North Carolina EMT State Practice Exam

In managing a patient with COPD, why is high-flow oxygen sometimes considered problematic?

1. It is always contraindicated

2. It can have a negative impact on hypoxic drive

3. It gives too much oxygen to the brain

4. It leads to increased carbon dioxide retention

The correct answer is: It can have a negative impact on hypoxic drive

In managing a patient with chronic obstructive pulmonary disease (COPD), high-flow oxygen is sometimes considered problematic primarily because it can have a negative impact on hypoxic drive. Patients with COPD often have developed a reliance on low oxygen levels in their blood to stimulate their drive to breathe, known as hypoxic drive. When high-flow oxygen is administered, it can raise blood oxygen levels to a point where this drive is diminished or suppressed, potentially leading to inadequate ventilation and further complications. This is particularly crucial in understanding the balance needed in oxygen therapy for COPD patients. While adequate oxygenation is essential, too much oxygen can suppress the respiratory centers of the brain, leading to decreased respiratory effort and could even contribute to respiratory failure in extreme cases. Thus, while oxygen therapy is vital, careful monitoring and titration to maintain an appropriate level for these patients is crucial in preventing harm.