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The Decision to use PRN Oxygen in a Treatment Session

Bini Litwin, PT, DPT, PhD, MBA

November 13, 2013

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Question

If you are working with a patient who has oxygen ordered PRN, at what point would you decide if you would put the oxygen on during your treatment session?

 

Answer

In the case study in my course, the patient's respiratory rate was 90 at rest. I was concerned as to what was going to happen with activity. I would start him at a very low level of activity, and I would have him do the breathing exercise, the pursed lip breathing, before.  I would try this first.  I would not automatically put on the supplemental oxygen. Chances are that apprehension or pain are creating the increased respiratory rate, and it is a temporary problem that we can alleviate through ways other than using supplemental oxygen.  If it was a patient who I knew had long-term breathing problems or had had a surgical procedure that might impair the ventilatory process, I might ask the physician before I got started if he wanted the patient to start at a very low level of 2 liters. However, I do not think I would put it on or push it until I really assessed that patient’s tolerance for activity and how well they did with low levels of mobility like some in-bed activites. I like to watch them with bed mobility or with transitions from lying to sitting to standing to see what happens when I use breathing interventions first.

 


bini litwin

Bini Litwin, PT, DPT, PhD, MBA

Dr. Litwin PT DPT PhD MBA has been a physical therapist for over 35 years, having worked in various clinical settings throughout her professional career. She has been on faculty at Nova Southeastern University in Ft Lauderdale, Fl for the past 14 years, where she is Associate Professor in the Physical Therapy Department.  Her teaching responsibilities include Cardiovascular and Pulmonary PT, Applied Clinical Decision Making and Critical Inquiry. She has numerous peer reviewed publications and presentations at national and international conferences.

 




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