|
During a medical emergency, the EMS provider should remember to treat the patient, not the machine. Patients who are displaying signs of shortness of breath should be given oxygen. In an ACS setting, 2-4lpm by nasal cannula is usually sufficient to provide an SpO2 of ≥ 94%. However, if you are in doubt, administer oxygen via the nonrebreather mask. Depending on where the infarct is located within the heart, high concentration may be indicated. Be sure to adhere to your local protocol for oxygen administration.
AHA 2020 guidelines: "EMS providers should administer oxygen if the patient is dyspneic, is hypoxemic, has obvious signs of heart failure, has an arterial oxygen saturation less than 90% or unknown. Providers should adjust oxygen therapy to a noninvasively monitored oxyhemoglobin saturation 90% or greater. The usefulness of supplemental oxygen therapy has not been established in normoxic patients with suspected or confirmed ACS, so providers may consider withholding it in these patients [29]
In addition, guidelines state "Give supplemental o2 when indicated. For cardiac arrest patients, administer 100% for oxygen. For others adjust oxygen administration to achieve oxygen saturation of 95% to 98% by pulse oximetry (90% for ACS and 92% to 98% for post-cardiac arrest care. |
