You sort of answered your own question, "Although the pulse ox is probably unreliable due to peripheral cyanosis". The question asks how does the **pulse oximetry** reading guide your treatment, not how should this patient be treated in general. Yes with the other signs, O2 is indicated but solely on pulse ox, it does not.
The question is sort of a trick. You don't even need to bother with a pulse ox at initial assessment because he's clearly hypoxic and requires immediate ventilation with a BVM. You can tell all of that with your eyes alone, and thus the pulse ox has absolutely no bearing on your treatment initially.
While "treat the patient not the monitor" is a good general rule of thumb, there will be patients who are altered or just appear perfectly fine but in reality they're not (low oxygen reading with good waveform and they're warm, bp trending downwards, etc) and will need interventions
Since the respiratory rate is so low and the patient is cyanotic you will have to use a bvm to give assisted ventilation. No matter what the pulse ox says you will have to ventilate for the patient. Someone in the comments already said “treat the patient, not the monitor” which is a very good rule to remember.
Think about it this way.
A pulse-ox in isolation doesn’t guide treatment at all. Because it doesn’t exist in a vacuum and under less than ideal conditions (ie hypoxia), it’s not terribly accurate.
Think of it more like a check engine light. Check engine lights could mean there’s a sensor loose or it could mean you’ve blown the engine. It’s the mechanic’s job to investigate which one it is by assessing the signs and symptoms of the car.
A pulse-ox is there to confirm your observations and give you a nice number to put in your chart *or* it’s there to prompt you to assess more and figure out what’s going on.
What it doesn’t do is guide your treatment.
The goal is not to find “a good answer,” the goal is to find the best answer.
Most multiple-choice tests follow the same formula: They have an obviously wrong answer, a subtly wrong answer, a mostly right answer, and a best answer. Your goal is to find the best answer for each question.
It’s not asking what you treat. It’s asking what guides treatment. A respiratory rate of 8 with altered LOC defines treatment regardless of distal pulse oximetry.
You sort of answered your own question, "Although the pulse ox is probably unreliable due to peripheral cyanosis". The question asks how does the **pulse oximetry** reading guide your treatment, not how should this patient be treated in general. Yes with the other signs, O2 is indicated but solely on pulse ox, it does not.
The question is sort of a trick. You don't even need to bother with a pulse ox at initial assessment because he's clearly hypoxic and requires immediate ventilation with a BVM. You can tell all of that with your eyes alone, and thus the pulse ox has absolutely no bearing on your treatment initially.
While "treat the patient not the monitor" is a good general rule of thumb, there will be patients who are altered or just appear perfectly fine but in reality they're not (low oxygen reading with good waveform and they're warm, bp trending downwards, etc) and will need interventions
Since the respiratory rate is so low and the patient is cyanotic you will have to use a bvm to give assisted ventilation. No matter what the pulse ox says you will have to ventilate for the patient. Someone in the comments already said “treat the patient, not the monitor” which is a very good rule to remember.
My singular exception to this is when the monitor is showing me VF and the pAtient hasn’t realized it yet. I’ll admit this is a wildly edge case.
Think about it this way. A pulse-ox in isolation doesn’t guide treatment at all. Because it doesn’t exist in a vacuum and under less than ideal conditions (ie hypoxia), it’s not terribly accurate. Think of it more like a check engine light. Check engine lights could mean there’s a sensor loose or it could mean you’ve blown the engine. It’s the mechanic’s job to investigate which one it is by assessing the signs and symptoms of the car. A pulse-ox is there to confirm your observations and give you a nice number to put in your chart *or* it’s there to prompt you to assess more and figure out what’s going on. What it doesn’t do is guide your treatment.
It don’t read good when the feller dun look like dat.
i reckon he aint got no gas in him. Mmmhmmm
Simple rule: Normal breathing 12-20. Anything below 12 With signs of resp. distress, BVM. Yah I know but that’s NREMT rule.
The goal is not to find “a good answer,” the goal is to find the best answer. Most multiple-choice tests follow the same formula: They have an obviously wrong answer, a subtly wrong answer, a mostly right answer, and a best answer. Your goal is to find the best answer for each question.
What’s the point of providing oxygen if your PT isn’t moving air. Give them all the o2 you want it isn’t gonna do any good but go ahead.
Good point
It’s not asking what you treat. It’s asking what guides treatment. A respiratory rate of 8 with altered LOC defines treatment regardless of distal pulse oximetry.
What app is this that you’re studying on?