Why should patients with an altered mental status and no pulse oximeter reading initially receive supplemental oxygen therapy?

Patients with an altered mental status may have a reduced ability to respond or clear their airway, which can significantly increase their risk of hypoxia—an inadequacy of oxygen in the body. When the brain does not receive enough oxygen, it can lead to confusion, disorientation, or loss of consciousness, manifesting as an altered mental status. Administering supplemental oxygen in these patients can help to ensure that their brain and other vital organs receive adequate oxygen, potentially reversing or mitigating their altered mental status.

Providing supplemental oxygen in such cases is therefore critical in addressing the underlying issue of hypoxia. This proactive approach is vital, especially since patients may not show accurate readings on a pulse oximeter, particularly when they are presenting with an altered mental status. Rather than relying solely on devices, addressing the potential underlying hypoxia through oxygen therapy is a necessary and immediate intervention.

While other options, such as mitigating carbon monoxide poisoning, preventing cyanosis, or establishing the accuracy of the pulse oximeter may be relevant in different contexts, they do not directly address the primary concern for patients presenting with altered mental status—namely, ensuring adequate oxygenation to the brain.