When should oxygen be withheld from a patient?

Oxygen should be withheld from a patient who is hyperventilating without hypoxia because hyperventilation often leads to elevated carbon dioxide levels being expelled from the body, causing a decrease in bicarbonate levels and potentially creating a condition known as respiratory alkalosis. In such cases, the patient’s body is already receiving more oxygen than it needs, and administering supplemental oxygen may not provide any benefit and could potentially worsen the situation by further driving down carbon dioxide levels, which may lead to symptoms like light-headedness or tingling in the limbs.

In situations of respiratory distress or for an unconscious patient, oxygen is typically indicated to ensure adequate oxygenation and prevent hypoxia, while for patients with a history of COPD, cautious oxygen therapy is often employed to avoid suppressing their respiratory drive, but withholding oxygen outright isn't standard practice. In short, it’s critical to assess a patient's overall condition and need for oxygen rather than applying a blanket policy.