Is that the Smell of Oxygen in Use?

 As we pull up to the assisted living center with lights flashing and anticipation for the smell that seems so common as you walk in the door, we breathe a sigh of relief.  There is oxygen in the air and friendly people to greet us.  The call is for breathing problems and a possible stroke and we are taken to a room  and find an elderly germen man sitting up in a soft chair with two care workers, a family friend and the patient’s wife all in a small room. My paramedic partner begins assessing the patient and finds him to be very lethargic and not answering questions. His airway is open and he seems to be maintaining it on his own. A field neurological exam we refer to as a Cincinnati Stroke scale is used to find he has some weakness in his left side. A blood pressure and pulse are taken and found to be normal. He is a diabetic, so a blood glucose is taken and found to be 137, not bad for a diabetic. I notice an oxygen machine in the corner and see a long tube with a cannula on the end. I ask the care givers if the patient is normally on oxygen and I’m told he has not needed it for the past few days. The patient is loaded onto the cot and as I move I can now see the heart monitor and notice the patient’s SpO2 is 84%, not good. I point this out to my partner who has been asking questions to the care givers and family. He hands me an oxygen mask and we apply it with 15 LPM. As we wheel him down the hall and load him into the ambulance we witness a miracle. The man begins to come around and by the time he arrives at the hospital he is talking to us and answering questions appropriately. Was it a mini stroke, a diabetic issue or something else? 

The symptoms of generalized hypoxia depend on its severity and rate of onset. In this case it may have taken hours or perhaps a day for signs and symptoms to be revealed. In the case of altitude sickness, where hypoxia develops gradually, the symptoms include headaches, fatigue, shortness of breath, a feeling of euphoria and nausea. In severe hypoxia, or hypoxia of very rapid onset, changes in levels of consciousness, seizures, coma, priapism, and death occur. In cases where the oxygen is displaced by another molecule, such as carbon monoxide, the skin may appear 'cherry red' instead of cyanotic.