(The real reason) Why COPD patients get low-flow O2

nasalcannula_dummyWith brand-new EMT students riding with me, I like to take a moment to explain why many of our “shortness of breath” patients are likely to receive a nasal canula instead of a NRB cranked to 15lpm. We talk about baroreceptors and chemoreceptors and the hypoxic drive and how they’re likely to see a question about COPD patients and oxygen administration somewhere along the line.

Turns out that’s all wrong.

LifeInTheFastLane sent an email with their most-viewed articles of 2015, and this one, Oxygen and CO2 Retention in COPD, was right at the top. And for a good reason.

The gist of it: increased O2 administration causes vasodilation of normally constricted vessels leading to poorly ventilated alveoli. This causes a V/Q mismatch. Also, the Haldane Effect.

The next time you have a student or are oxygenating a COPD patient, consider why, and get that hypoxic drive stuff out of your head.

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