCOR, etc.) get on board, or are made to be less influential (read, fear of going against the authorities), change will happen…

  • Nathan says:

    Glad to heat Im not the only one struggling with motivating change with medical directors and other providers!

  • Nathan says:

    *hear*

  • Peet Nienaber says:

    Hi, thanks guys, this was very interisting, I hope this go down to EMS as protocol. 

  • Maria says:

    Hey all, this was absolutely great…so very informative.  Hopefully the changes mentioned here can be implemented into EMS sooner rather than later.

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
Christopher
59 year old male: chest pressure – Conclusion
I read back over the details on this case and they didn't include whether or not the patient was Left-dominant. Your hunch is probably correct!
2014-09-22 12:55:42
Jeff
Rate Related VS. Primary ST-T Changes:
He's complaining of 10/10 chest pain that coincided with palpitations with a HR of 206 that is probably A-Fib. I am guessing that if you correct his rate you will allow his myocardium to become perfused again and his chest pain will subside. I would pre-sedate him with Midazolam 2mg and electrically cardiovert starting @…
2014-09-21 19:17:36
Michael
Rate Related VS. Primary ST-T Changes:
I just don't see adequate evidence for WPW. I would be confident administering this PT Cardizem at .25mg/kg based on his hemodynamic stability. I'd also like to know more about PT history, like does he have AFIB at baseline and, if so, what does he take for it. I would also ask about a history…
2014-09-21 12:06:31
Tony
59 year old male: chest pressure – Conclusion
Thank you Christopher. I am wondering if this particular patient is one of the minority where the LCx is the dominant artery supplying the Posterior and Inferior regions. I believe this to be the case in only about 15% of the population. Whereas approx. 80% are Right dominant.
2014-09-21 08:39:21
John
Rate Related VS. Primary ST-T Changes:
ECG is a rapid atrial fibrilation with ventricular rates approaching 300 beats per minute suggestive of WPW. Widespread ST segment depression is most likely rate related ischemia; elevation in aVR is not a reliable finding with a rapid heart rate point away from LMCA occlusion. Slow the rate before looking for ischemia, injury, or infract.…
2014-09-21 01:49:03

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