Non-rebreather use?

I used a non re-breather mask with 5L O2 with a Pt who was mottled, RR 28-32, O2Sat 88. I couldn't find a regular mask and my thought was that he was mouth breathing so a canula wouldn't have done much good.

Did I use the right O2 delivery system or should I have used the canula?
Right system wrong liter flow. A non-rebreather requires 10-15 lpm.

Quote from Do_GoodI used a non re-breather mask with 5L O2 with a Pt who was mottled, RR 28-32, O2Sat 88. I couldn't find a regular mask and my thought was that he was mouth breathing so a canula wouldn't have done much good.Did I use the right O2 delivery system or should I have used the canula?

Great explanation Akulahawk! OP Given your description of the patient I still think the NRB was a good choice had it been used correctly.

Quote from FlyingScotGreat explanation Akulahawk! OP Given your description of the patient I still think the NRB was a good choice had it been used correctly.

Quote from akulahawkTo prevent reservoir bag collapse at lower flow rates, take the rubber tabs off the side of the mask and that will make it function like a simple mask, with the typical flow rates you can use with those. "Room air" will be more easily inspired and will mix with the O2 in the mask. The concentration of O2 will be lower than with a fully-functioning NRB at a high flow rate. Depending upon the patient's work of breathing, I might start off with a nasal cannula and "upgrade" the O2 delivery device & concentration based on the response.Personally, I'd have likely started off with a cannula and titrated up from there, if the patient's status warranted starting that low.

A respiratory rate as high as reported by the OP qualifies as respiratory distress and the mottled skin is concerning for circulatory shut down. The oximetry of 88% is less of a worry for me because honestly it's not that low. In addition, the theory that giving COPD patients high flow 02!will shut down their respiratory drive is a myth that has been disproven over and over. I would certainly hope that this patient was transported immediately or a rapid response was called that would limit the possibility of the need for high flow 02 for any length of time. Despite this, I still stand by my praise of your post. You gave a lot of good information.

Yep like the others said, you were fine with the NRB but too low on your O's. Next time take a good look at the NRB and make sure the bag is filled, it won't hurt anything by having the O's up more than the pt may need because of the equipment you have. I would assume the pt still felt like they couldn't breathe with the O's that low.

Many RTs have assured me again and again that NC's still provided oxygen even if the patient is mouth breathing. If you don't have adequate equipment you have to work with what you have.