Procedure 1

Oxygen Administration

Severe Respiratory Distress

Chronic Obstructive Pulmonary Disease (COPD)





A.  Severe Respiratory Distress

General Care

BLS        1.      Administer high flow oxygen by a non-rebreather facemask or    BVM to all of the following but not limited to:

a)   Patients in congestive heart failure (CHF) or with suspected pulmonary edema.
b)   Patients with obstructive pulmonary disease in severe respiratory distress.
c)   Patients with upper airway burns and toxic inhalations.


B.  Chronic Obstructive Pulmonary Disease (COPD)

Adult Care

BLS        1.      If the patient is showing signs of respiratory distress, administer            high-flow oxygen as in any other critical patient.

2.      If the patient is awake, alert and not showing signs of respiratory distress and on home oxygen therapy, administer oxygen via nasal cannula at 1 L/minute higher than their rate at home.  If the home oxygen rate is not known or if the patient is awake, alert and not showing signs of acute respiratory distress, administer oxygen at
3 L/minute via nasal cannula and monitor respirations.

C.  Stroke/CVA

General Care

BLS        1.      Patients without severe respiratory distress presenting with signs and/or symptoms of an acute CVA will be given O2 via nasal cannula at 2-4 L/min.

2.      If signs of severe respiratory distress are present treat according to section (A) above.
3.      If pulse oximetry is available, administer O2 by the most appropriate means in order to achieve a saturation of > 96%.


D.  Special Notes

Patients not falling under the above categories will be treated with a non-rebreather face mask at 12-15 L/minute.  Additionally, a pulse oximetry reading that falls within normal limits does not eliminate the requirement for O2 delivery.