Pulse Ox/ Permission

[OCEMTDOC]

Hey Everyone,

If I bought my own pulse ox do I typically need to get my permission from my company to use it? As long as I manually check pulse/ blood flow radially before and after transport I don't think it would be a big deal. I just would like to use it as an extra tool to monitor the patient.

Thanks

 

[Qulevrius]

Does your company list O2 sat reading on the PCR/ePCR ? If yes, you have to do it. If no, would you not use pulse oximetry devices in sending facilities because they aren't approved by your company ? Long story short - it's a non-invasive procedure and for all intent and purpose, buying/using your own pulse ox = buying and using your own stethoscope (instead of the cheap POS the companies provide us with).

 

[DesertMedic66]

Does your company list O2 sat reading on the PCR/ePCR ? If yes, you have to do it. If no, would you not use pulse oximetry devices in sending facilities because they aren't approved by your company ? Long story short - it's a non-invasive procedure and for all intent and purpose, buying/using your own pulse ox = buying and using your own stethoscope (instead of the cheap POS the companies provide us with).

Just because it's listed on the ePCR does not mean you have to do it. My company has Chest Tube Montering on ours but that is something we don't do.

 

[Qulevrius]

Is Chest Tube Monitoring listed under 'Primary Assessment' ? If yes, you kinda do have to do it. But I'm guessing it's optional (in case the pt does indeed has a chest tube).

The only reason I would not take a pulse ox reading is if I don't have the means to do it. The company 'understood' and didn't bust our balls for reassessments w/o O2 sat (they never provided us with oximeters). But for any hospital discharge, it was a must.

 

[DesertMedic66]

Is Chest Tube Monitoring listed under 'Primary Assessment' ? If yes, you kinda do have to do it. But I'm guessing it's optional (in case the pt does indeed has a chest tube).

The only reason I would not take a pulse ox reading is if I don't have the means to do it. The company 'understood' and didn't bust our balls for reassessments w/o O2 sat (they never provided us with oximeters). But for any hospital discharge, it was a must.

It doesn't matter what is listed on a PCR. If that skill is not in your scope of practice then you should not be doing it (pulse ox is not a BLS skill everywhere)

 

[Qulevrius]

Then help me understand this. Primary assessment consists of CC/2', LOC, GCS, eyes+lungs and v/s (BP, HR, O2 sat and T). That is the particular order it is listed on the PCR. Primary assessment/follow up reassessments are never negotiable. Other than that, there are optional things such as pain management (in case the pt states any pain), precautionary measures (in case the pt requires them) and interventions (in case the pt needs it), and they have to be documented. If the pt has self-operated pump, non-arterial line, g-tube etc, I can transport because it falls under the scope of practice. What I already said and will repeat, is that as long as it is required by the company and does fall under my scope of practice, I have to do it.

 

[STXmedic]

I have never heard of patient care being dictated by what's on your generic, non patient specific PCR. That sounds ridiculous and sure as hell not what we do down here.

 

[Tigger]

Since when does a primary assessment require an SpO2 reading? It could be helpful, but required seems a bit onerous/useless.

 

[Ensihoitaja]

Since when does a primary assessment require an SpO2 reading? It could be helpful, but required seems a bit onerous/useless.

Presumably because then you can bill extra for it?

 

[Qulevrius]

Presumably because then you can bill extra for it?

Nah, it's just a c/p off of hospital charts. CC/2', LOC, GCS, eyes+lungs+SS and v/s consisting of BP, HR, SpO2 and T. Whether or not it is viable, necessary, onerous or redundant is an entirely different subject - as long as the company requires it. Welcome to LACo BLS.

 

[Aprz]

I am going to chip in with everyone else. Just because it is on your PCR doesn't mean it is required on in your scope of practice.

If your company wants you to document the hospital's last set of vitals. Sure... I guess that is all right. Be clear that it is not your own set and then obtain your own set. Saying they want you to document what their vital signs were and then doing pulse oximetry does not mean it is okay for you to pulse oximetry or other things that are out of your scope of practice. You can refuse to do something a company ask you to do if it is illegal or unsafe. This includes if the company ask you to act outside of your scope of practice or write a fraudulent PCR (sounds like LA is notorious for that).

Don't buy a pulse oximeter for work. It is useful for monitoring their pulse and getting their SpO2, but not that useful. Not worth the bother.

 

[Tigger]

Does your company list O2 sat reading on the PCR/ePCR ? If yes, you have to do it. If no, would you not use pulse oximetry devices in sending facilities because they aren't approved by your company ? Long story short - it's a non-invasive procedure and for all intent and purpose, buying/using your own pulse ox = buying and using your own stethoscope (instead of the cheap POS the companies provide us with).

This is what you wrote initially. Excuse us for taking issue with that. Maybe your company requires it, most are smart enough not to.

 

[Qulevrius]

This is what you wrote initially. Excuse us for taking issue with that. Maybe your company requires it, most are smart enough not to.

Careful not to catch vertigo bru, that horse of yours is mighty high.

 

[STXmedic]

Careful not to catch vertigo bru, that horse of yours is mighty high.

Why? Because your ridiculous policy was called out? Some companies suck. It's not your fault. Just realize most companies aren't anything like LACo (thank god).

 

[Qulevrius]

Calling out companies on their policies is OK, take it up with them all you want. Being condescending to others on the forum while sporting a 'Community Leader' tag = not cool. Jus' sayin'

 

[STXmedic]

I'm sorry if you got your feelings hurt for your company being called out, but I don't see where Tigger was being condescending to you. He made direct quotes, and mentioned how good companies are smart enough to not make something as ridiculous as that a policy. So unless you are the owner or policy-maker of your company, I don't see him attacking you.

 

[Tigger]

Calling out companies on their policies is OK, take it up with them all you want. Being condescending to others on the forum while sporting a 'Community Leader' tag = not cool. Jus' sayin'

Please explain how this is being condescending? You made a generalization that was incorrect. Most companies/services do not require you to fill out every single box of the PCR, especially regarding vital signs. Perhaps we wish to provide accurate education to the OP who is presumably relatively new?

 

[Akulahawk]

Hey Everyone,

If I bought my own pulse ox do I typically need to get my permission from my company to use it? As long as I manually check pulse/ blood flow radially before and after transport I don't think it would be a big deal. I just would like to use it as an extra tool to monitor the patient.

Thanks

Does your company list O2 sat reading on the PCR/ePCR ? If yes, you have to do it. If no, would you not use pulse oximetry devices in sending facilities because they aren't approved by your company ? Long story short - it's a non-invasive procedure and for all intent and purpose, buying/using your own pulse ox = buying and using your own stethoscope (instead of the cheap POS the companies provide us with).

A company that I used to work for a long time ago built a PCR that could be used by BLS, ALS, or CCT-RN level providers. It had a LOT more listed than what any local BLS provider was even authorized to do, and even ALS providers for that matter. The real question is if the OP is authorized, in his/her scope of practice, to take and monitor SpO2 readings. If the answer to that question is "yes" then the next question is whether or not the company will authorize it. While an SpO2 unit is non-invasive, when it's used by an individual for their own use on themselves or their family, that's one thing. However, if you're using it in a medical environment, who does the upkeep/calibration to ensure that it's as accurate as the manufacturer or FDA (or any other appropriate regulatory agency) requires it to be? Since that's the case, will the company do the biomed maintenance on the unit for the OP?

Now all that notwithstanding, when I transported patients from a facility where they were monitoring the patient with EKG, SpO2, NIBP, etc, I would write down all those values that were provided for me by the facility, even if the patient was being downgraded to BLS for transport to another facility. If any of those readings required interpretation above my current level of licensure, I would also include info about who did the interpretation for me. That very well could have been in the form of: "Received report from Bob, RN at Some Hospital ER, including VS and EKG interpretation."

 

[Jim37F]

Our ePCR vital signs field has boxes for a bunch of different things, the usual systolic/diastolic blood pressures, pulse rate, respiratory rate, but also has boxes for things like MAP, SpO2, EtCO2, Blood Glucose, Pain scale, etc (I'll have to take another look next time I'm at work at all the boxes available). One of the intricacies of our particular ePCR software is that one of the "critical" fields (required to be filled out, otherwise I can't even upload the ePCR without it) is the Pain scale (and who was documenting that particular line of vitals). I.e. if I want to document the Pts BSG, I also have to put in their current pain (doesn't matter what the CC is), but I do not have to document a full set of every possible vital the ePCR designers decided to include (plus our ePCR software is designed to be used by both BLS and ALS crews so I only have to put in whats applicable mostly)

For a BLS transport if I was documenting SpO2, that'd be a surefire way to see a Supervisor truck pulling up to one of our posts and have to explain how I'm documenting something without the proper tools to do so since we don't stock those on BLS units (it's understood and acceptable to document pulse ox readings off the hospitals or fire's monitors on scene)

 

[StCEMT]

I will check them at the hospital just to see if they need O2, but usually if they do the hospital already knows about it. Otherwise no, I don't have one provided to me or a bunch of money to spend on one. And no, I don't have to list it on 99% of what I do. It is an option, but I have something like what Jim mentioned. Critical things I HAVE to fill out for it to transmit and then other things I can add in or that pop up depending what I write. O2 sat is not one that I must fill in every time, matter of fact I don't think I've ever had to fill one in.