Medication 7-669 - Oxygen

Polk, Hickory, Cedar, & St Clair EMS Protocols

Scope of Practice:

• Emergency Medical Responder
• Emergency Medical Technician
• Advanced Emergency Medical Technician
• Registered Nurse
• Paramedic

Route(s):

• ET, IN, Inhalation, Neb,

Pharmacodynamics (class and mechanism of action):

• Necessary for aerobic cellular metabolism.

Pharmacokinetics:

• Half-life: NA.
• Onset time: NA.
• Peak action time: NA.
• Duration of action: NA.

• Peak	1	minutes
  Duration	1	minutes

Dosing:

• Refer to specific protocol(s) for dose(s).
• Generalized dosing chart:

• Condition	Target SpO2
  Anaphylaxis	100%
  Anemia	100%
  Toxin (i.e. Carbon Monoxide, Cyanide, Smoke Inhalation, etc.	100%
  Cardiac Chest Pain	90% - 99%
  Dyspnea	88% - 99%
  ROSC	92% - 98%
  Stroke	94% - 99%
  Trauma	100%

Indications:

• Virtually all protocols where SpO2 is less than 88%. The overall goal of Oxygen therapy is to avoid tissue hypoxia.
• Arterial hypoxemia or a failure of the Oxygen-hemoglobin transport system.
• Arterial hypoxemia: Oxygen saturation of less than 88% and may result from impaired gas exchange in the lung, inadequate alveolar ventilation or a shunt that allows venous blood into the arterial circulation
• Failure of the Oxygen-hemoglobin transport system: Reduced Oxygen carrying capacity in blood (i.e. anemia, carbon monoxide poisoning) or reduced tissue perfusion (i.e. shock).
. .

Contraindications:

• Known Paraquat Poisoning unless SpO2 is less than 88%.

Pregnancy Risk Factor:

• No Category
• FDA has not yet classified the drug into a specified pregnancy category.

Potential Incompatibilities:

• None.

Precautions and Adverse Effects:

• Humidify when providing high-flow rates over extended periods of time.
• Hyperoxia resulting from high FiO2 administration producing saturations higher than 94-96% can cause structural damage to the lungs and post reperfusion tissue damage.
• Use caution with patients who are chronically hypoxic (i.e. COPD, ALS, MS) have shifted their Oxygen dissociation curve and require lower Oxygen saturations. Prolonged Oxygen therapy may depress ventilator drive
• High blood Oxygen levels may disrupt the ventilation / perfusion balance and cause an increase in dead space to tidal volume ratio and increase PCO2.
• May cause drying of mucous membranes.

Antidote:

• NA.

Controlled Substance Information:

• Not a scheduled drug
• The DEA and FDA have not identified this drug with a schedule classification.
• DEA number: NA.
• Narcotic: No.
• Street names: NA.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols by Theron Becker is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.