Purchasing an Oxygen kit and where to get O2

[divingmedic]

But that is only going to give what precentage of oxygen is being put out by the device. What is more important is what percentage that is being taken in by the hemaglobin. The FIO2 of any device is always subject to a great number of things. Oxygen is only going to help not cure DCS.

 

[Thalassamania]

But that is only going to give what precentage of oxygen is being put out by the device. What is more important is what percentage that is being taken in by the hemaglobin. The FIO2 of any device is always subject to a great number of things. Oxygen is only going to help not cure DCS.

I don't know where you're going with this, but the question on the table is the FIO₂ of various masks.

 

[DaFireMedic]

I'm looking for real data, not quotes from a textbook. I've read (and for that matter written) enough texts to not place my faith there, that's just the best the author remembers and that the the editors missed or didn't know either. On the other hand it may well be right. I'd like the references that support those numbers.

I just pulled out the latest Mosby paramedic textbook, and the AAOS Emergency care textbook and they give similar numbers. The fact is that this is the best data available, and is what is taught and accepted among the emergency medical community. This in itself does not make the data accurate, but it does represent the best data currently available. Such numbers will never be exact under all circumstances. But debating 5% differences in O2 administration is counterproductive, as there are many variables beyond that effect a persons ability to metabolize oxygen (patient's physical conditioning, body metabolism, lung conditions, diseases, etc.) I just want the best method of oxygen delivery for a given circumstance.

 

[Thalassamania]

I just pulled out the latest Mosby paramedic textbook, and the AAOS Emergency care textbook and they give similar numbers. The fact is that this is the best data available, and is what is taught and accepted among the emergency medical community. This in itself does not make the data accurate, but it does represent the best data currently available. Such numbers will never be exact under all circumstances. But debating 5% differences in O2 administration is counterproductive, as there are many variables beyond that effect a persons ability to metabolize oxygen (patient's physical conditioning, body metabolism, lung conditions, diseases, etc.) I just want the best method of oxygen delivery for a given circumstance.

I don't care about the "best" way to administer oxygen to the average patient that is seen on a paramedic run. Just being a diver selects out a lot of people. Actually I'll take that one step further, I'm not overly concerned with the "best" way to administer oxygen to the average diver. My first concern is the best way to administer oxygen to a diver who is healthy enough to pass a diving duty medical exam, because that's mainly whom I dive with, after that comes the question of the "average diver." With a much more uniform population the variables that you mention recede into the background and sheer hard numbers come to the fore. They've got to be out there somewhere.

 

[divingmedic]

I don't care about the "best" way to administer oxygen to the average patient that is seen on a paramedic run. Just being a diver selects out a lot of people. Actually I'll take that one step further, I'm not overly concerned with the "best" way to administer oxygen to the average diver. My first concern is the best way to administer oxygen to a diver who is healthy enough to pass a diving duty medical exam, because that's mainly whom I dive with, after that comes the question of the "average diver." With a much more uniform population the variables that you mention recede into the background and sheer hard numbers come to the fore. They've got to be out there somewhere.[/quot

to put in a very short and simple answer, if they are breathing on their own then a non breather, if not I am going to use a BVM.

 

[Thalassamania]

to put in a very short and simple answer, if they are breathing on their own then a non breather, if not I am going to use a BVM.

but a non breather may be as low as 80%. It seems the only way to guarantee 100% to a conscious diver is a demand valve, and it seems the best way to guarantee 100% to a unconscious diver is either the same or a bag resuscitator if they're not breathing on their own. While they may be the best thing since sliced bread in other circumstances, I just don't see a non breather being an optimum choice in a diving situation.

 

[divingmedic]

I trust a BVM over a demand valve, but then I have been a paramedic for 27 years and highly skilled in their usuage. It still baffles me why DAN is promoting the use of them when Ems did away with them years ago.

 

[DaFireMedic]

I don't care about the "best" way to administer oxygen to the average patient that is seen on a paramedic run. Just being a diver selects out a lot of people. Actually I'll take that one step further, I'm not overly concerned with the "best" way to administer oxygen to the average diver. My first concern is the best way to administer oxygen to a diver who is healthy enough to pass a diving duty medical exam, because that's mainly whom I dive with, after that comes the question of the "average diver." With a much more uniform population the variables that you mention recede into the background and sheer hard numbers come to the fore. They've got to be out there somewhere.

I don't think that we are as far from agreeing as what it may seem. You just said that you are concerned with utilizing the best way to administer O2 to the person that needs it, in your case the diver that you are assisting. I agree, but I would add that the hard numbers are irrelevant, as they are not something that you have any control over, except in the choice of delivery device and the proper use of it. If you are using a BVM with supplemental oxygen to assist an unconscious, non breathing person (diver or not), you cannot control the whether it is providing 85% or 100% O2. You can only make sure that the O2 is set properly and that the reservoir is filling adequately, and that you are performing the technique properly. The hard numbers don't matter much at that point, you only need to know that method A gives a higher percentage than method B.


The diving duty medical exam may make it more uniform than the general public, but the same variables still exist, as do the O2 delivery methods for a given situation. Divers come in all physical conditions, undiagnosed diseases, metabolic rates, age, etc, even those who have passed the diver duty medical exam. But these only apply to the persons ability to metabilize the oxygen, not to what method of administration you will use for a given situation. A diver who surfaces unconscious/not breathing will get the same O2 administration method as a bystander on the island who just dropped over from heart failure if they are presenting the same. I am only concerned with what I have control over.

I see what you are saying about the hard numbers with regards to Non-Rebreather vs Demand. This makes sense, although a non-rebreather will provide the highest numbers of its range when the reservoir is filling fully between each breath. The reason I would choose a demand device over an NRB is that the NRB is constant flow, and with a possible limited supply of O2, could mean the difference in preventing a gap in treatment.

 

[DaFireMedic]

I trust a BVM over a demand valve, but then I have been a paramedic for 27 years and highly skilled in their usuage. It still baffles me why DAN is promoting the use of them when Ems did away with them years ago.

I agree, but as you already know the BVM takes practice to use correctly, far more so than the demand valve. The demand valve is perhaps the easiest to use and teach to the layperson, and they have the flexibilty for use as demand oxygen source for the conscious patient. But I agree, they should be removed from DAN's list of approved devices. I have one on my setup, but only for the conscious person to use, NOT for assisting ventilations.

 

[divingmedic]

If they are not breathing I would rather intubate them, but I do not go around carrying a advanced airway kit on my dive trips, then we get into the whole medical control thing. I think this horse is dead and beaten to a bloody pulp.