How Much Oxygen to Give a Patient with COPD? (TMC Practice Question)

This video breaks down a TMC Practice Question about providing oxygen therapy to a patient with COPD. What should you be aware of in this case?

➡️A 61-year-old male patient with emphysema is receiving oxygen via air-entrainment mask at 45%. One hour after oxygen therapy was initiated, the patient appears lethargic and obtunded. Which of the following is the most likely cause in the change of the patient’s status?
A. Hypotension
B. Refractory hypoxemia
C. Respiratory muscle fatigue
D. Oxygen-induced hypoventilation

Do you know the answer? Let's break it down.

First and foremost, you needed to recognize that emphysema in an obstructive disease that is classified as a type of COPD. Patients with COPD are typically chronic CO2 retainers which means that their ABG results would show: Compensated (Chronic) Respiratory Acidosis.
 
These patients are prone to oxygen-induced hypoventilation which means that receiving high levels of oxygen can affect their ventilation-to-perfusion balance in the lungs. It ultimately causes an increase in deadspace ventilation and, thus, an increase in the PaCO2 level. So for COPD patients, it is recommend to provide an FiO2 that is low enough to keep their PaO2 in the 50-60 torr range. This is equivalent to an SpO2 85-90%.

With that said, this is where a lot of confusion comes into play for many students when covering this topic. Because sometimes they are scared to give any oxygen to the patient, just because they have COPD. That's the big misconception. Yes, you should be careful and be mindful of their condition. But always remember: You should NEVER deprive oxygen from a patient in need just because they are a CO2 retainer. Hypoxemia is still hypoxemia, no matter if the patient has COPD or not. So as a Respiratory Therapist, you still need to treat these patients by providing adequate amounts of oxygen.

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🚑MEDICAL DISCLAIMER
Medicine and Respiratory Therapy are continuously changing practices. The information in this video is for educational and entertainment purposes only. For medical advice, please consult with a physician or qualified medical professional.

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⏰TIMESTAMPS
0:00 - Intro
0:30 - Practice Question
1:07 - Explanation
3:08 - Correct Answer

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🖼CREDIT FOR MUSIC AND GRAPHICS:

#RespiratoryTherapy #RespiratoryTherapist #RespiratoryTherapySchool

[Tinfoilhat]

I am a COPD patient on oxygen. I set my equipment on low oxygen percentage for that very reason. It's a balancing act. I use an oximeter to measure o2 absorption all the time. If i do need to increase o2 percentage, it is only for short periods of time.

[maristella]

I got the answer right. You are amazing. Thank you!!!

[brittneywashington]

thank you. I love your channel, I am a student and you help me out tremendously

[patriciajohnson]

Can you please tell me this so I can understand it. I'm HAVE COPD AND CANNOT UNDERSTAND ANYTHING YOU ARE TALKING ABOUT.

[leenooomohamed]

thank you very very very very very very much ... it was great Ilike it

[drjamunakrishnan]

To read domicilary oxygen therapy.the aim of therapy is prolongation of life in rehabilation of copd.second objective will be to prevent acute exacerbation thro vaccinations and prevent hospitalization.where falling into right hands becomes individual luck.how much o2 to deliver only the pulmonologist to decide based on patient comfort zone.

[johnmoss]

Does the more lung diseases you have . Is it a cause for more steady usage of oxygen. I have asthma copd overlaps syndrome, Eosinophilic asthma, Non auditory asthma, and I'm a severe environmental allergy sufferer. I'm on 2 liter pretty much 24/7. If to much oxygen causes problems then why do I feel like crap when my blood oxygen levels are below 90%and I feel better at above 90 %. I almost passout at under 87 %. I have been on 2 liter of oxygen for over 9 years now. Is this doing me harm? By your explanation it is. I'm I right in the understanding your answer. I have a professor of pulmonary disease as my doctor.

[missdonzcox]

My sister recently died in her sleep and she was on a home oxygen concentrator with the oxygen level on 3 and a half and the doctor said death by COPD your thoughts would be muchly appreciated

[rahulsomaiya]

Can a nonsmoker person have COPD at 35 age ?

[patricesilva]

I'm grateful for Our Lord n Savior and who puts all these

[jimbetche]

I got it right before he even started explaining it lol.

[sondrajoyce]

NO! NOT DO YOU EXPECT US TO KNOW WHAT ALL THOSE LETTERS W/NUMBERS MEAN??