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Finding My Place In The Respiratory World

Hypoxic Drive

Published February 15, 2013 8:25 AM by Kevin Johnson

We have all read about it. We are aware of it's existence. It lurks somewhere in the deepest recession of our Eagan's filled psyche; we know it's possible. But, just as a stat IS, it doesn't mean you will ever actually see it. At least that's what you pray...

The docs are aware of it too. Sure the older, more seasoned vets realize that the tales of this phenomenon are greatly exaggerated, but like a Big Foot, they fear it sneaking up on them when they least expect it. And so they write crazy orders like "keep SpO2 < 86%" and "not >2.5L NC"; orders of which no RT shall pass, cyanosis be damned! What mythological creature could drive such smart men and women to such measures of insanity? What is the vile beast lurking in the medulla oblongatas of lungers across this great land that causes such visions?

The dreaded HYPOXIC DRIVE!

Every RT has had it drilled into his or her brain since day one of respiratory school that you should never withhold O2 for fear of knocking out the HYPOXIC DRIVE! But when it comes to reasoning with a physician, reason doesn't always trump "well my med degree says so!" So despite obvious distress, O2 is withheld... And sadly it is the patient who suffers, while the docs stubbornly hold their ground, determined that the pot of gold at the end of the rainbow really does exist.

So how is an RT to fight this bogus fear? How are you experienced RTs out there in respiratory world combating these rediculous orders? I have not been an RT for long, but have already had to fight this battle twice and both times was unsuccessful to the detriment of the patient...

Any tips?

 

posted by Kevin Johnson

2 comments

FYI,

I give a detailed explanation of the Hypoxic Drive MYTH with references to show docs the truth, in my book, "ABG Pocket Guide".

Available at www.RespiratoryBooks.com.

It is also available online at www.RespiratoryUpdate.com.

Check it out and hope this helps.

Dana

Dana Oakes, , President RespiratoryBooks.com February 20, 2013 10:47 AM
Orono ME

Unfortunately we not only have to deal with the Docs,but RNs,EMT/paramedics and others.  A featured speaker at last years Foocus Conference (a RRT with 30 years), claimed that hyoxic drive did not exist and his goal in his Thousand Bed institutions was to eliminate all air flow meters.  Of course he had no qualified studies to back his claim.  Although rare I have seen it a half dozen times in my 40 years and constantly fight the hypoxic battle as well.  I think that is why we are here to fight ignorance.

For your MD I would use other MD's and or peer reviewed articles

in responsible journals.

Kim Marx, Respiratory - RRT RPFT RPSGT, Hospital February 15, 2013 9:47 AM
Macclenny FL

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