Hypercapnia is a frequent cause of AMS in the emergency department. Today we are going to bust a few myths and address of some of the common pitfalls in the management of these very sick patients. Let's get started.

Hypercapnia is a frequent cause of AMS in the emergency department. Today we are going to bust a few myths and address of some of the common pitfalls in the management of these very sick patients. Let's get started.

During 15 minutes of high oxygen administration, an initial decrease in minute ventilation, which recovers substantially, is seen in patients with acute exacerbation of chronic obstructive ...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3682248/

The consequence of this myth is that providers are often reluctant to give supplemental oxygen to a patient with COPD and CO2 retention because they are afraid of inhibiting the patient's "hypoxic drive" and further worsening their condition.

Interactive Model of the Alveolar Gas Equation:

http://vam.anest.ufl.edu/simulations/alveolargasequation_simple.html

Link to Video: https://youtu.be/zZX9jJqSlQs

We can see here for a healthy adult the mm

Link to Video: https://youtu.be/dHi9ctwDUnc

The consequence of this myth is that providers are often reluctant to give supplemental oxygen to a patient with COPD and CO2 retention because they are afraid of inhibiting the patient's "hypoxic drive" and further worsening their condition.

NIPPV Contraindications:

- Inability to protect airway or clear secretions.
- Impaired level of consciousness
- Cardiac or respiratory arrest.
- Hemodynamic instability.
- Facial surgery/trauma/deformity.
- Pneumothorax.
- Upper airway obstruction.
- Complicated multi-organ failure.
- Recent esophageal anastomosis.

Hypercapnia is a frequent cause of AMS in the emergency department. Today we are going to bust a few myths and address of some of the common pitfalls in the management of these very sick patients. Let's get started.