Should you use a non rebreather mask on a copd in distress?

Answer 1

Many COPD patients have no history of smoking. What you are asking is whether high levels of oxygen are indicated for those with chronic lung pathologies. Regardless of WHY the patient is in distress, withholding oxygen to someone with demonstrated critically low oxygen levels does more harm than good. There are many confusing and contradictory statements made about oxygen delivery and many are based on bad assumptions.

To simplify the story:

1) one should have a means of determining low blood oxygen levels;

2) aim for a blood oxygen level of 90-94% or so;

3) just because you are delivering 100% oxygen in the mask doesn't mean that the patient is receiving 100% to the bloodstream (i.e. a 24% mask can deliver "too much" oxygen and a 100% mask may not deliver enough depending on their condition);

4) the conventional non-rebreather mask only delivers 55-60% oxygen at the best of times, proven by research;

5) most textbooks are not research and often quote oxygen levels using no references that support those claims (thereby perpetuating the myth);

6) the worst possible thing one can do is with-hold oxygen to someone demonstrating critically low blood oxygen levels...deliver what you can to get them to 90-94%.

A non-rebreather mask may not deliver enough oxygen to a patient as their condition worsens. Therefore, as long as you can demonstrate a "need" for oxygen, a non-rebreather mask may be perfectly acceptable and occasionally insufficient.

Answer 2

yes