# PulseOx for BLS



## MMiz (Jan 25, 2006)

Almost a year ago I started a thread looking for reasons why BLS units should carry PulseOx units.  We now have them on the rigs, but I'd say that I would much rather see the money spent elsewhere.  I used the PulseOx to wow kids at the Middle School EMS Club... but realized that the readings were all over the place.

It's a great tool, but a simple pinch of a finger or visual exam does a good job too (It's $700 cheaper too!)


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## TTLWHKR (Jan 25, 2006)

I've lost three, and never even used them. :unsure:  I think the Nonin gnomes carried them away. Ours are black and yellow, with a colored string thing. I usually use the one attached to the monitor, but some how the little one in the rig disappears.


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## ResTech (Jan 25, 2006)

I am a fan of pulse oximitry for BLS... a very simple tool for evaluating (and continuously evaluating) oxygenation and heart rate.... especially for pt's. with obstructive pulmonary diseases... makes it easier to see pt. response to treatment. Yes, they are expensive but I think itz a worth while investment. In PA, we have funds available every year called EMSOF, which is taken from surcharges on traffic citations. The state matches approved purchases 50% so it really cuts down on the cost of a pulse ox. 

The biggest thing I see as a negative with BLS providers using pulse oximitry is they dont understand exactly what they are measuring and the related physiology. But even with this lack I still think the numeric value alone is helpful for BLS. 

TTLWHKR,
When you say the "little one", are you referring to the little finger-style unit?


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## coloradoemt (Jan 26, 2006)

ResTech said:
			
		

> I am a fan of pulse oximitry for BLS... a very simple tool for evaluating (and continuously evaluating) oxygenation and heart rate.... especially for pt's. with obstructive pulmonary diseases... makes it easier to see pt. response to treatment. Yes, they are expensive but I think itz a worth while investment. In PA, we have funds available every year called EMSOF, which is taken from surcharges on traffic citations. The state matches approved purchases 50% so it really cuts down on the cost of a pulse ox.
> 
> The biggest thing I see as a negative with BLS providers using pulse oximitry is they dont understand exactly what they are measuring and the related physiology. But even with this lack I still think the numeric value alone is helpful for BLS.
> 
> ...


 
This is so true. My partner and I had a new hire recently who was trying to get through a clearance ride that used a pulse-ox on a pt simply because, as she stated, "I thought that was what you wanted me to do."


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## DT4EMS (Jan 26, 2006)

I think the pulse ox should be standard. But like every tool, it needs to be used as a "part" of patient care. A pulse should be checked to make sure it matches the rate on the display. 

Treat the patient not the machine/monitor etc. It is like using an auto-cuff to measure B/P but never taking a manual pressure.


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## ffemt8978 (Jan 27, 2006)

DT4EMS said:
			
		

> *Treat the patient not the machine/monitor etc*.



Well said.


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## TTLWHKR (Jan 27, 2006)

ResTech said:
			
		

> TTLWHKR,
> When you say the "little one", are you referring to the little finger-style unit?


 
Yes. And my post is too damn short.


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## ResTech (Jan 27, 2006)

I was just curious who the genius was that would put that type of unit on an ambulance. Of course its gonna walk.. slips nice into someones pocket


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## TTLWHKR (Jan 27, 2006)

WOO HOO! 2,601!!

Anyhoo. I found one crushed in the driveway of the ER, I assume it fell out and was kicked away and ran over by an ambulance. :glare:

The thought on the small ones is easy to deploy and get a simple RA Sat, with out using the monitor. They are usually wrong, easy to lose, and I always offer to leave them in BLS units I intercept. But the SOB's always give them back.


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## Ridryder911 (Jan 27, 2006)

There is no problem with pulse oximetry,the problem is those that use them. Too many are trying to base tx. etc... on the numbers, in which should never occur. Again, poor undersanding of how and why they work. Most EMT's assume that a reading of > 95% is adequate reading. Do EMT's undertand if your hemoglobin is low or RBC's decreased due to bleeding,or having a low blood volume (such as anemia) you can still have a sat of 98%, but be very hypoxic. 

End tidal carbon dioxide (EtCo2) capnography is another excellant tool. Showing appropiate times of giving nebulizers, and differentiating between obstructive diseases and CHF. Of course giving an absolute of proper intubation placement

Both pulse oximetery (measures perfusion) and capnography (measures ventillation)... yes, there is large difference between the two, are great adjunct to make our diagnosis more accurate.

These are only aids for making good clinical descicions.

Be safe, 
R/R 911


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## Wingnut (Jan 28, 2006)

Ok, I don't understand, from what I'm reading you all run into a lot of people who take short cuts. If someone is looking for a job with short cuts WHY did they go into EMS? We spent a week on pulse ox, just because apparently so many people read the numbers and apparently some short lived EMT's here didn't give the pt O2 because they claimed pulse ox reading was "good."  Another one that we were CONSTANTLY pummeled with (aside from scene safety/BSI) was to not make up BP's if you can't get one. That's apparently another problem. Why??Why??Why??


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## coloradoemt (Jan 28, 2006)

Wingnut said:
			
		

> Ok, I don't understand, from what I'm reading you all run into a lot of people who take short cuts. If someone is looking for a job with short cuts WHY did they go into EMS? We spent a week on pulse ox, just because apparently so many people read the numbers and apparently some short lived EMT's here didn't give the pt O2 because they claimed pulse ox reading was "good." Another one that we were CONSTANTLY pummeled with (aside from scene safety/BSI) was to not make up BP's if you can't get one. That's apparently another problem. Why??Why??Why??


 
I will be more than happy to help you STOP THE MADNESS!!!:wacko:
If you have an idea where to start of course...


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## Ridryder911 (Jan 29, 2006)

I can tell you why.... most EMT's do not take this profession seriously. As well, we do not educate our EMS professionals ... we train them. Therefore, it is easy to become one and does not take much effort. If we started emphasizing anatomy & physiology , science etc..and implemented TQiI with enforcement it might change. 

Several EMS adminstrators are apathetic and do not really care the patient is provided as long as there is no litigation and they are able to receive payments. Other wise they would start discharging immediately, medics that performed these occurences and are unable to peform, and have the knowledge of this job.

Be safe,
R/R 911


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