I was standing by observing this tense scenario just after the breathing tube had been removed during a routine tonsillectomy. Jackie started to obstruct and her oxygen level dropped rapidly. She was still heavily sedated and sleeping, but was making abdominal efforts to breathe. At this point I took action by offering to hold the mask on the patient’s face with my two hands while the anesthesiologist used his two hands to squeeze the bag on the anesthesia machine to help blow air through the patient’s mask. Rather than pressing the mask down tightly on the patient’s mouth and nose, I lifted up the patient’s lower jaw with my 3rd to 5th fingers while squeezing the mask on the patient’s face using my thumbs. Almost immediately, it became much easier to squeeze air into the patient’s lungs and the oxygen level started to come back up again.
After a few minutes of letting Jackie breathe like this, she was able to breathe on her own again, with an oxygen level of 99% on 100% oxygen. In the few minutes it took to transfer her to the stretcher, the nasal oxygen prongs were off, but she was able to breathe on her own and still oxygenating at 97%. Despite this “normal” oxygen level on room air (around 21%), the anesthesiologist insisted on placing her back on 100% oxygen during transfer to the recovery room.
If you look at health trends these days, the perennial message is that your body needs more oxygen. We are inundated with countless oxygen-enhanced beverage options, and even more breathing devices and techniques to increase oxygen levels in your brain and your body. For most patients who undergo surgery, it is expected that you will be given oxygen through plastic nasal prongs hooked up to the wall. The basic assumption is that either due to illness or after surgery, you will not be able absorb oxygen in your lungs, or you won’t be able to breathe deeply enough after surgery.