Dang, must be nice! Correct me if I'm wrong, but in SoCal, aeds are completely optional. The only ambulances that have them are approved 911 providers. And that's by choice.
LACo EMT Scope: Pulse Oximetry Added
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Dang, must be nice! Correct me if I'm wrong, but in SoCal, aeds are completely optional. The only ambulances that have them are approved 911 providers. And that's by choice.
Christopher
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That is insane. AED's are required for all levels of ambulances, whether IFT/convalescence or 911.
OP
OP
NPO
Forum Deputy Chief
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Thats correct. In fact, CA has it regulated to a point where it becomes difficult and excessively expensive to maintain AEDs on all ambulances.
Gyms are required to have them. But not an ambulance... <_<
MedicalSlick
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Although great that SPO2 (PulseOx) was added to your certain scope, remember to not be the person to put the pt. on 15LPM via mask when the pulse ox says %70 but pt. provides no symptoms (Dyspnea, cyanosis, etc..), because then you just look like a jackwagon.
JPINFV
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So you're saying not to treat the acutely hypoxic person because of a lack of immediate symptomatology and no reason to suspect that the pulseox reading is wrong (i.e. pulse not correlating, terrible waveform, etc)?
Chris07
Competent in Incompetence
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..remember that old classic and favorite saying...."treat the patient not the monitor" 
Jim37F
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Hmmm....if my monitor showed 70% but the patient showed no other signs of needing O2.....I'd probably take it off the patient, give it a quick sani-cloth wipe and put in my finger to see what it says (we're supposed to check ours during shift check out each morning). If it then showed my normal ~95% and the patient still at 70%, I'd probably put them on a NC and see what it says and make sure I alert the hospital to the fact that our patient is now showing a significantly reduced Spo2 than what they were on scene but no other changes and see what they say
JPINFV
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..remember that old classic and favorite saying...."treat the patient not the monitor"
I'm treating the fact that a tool I'm using (which I have presumably troubleshot to ensure that the reading is accurate... correlating pulses, good waveform, etc) that measures an aspect of the patient that I can't directly measure is giving me a critical value. It's like saying that you aren't going to treat hyperkalemia (yes, I know that EMS generally doesn't have access to lab value) simply because there's no EKG changes (yet). It's not "go crazy and upgrade code 3," but to say, "do nothing" is more than a bit mindbogglingly. More so when the moral of the "treat the patient not the monitor" fairy tail is "Don't ignore a normal pulseox because your patient is compensating with a rate of 40."
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I would tend to agree... if the tool I've got is giving me some good numbers, I'm quite likely to begin treating based on those numbers. In the case of the pulse oximeter giving a 70% reading and I know it's giving me good readings, you'd better believe I'm going to put the patient on at least some oxygen. While the patient may be compensating well for now, just bringing the SpO2 up to a more normal reading may somewhat resolve some issues... like perhaps the reason you were called out to begin with... like perhaps my all-time favorite chief complaint from many a SNF: "Weakness and Lethargy."
It's kind of funny when you show up and assess your patient and you realize that they're just a little bit hypoxic. Then you give just a little oxygen and they suddenly perk up...
What's less funny is when I get the report for such a patient and I'm told they put the patient "all the way up to 3 LPM" and when I get to the patient, they're still profoundly hypoxic and they start to perk up a bit when I put them on a much higher concentration. Oh, the glares I got from some of the nurses when I did that...
It's kind of funny when you show up and assess your patient and you realize that they're just a little bit hypoxic. Then you give just a little oxygen and they suddenly perk up...
What's less funny is when I get the report for such a patient and I'm told they put the patient "all the way up to 3 LPM" and when I get to the patient, they're still profoundly hypoxic and they start to perk up a bit when I put them on a much higher concentration. Oh, the glares I got from some of the nurses when I did that...
Lol seriously time for yall to get out of that state.