Paramedic National Registry Practice

If a patient with carbon dioxide retention tears off their non-rebreather mask, how should oxygen be delivered?

1. Venturi Mask

2. Nasal Cannula

3. Bag-Valve Mask

4. Simple Face Mask

The correct answer is: Nasal Cannula

In the case of a patient with carbon dioxide retention, delivering oxygen effectively while minimizing the risk of further carbon dioxide buildup is crucial. Using a nasal cannula is appropriate in this situation because it allows for a controlled and lower concentration of oxygen delivery, typically around 24% to 40%. This is particularly beneficial for patients retaining carbon dioxide, as it helps maintain adequate oxygen saturation without overwhelming the respiratory system, thus preventing potential respiratory distress or additional complications. In contrast, other methods like a Venturi mask can deliver specific and controlled oxygen concentrations, but they may not be as well tolerated or effective in a patient who is already experiencing difficulty managing carbon dioxide levels. A bag-valve mask may also deliver high concentrations of oxygen but can increase the risk of hypercapnia (high carbon dioxide levels) if the patient is unable to effectively expel carbon dioxide. A simple face mask provides a higher concentration of oxygen than a nasal cannula but is less effective in controlling the exact amount of oxygen being delivered and may lead to discomfort or loss of the mask, similar to the scenario with the non-rebreather mask. Therefore, using a nasal cannula strikes the right balance of effective oxygen delivery with a reduced risk of exacerbating carbon dioxide retention.