Injectable Oxygen

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exodus

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DrankTheKoolaid

DrankTheKoolaid

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Yeah pretty interesting concept. Will be a study to watch thats for sure. Thats not where I read about it but I listened to a podcast with the folks doing the study, he had a lot of interesting things to say. When i get to my home comp Ill put up a link to it
 
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Sandog

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I wonder how they prevent embolisms?
 
Schroeder

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Holy cow, it seems almost too good to be true.
 
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DesertMedic66

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If I remember correctly one of the main arguments against it is yes you get oxygen inside but where is the carbon dioxide going after the body converts it? Is it just going to keep building up in the blood?
 
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Doczilla

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Well, the issue is maintaining coronary perfusion pressure more than it is maintaining pao2. Most people can rely on residual capacity for several mins, but without adequate CAPP, this is worthless.
 
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EMT B

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I'd really really hate to necro this, but they just added an update to the study.

clicky

So your patient is getting oxygenated, but they aren't ventilating. Anyone else worried about acidosis due to a build up of serum CO2 levels? In what situations do you think this would be helpful, and when do you think it could become harmful?
 
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mycrofft

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Yeah, I've had my head handed to me a few times when I got too focused on O2 and not enough on CO2 etc.

Wonder what the liters per minute exchange would have to be, especially as regards accessing the circ system to reliably infuse it? How does it affect the kidneys after it's work is done? Where doe the fat go after the oxygen's spent?

And as regards "battlefield" situations, how portable is it, how stable, how much prep is required?
 
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EMT B

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From what I've heard, it will be slightly larger than an amp of D50 and comes mostly pre assembled, just like the D50
 
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blindsideflank

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Well the body can handle some acidosis. I think I read that the heart works better at a ph of 7.2. I'm also concerned about reperfusion injury, perhaps hypothermia plus this would be necessary.

It's a good fit for EMS and our "may as well try it, we have no other options" mentality. (which is true and I think very unique to EMS and why we have such a cool scope of practice ie:pericardiocentesis etc.)

How about having 5-8 mins to intubate?
 
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EMT B

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you could give the patient some bicarb, but thats still not going to remove the CO2 from the body. And then you have to worry about sodium overload.

Maybe it was just my teacher's philosophy, but I was told if you have to push more than 2 IV drugs to fix the problem, then it isn't your job to fix.
 
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chaz90

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EMT B said:
Maybe it was just my teacher's philosophy, but I was told if you have to push more than 2 IV drugs to fix the problem, then it isn't your job to fix.
Click to expand...

Hmm, how about severe anaphylaxis? IV Diphenhydramine, let's say you do an IV Epi drip, and Solu-Medrol after you get bored and already have the Albuterol neb on (also IV saline boluses, but that's kind of cheating to make my point). I'd say anaphylaxis is something an ALS provider should strive to fix. There are plenty of other examples too. I think it would be more accurate to say "let's really think if we're going about this the right way" if we're to the point of pushing 3+ IV meds pre hospitally.

Still agree with your point on the original topic though. There's a lot of problems that need to be worked out with this concept of "injectable oxygen." CO2 accumulation and acidosis are only two of them, and this is a looonnng way from common use in the field.
 
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NomadicMedic

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EMT B said:
Maybe it was just my teacher's philosophy, but I was told if you have to push more than 2 IV drugs to fix the problem, then it isn't your job to fix.
Click to expand...

Guess we better try to do that RSI with just two drugs. Which should I pick?

You teacher sounds like someone who'd rather preach worn out maxims than teach proper interventions. I bet he has a tshirt that says "BLS before ALS" too. :/
 
Sandog

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The volume of O2 would have to be very small to be inject-able, I would imagine the injection would have to occur within the tissue of concern to do any good, and then the efficacy would only be for a very short period of time,
unless the dispensing device was large, and then you would still need to transport the stuff through the body?
I dunno, above my pay grade.
 
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ExpatMedic0

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By that rule of thumb, If I am only doing RSI with 2 drugs, I guess I might as well administer one of them to myself.... Probably midazolam, that way I wont remember how awful of a clinician I am thanks to its amnesia effects.
 
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