7. Red flags and emergency escalation
Any of the following is acted on immediately. EMS is activated first for respiratory failure; provider notification and orders follow. Oxygen is never withheld from a hypoxic patient in an emergency, but the ordered ceiling is respected in routine care to avoid suppressing the respiratory drive.
Red flags — act immediately Severe respiratory distress — accessory-muscle use, inability to speak in full sentences, or a respiratory rate far above the ordered range → activate EMS. Cyanosis, or SpO₂ below the ordered floor that will not rise with the ordered oxygen → activate EMS. A silent chest (no audible air movement) → impending respiratory failure — activate EMS. New confusion, drowsiness, or a falling level of consciousness → possible carbon-dioxide narcosis — activate EMS; do not simply increase oxygen above the order. An increase in all three cardinal symptoms, or a moderate exacerbation not responding to the action-plan step → notify urgently for steroids or antibiotics. New or worsening lower-extremity edema with weight gain beyond the ordered threshold → possible cor pulmonale; notify (cross-reference Cardiovascular). |
|---|