# Oxygen D tank refilling



## Miscusi

Hi Guys, 

Ebay has brand new empty CGA 870 D tanks for around 50 bucks shipped. 

I am going to buy one for my home emergency kit. ( you never know, love thy neighbor and etc )

I have an EMT-B cert.

I have never filled a tank before.

Where in or near New York City can I have a personal D tank filled?

and how much can I expect to pay ?


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## exodus

You need to get an MD to authorize it with a prescription.


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## Medic Tim

Miscusi said:


> Hi Guys,
> 
> Ebay has brand new empty CGA 870 D tanks for around 50 bucks shipped.
> 
> I am going to buy one for my home emergency kit. ( you never know, love thy neighbor and etc )
> 
> I have an EMT-B cert.
> 
> I have never filled a tank before.
> 
> Where in or near New York City can I have a personal D tank filled?
> 
> and how much can I expect to pay ?



oxygen is a medication. You need medical oversight to administer and carry it. ...Unless NY is different than other states.


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## Miscusi

according to my research, O2 is avail without prescription for first aid uses (emergencies) 6 LPM or greater, 15 minutes or more... 

http://www.redcross.org/images/MEDI..._AdministeringEmergencyOxygenFactandSkill.pdf


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## MMiz

Miscusi said:


> according to my research, O2 is avail without prescription for first aid uses (emergencies) 6 LPM or greater, 15 minutes or more...
> 
> http://www.redcross.org/images/MEDI..._AdministeringEmergencyOxygenFactandSkill.pdf


That may be correct, but you're going to find it difficult to get the tank filled without a prescription.


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## Miscusi

MMiz said:


> That may be correct, but you're going to find it difficult to get the tank filled without a prescription.



That may be the case, which is why Im asking if anyone knows of a place that would fill a first aid bottle...

for example, here is a product of oxygen sold without prescription..

http://www.aedbrands.com/defibrillator/first-aid-oxygen/aed-companion-emergency-oxygen.html


I just don't like their price when eBay's brand new D tank is $50 bucks shipped...


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## Mariemt

Why on earth are they allowed to advertise that you need no training to use o2??? 

I apply a pulse ox during an arrest. Its not an o2 free for all!


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## epipusher

This makes two threads now,is this guy trolling?


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## TransportJockey

Mariemt said:


> Why on earth are they allowed to advertise that you need no training to use o2???
> 
> I apply a pulse ox during an arrest. Its not an o2 free for all!



I honestly don't know when the last time I used a pulse ox during an arrest is...


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## Achilles

MMiz said:


> That may be correct, but you're going to find it difficult to get the tank filled without a prescription.


Welding supply 


TransportJockey said:


> I honestly don't know when the last time I used a pulse ox during an arrest is...



Ours displays EtCo2 on the king.


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## TransportJockey

Achilles said:


> Ours displays EtCo2 on the king.



Exactly. And on non-advanced airway codes, I just slap a capnocanula on them while bagging. It works


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## DesertMedic66

Achilles said:


> Welding supply
> 
> 
> Ours displays EtCo2 on the king.



That's pretty much becoming standard on any advanced airway. SpO2 not so much. Never have used it on a full arrest.


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## Tigger

Aren't there studied showing that pulse oximetry readings are actually delayed by five or six minutes? Seems unwise to use on an arrest.


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## Mariemt

DesertEMT66 said:


> That's pretty much becoming standard on any advanced airway. SpO2 not so much. Never have used it on a full arrest.


We do it on everyone if we have the hands to do so.

We does what the protocols says we does...


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## Mariemt

Tigger said:


> Aren't there studied showing that pulse oximetry readings are actually delayed by five or six minutes? Seems unwise to use on an arrest.



Ummmm. No? I can tell my pt ( not an arrest pt of course) to take  couple deep breaths and it goes up within seconds.

I can put it on myself and hold my breath and watch it fall just as rapidly.

We use it per protocol to watch for over oxygenation during arrests at the beginning of CPR while it be trauma or medical while you are setting up your King etc etc. While it is true you expect o2 levels to be down at the beginning, our service prefers to monitor. If it will take time away from CPR, then we can skip it 

Studies show you have a less of a chance of permanent brain injury if you keep o2 SATs between 93 and 95 etc etc. .


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## rwik123

Mariemt said:


> Ummmm. No? I can tell my pt ( not an arrest pt of course) to take  couple deep breaths and it goes up within seconds.
> 
> I can put it on myself and hold my breath and watch it fall just as rapidly.
> 
> We use it per protocol to watch for over oxygenation during arrests at the beginning of CPR while it be trauma or medical while you are setting up your King etc etc. While it is true you expect o2 levels to be down at the beginning, our service prefers to monitor. If it will take time away from CPR, then we can skip it
> 
> Studies show you have a less of a chance of permanent brain injury if you keep o2 SATs between 93 and 95 etc etc. .



Ummmmmmm yes. Tigger is correct. Maybe not as drastic as minutes, but still pertinent. All this spo2 stuff you're talking about Mariemt is honestly BS. Capnography is far more applicable clinically, than Spo2 for arrests. 

Emcrit on it: http://emcrit.org/podcasts/oxygen-physiology/


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## Mariemt

rwik123 said:


> Ummmmmmm yes. Tigger is correct. Maybe not as drastic as minutes, but still pertinent. All this spo2 stuff you're talking about Mariemt is honestly BS. Capnography is far more applicable clinically, than Spo2 for arrests.
> 
> Emcrit on it: http://emcrit.org/podcasts/oxygen-physiology/


Sorry, still part of protocol, yes we use etco2 once established.


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## mycrofft

Achilles said:


> Welding supply
> 
> 
> Ours displays EtCo2 on the king.



Welding O2 is not USP.


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## ffemt8978

mycrofft said:


> Welding O2 is not USP.



USP?  United Society of Possums?

http://www.emtlife.com/showpost.php?p=503772&postcount=15

:rofl::rofl:


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## Akulahawk

mycrofft said:


> Welding O2 is not USP.


Correct. Welding O2 isn't guaranteed to be of the same purity as it would be if it's USP O2. (USP = United States Pharmacopeia). On the other hand, it's entirely possible that the oxygen you get from a welding gas supplier is actually USP, but just isn't labeled that way. 

Where you get the Oxygen, USP or otherwise, is quite likely a welding gas supplier. When I worked in the San Jose area, we used to get our medical gasses from Airgas. They're a welding gas supplier, but they also had a medical gas product line...

We had a cascade system for filling our D tanks if we were running low on filled Jumbo-D tanks. We preferred (by far) to have Airgas do the filling though. If we had to use the cascade system, it was because we'd run out and hadn't gotten any tanks back from Airgas. It was a system that worked pretty well.


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## Achilles

Akulahawk said:


> Correct. Welding O2 isn't guaranteed to be of the same purity as it would be if it's USP O2. (USP = United States Pharmacopeia). On the other hand, it's entirely possible that the oxygen you get from a welding gas supplier is actually USP, but just isn't labeled that way.
> 
> Where you get the Oxygen, USP or otherwise, is quite likely a welding gas supplier. When I worked in the San Jose area, we used to get our medical gasses from Airgas. They're a welding gas supplier, but they also had a medical gas product line...
> 
> We had a cascade system for filling our D tanks if we were running low on filled Jumbo-D tanks. We preferred (by far) to have Airgas do the filling though. If we had to use the cascade system, it was because we'd run out and hadn't gotten any tanks back from Airgas. It was a system that worked pretty well.



Just like when a fire department purchases a saw right?
It's fire grade because it says fire on it and adds 50$ to the price but its really no different from the saw that doesn't say fire on it.


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## NomadicMedic

Achilles said:


> Just like when a fire department purchases a saw right?
> It's fire grade because it says fire on it and adds $300 to the price but its really no different from the saw that doesn't say fire on it.



Fixed that for you.


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## Tigger

Mariemt said:


> Ummmm. No? I can tell my pt ( not an arrest pt of course) to take  couple deep breaths and it goes up within seconds.
> 
> I can put it on myself and hold my breath and watch it fall just as rapidly.
> 
> We use it per protocol to watch for over oxygenation during arrests at the beginning of CPR while it be trauma or medical while you are setting up your King etc etc. While it is true you expect o2 levels to be down at the beginning, our service prefers to monitor. If it will take time away from CPR, then we can skip it
> 
> Studies show you have a less of a chance of permanent brain injury if you keep o2 SATs between 93 and 95 etc etc. .



The five to six minutes came from a Bob Page talk about capnography. Since I cannot find a citation, I will rescind it.

Nonetheless there is plenty of evidence that there is a delay, and it can be significant. This is especially true with patients in extremis as they are likely to not be perfusing well enough to get an accurate oximetry reading. I have found several papers that state that pulse oximetry is not at all helpful in cardiac arrest as surprise, these patients are not perfusing well. On my last few ROSCs we weren't even able to get a SpO2 reading as the patients were still so poorly perfused, even after the addition of pressors. I would like to read those studies you mentioned above as I am not sure how the authors went about obtaining their data.

All told, it really isn't as useful of a tool as it is made out to be. Are you aware of what pulse oximetry measures? Hint: it is not the oxygen saturation level of blood. What does that tell you? 

Here's a good overview, note the author's opinion about its use in cardiac arrest. I have more studies and articles on the subject if you'd like.



Mariemt said:


> Sorry, still part of protocol, yes we use etco2 once established.



As many have said here before, there are few dirtier phrases in EMS than justifying an action or intervention based only on "it's protocol." If you don't understand why you are doing something, you shouldn't be doing it. No excuses.


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## ffemt8978

Tigger said:


> The five to six minutes came from a Bob Page talk about capnography. Since I cannot find a citation, I will rescind it.
> 
> Nonetheless there is plenty of evidence that there is a delay, and it can be significant. This is especially true with patients in extremis as they are likely to not be perfusing well enough to get an accurate oximetry reading. I have found several papers that state that pulse oximetry is not at all helpful in cardiac arrest as surprise, these patients are not perfusing well. On my last few ROSCs we weren't even able to get a SpO2 reading as the patients were still so poorly perfused, even after the addition of pressors. I would like to read those studies you mentioned above as I am not sure how the authors went about obtaining their data.
> 
> All told, it really isn't as useful of a tool as it is made out to be. Are you aware of what pulse oximetry measures? Hint: it is not the oxygen saturation level of blood. What does that tell you?
> 
> Here's a good overview, note the author's opinion about its use in cardiac arrest. I have more studies and articles on the subject if you'd like.
> 
> 
> 
> As many have said here before, there are few dirtier phrases in EMS than justifying an action or intervention based only on "it's protocol." If you don't understand why you are doing something, you shouldn't be doing it. No excuses.



Even if your Medical Director wants it done that way?


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## Mariemt

ffemt8978 said:


> Even if your Medical Director wants it done that way?



It is not a dangerous or potentionally harmful protocol at that. It is one we pit on as we are putting our fast patches on. 
Seriously Tigger. I think there are bigger fish to fry than nit picking  at that one


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## Tigger

ffemt8978 said:


> Even if your Medical Director wants it done that way?


Talk to your medical director if you don't understand why you are doing something. At least you will have his take, though it's obviously not infallible.



Mariemt said:


> It is not a dangerous or potentionally harmful protocol at that. It is one we pit on as we are putting our fast patches on.
> Seriously Tigger. I think there are bigger fish to fry than nit picking  at that one



I'm just pointing out that the literature shows it to be useless in cardiac arrest. There are best practices out there and it's worth researching what they are. If you don't want to use them, that's too bad.


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## Mariemt

Tigger said:


> Talk to your medical director if you don't understand why you are doing something. At least you will have his take, though it's obviously not infallible.
> 
> 
> 
> I'm just pointing out that the literature shows it to be useless in cardiac arrest. There are best practices out there and it's worth researching what they are. If you don't want to use them, that's too bad.



I understand during cardiac arrest your body won't be profusing etc.
We are using the pulse ox for reoxygenation. Maybe we are hopeful we are going to bring this patient back. 
This is not a protocol I am worried about addressing.


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## TheLocalMedic

I still don't know why anyone would want to have their own O2 bottle...  

And I suggest that anyone who carries their own tank should also have a corresponding "BEWARE: I'M AN EMS WHACKER" decal on their vehicle.


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## IslandTime

TheLocalMedic said:


> I still don't know why anyone would want to have their own O2 bottle...



A lot depends on where one is located. We are a rural combined department with volunteer EMTs. Oops, I guess that's a couple strikes against us.    Our EMTs carry oxygen in their vehicles. AEDs are carried by a variety of folks, both EMT and firefighter. The bottom line is our ability to get emergency care on scene as quickly as possible. The difference can be quite pronounced. We might have an individual on scene within a few minutes while the ALS rig is still 10-15 minutes away. 

Having said that, I think there is a huge difference between deciding to go out and buy/carry an O2 bottle on your own Vs being issued one by your company/department.


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## TheLocalMedic

IslandTime said:


> The bottom line is our ability to get emergency care on scene as quickly as possible. The difference can be quite pronounced. We might have an individual on scene within a few minutes while the ALS rig is still 10-15 minutes away.



Okay, you have a point there.  I suppose in a setting that is rural enough, there may be some justification...  

But the OP's location says NYC...  hardly rural.  My whacker radar is still pinging...


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## IslandTime

TheLocalMedic said:


> Okay, you have a point there.  I suppose in a setting that is rural enough, there may be some justification...
> 
> But the OP's location says NYC...  hardly rural.  My whacker radar is still pinging...



Good point. I'd forgotten about that part.     Target dead ahead, 2,000 yards and closing.


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## Miscusi

IslandTime said:


> Good point. I'd forgotten about that part.     Target dead ahead, 2,000 yards and closing.



I honestly think its just cool to have for the first aid kit at home. and the price is not unreasonable. and it lasts forever if you don't use it, so....


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## Achilles

Miscusi said:


> I honestly think its just cool to have for the first aid kit at home. and the price is not unreasonable. and it lasts forever if you don't use it, so....



Still needs to be hydro tested every X amount of years


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## ffemt8978

Miscusi said:


> I honestly think its just cool to have for the first aid kit at home. and the price is not unreasonable. and it lasts forever if you don't use it, so....



Then you're wanting it for the wrong reasons...

And to the rest of our members, take it easy on the anti-whacker responses.  If you feel the need to post one, make sure it is polite and civil....otherwise I will be swinging the ban stick.


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## Miscusi

Achilles said:


> Still needs to be hydro tested every X amount of years




My research indicates that should the test date come, it does not have to be tested until you are done using it.  then it must be tested before it is refilled. there is no need to empty a tank just to have it tested. ( what a waste )

let me pause here where I find a link...

here:  "If a cylinder is in use (filled or partially filled with oxygen) and it reaches its retest date, there is no requirement to pull the cylinder from use or empty the cylinder to facilitate retesting. The cylinder can stay in use until it is emptied. There is no time limit for keeping the cylinder in use. After the cylinder is emptied, it must be tested before it can be refilled and transported."

from the US ARMY medical dept:

http://www.usamma.amedd.army.mil/assets/docs/oxygen cylinder markings.pdf


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## ffemt8978

Military hydorstatic testing requirements are different than civilian testing requirements.


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## Miscusi

ffemt8978 said:


> Then you're wanting it for the wrong reasons...



It may not be your reason, but I cant say my reason, which is to have one in my first aid kit in case it is needed in an emergency, is wrong.

I think my reason is actually very right ! 

Being how there is no shortage of cylinders out there, my purchase will not deprive any particular sector of a cylinder.

And as a trained individual, should a human being happen to be in need if emergency first aid oxygen, I can really help him out.

I can see no wrong in that...


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## Miscusi

ffemt8978 said:


> Military hydorstatic testing requirements are different than civilian testing requirements.



that definitely sparked my interest and will do more research...


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## ffemt8978

Miscusi said:


> It may not be your reason, but I cant say my reason, which is to have one in my first aid kit in case it is needed in an emergency, is wrong.
> 
> I think my reason is actually very right !
> 
> Being how there is no shortage of cylinders out there, my purchase will not deprive any particular sector of a cylinder.
> 
> And as a trained individual, should a human being happen to be in need if emergency first aid oxygen, I can really help him out.
> 
> I can see no wrong in that...


That's not what you said...you said


Miscusi said:


> I honestly think its just cool to have for the first aid kit at home. and the price is not unreasonable. and it lasts forever if you don't use it, so....



And do you not see a problem in administering a drug without a license to do so (and yes, oxygen is considered a drug)?

But let's run down the list of potential problems with this idea:

1) Regulator - you're going to need to buy one of these and it may or may not have to be inspected
2) Tubing - this stuff has a shelf life, so you will be buying replacements over time.
3) Mask - you're going to need various sizes and nasal canulas also.  Again stuff with a shelf life
4) Paperwork - you're going to need to keep records of when and where the cylinder was filled, and all testing performed on the cylinder.
5) Storage - where do you plan on keeping this cylinder, and how are you going to ensure that it remains relatively clean and secure?


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## ffemt8978

Miscusi said:


> that definitely sparked my interest and will do more research...



My point was that just because the military does it one way does not mean it's applicable outside of the military.  IIRC, we have to empty a cylinder when it's test date comes up


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## Miscusi

I said it over the life of the thread, the 02 is for the first aid kit to help others if needed.

my research indicates that o2 is Rx except if used in emergencies at 6 lpm+ and it can last a certain amount of minutes. and I have linked a reference and also a retailer that sells such o2 with no prescription.

true that nothing lasts forever, but masks tubes and etc lasts a heck of a long time, and my stuff don't even have any EXP date printed on them.

Paperwork cant be so bad, keep receipts in a file ?

storage... just put it in the 02 bag and leave it with the rest of the first aid kit. ( inside closet )

---------------------------------------- 
So I cant find any regulations regarding having to empty a 02 tank when the 5 years is up, I can only find information saying that tests must be done every 5 years, and if your tank is not tested - it cannot be refilled until it is tested.

When you say "we have to empty a cylinder when test date comes up" could that just be an In-House thing your logistics department decided to do?  

"Compressed oxygen is a hazardous material. (49 CFR Section 
172.101, Table).  Each cylinder used for the transportation of compressed 
oxygen must meet DOT specifications and bear DOT specification markings and 
be "qualified."  No one may use an unqualified cylinder in transportation.

          Such cylinders must be "requalified" at certain times and under 
certain conditions. Requalification must be done by a person holding DOT 
approval. (Section 180.205). Cylinders which are not qualified or 
requalified may not be refilled."

the NYS EMS have an oxygen policy here: http://www.health.ny.gov/professionals/ems/pdf/98-06.pdf

here is the part I think is worth quoting

"Any cylinder placed in service by an EMS service, whether or not it is currently on a vehicle, must be within test requirements as evidenced by a valid hydrostatic test date imprinted on the cylinder."

I read that as any tank used must have been tested and have a test date on the tank. I think a tank that is built to last indefinitely is considered within test requirements if there is still pressure inside it, and it is in good condition. 

I think that if a tank that has a test date past 5 years, it is still good to be used, but just needs testing before refilling. BECAUSE the dangerous part is increasing the pressure inside the tank, ( filling ) If the tank already has 2000 psi in it, and it has been sitting there for months upon months just fine, decreasing the pressure inside it wont harm the tank, ie using it, or purposeful emptying.  I think that having 2000 psi in a tank is like a test all in itself...

but anyway as a layperson at home, I am not a EMS Service therefore my first aid bottle at home would not be under control of the NYS EMS, therefore it would just fall under DOT guidelines of "it cannot be refilled unless it is tested.."

This is of course just what I, one person, was able to research and this is the views of one person. I could be wrong, as we are all just human, 

If anyone have evidence supporting or countering my research I would love to hear it.


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## TheLocalMedic

Okay...  So you're in for the long haul.  You plan on just storing this stuff until it's needed...  even if it _never is_.  If you're in NYC, how far away do you really think help is?  Do you plan to tote this stuff with you everywhere you go on the off chance you randomly run into someone who is short of breath?  You'll  just whip out a tank and mask and save the day?

I just don't understand _why_ you want it.  Because it's cool?  

Want to know what's in my first aid kit?  Some basic bandages, tweezers, neosporin and a pocket mask.  Sure, I could carry a whole jump bag in my car, but to what end?


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## Jon

Miscusi,


Here's what I don't get. Why spend money to buy something to put in your closet, "just in case".

Current research is showing that oxygen isn't harmless, and that overuse can be more dangerous than not using it.



If you went to be prepared for "just in case" - spend this money to stock up on food and water. Become a "prepper" to some level. A BLS bag and O2 kit have very little place in a disaster. Oxygen is only going to last for a short time anyway.


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## TheLocalMedic

Jon said:


> Miscusi,
> 
> 
> Here's what I don't get. Why spend money to buy something to put in your closet, "just in case".
> 
> Current research is showing that oxygen isn't harmless, and that overuse can be more dangerous than not using it.
> 
> 
> 
> If you went to be prepared for "just in case" - spend this money to stock up on food and water. Become a "prepper" to some level. A BLS bag and O2 kit have very little place in a disaster. Oxygen is only going to last for a short time anyway.



This


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## STXmedic

This















thread is ridiculous.


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## Mariemt

Between your new SAM splints, AEDs,  O2 tanks and all your other stuff... you will need a wagon to haul it all.


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## ffemt8978

Mariemt said:


> Between your new SAM splints, AEDs,  O2 tanks and all your other stuff... you will need a wagon to haul it all.



Just a quick hint....






It's called an ambulance.



:rofl:


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## Mariemt

ffemt8978 said:


> Just a quick hint....
> 
> 
> 
> 
> 
> 
> It's called an ambulance.
> 
> 
> 
> :rofl:


Lol. True true, but this is not for professional use ya know?


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## Miscusi

To you people who don't agree, or cant see the reason why...  that's just your personal preference.

I have money, It isn't expensive, Its something I would like to have.

I will never force you to go get one yourself, 

but I think having a first aid 02 bottle to help ppl in emergencies is cool. 

Not because help isn't close, nor am I going to haul it everywhere, 

*"Current research is showing that oxygen isn't harmless, and that overuse can be more dangerous than not using it." *

its not for overuse.
its for first aid use.


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## ffemt8978

Miscusi said:


> To you people who don't agree, or cant see the reason why...  that's just your personal preference.
> 
> I have money, It isn't expensive, Its something I would like to have.
> 
> I will never force you to go get one yourself,
> 
> but I think having a first aid 02 bottle to help ppl in emergencies is cool.
> 
> Not because help isn't close, nor am I going to haul it everywhere,
> 
> *"Current research is showing that oxygen isn't harmless, and that overuse can be more dangerous than not using it." *
> 
> its not for overuse.
> its for first aid use.


Again, if you are doing it because you think it's cool...then you're doing it for the wrong reasons.

And how many lives do you think you will save by administering oxygen?  Better yet, let me ask all our forum members here this question:

"How many lives have you saved by administering oxygen (and nothing else)?"


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## Medic Tim

ffemt8978 said:


> Again, if you are doing it because you think it's cool...then you're doing it for the wrong reasons.
> 
> And how many lives do you think you will save by administering oxygen?  Better yet, let me ask all our forum members here this question:
> 
> 
> 
> "How many lives have you saved by administering oxygen (and nothing else)?"



Big fat 0 here ... At least so far in my 7 years as a medic.

Living in an urban setting I really don't see the need for all of this. Is this a case of new medic syndrome (EMT for the USA I guess)?
Being a new EMT can be very fun an exciting... We have all been there. One day you op will understand and try to warn a new young Ricky rescue of doing what you are now. It is one of the cycles of ems.


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## Miscusi

ffemt8978 said:


> Again, if you are doing it because you think it's cool...then you're doing it for the wrong reasons.
> 
> And how many lives do you think you will save by administering oxygen?  Better yet, let me ask all our forum members here this question:
> 
> "How many lives have you saved by administering oxygen (and nothing else)?"



Let me define "Cool" for you as I was using it.

I mean it as "being a positive"  or "good"

You probably think I was going to put sunglasses on it.

Sometimes you will hear the reverse usage of the word cool, such as, "I just stole the wallet from the patient" ! upon which you say " THATS NOT COOL "


I will not speculate on the future, and it is not "with nothing else", the first aid use of oxygen is very specific, for hypoxia, emergency resuscitation.

Its really not a big deal. Many authorities believe it helps, having it handy isn't going to have any negative effects, but if one day it can help someone that would be great, and if I die before that day comes then so be it.

and about the "why spend" or "Waste of money" , I do not demand any kind of return on this "investment" of 60 dollars, I pay more than that for lunch sometimes..


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## Medic Tim

Miscusi said:


> Let me define "Cool" for you as I was using it.
> 
> I mean it as "being a positive"  or "good"
> 
> You probably think I was going to put sunglasses on it.
> 
> Sometimes you will hear the reverse usage of the word cool, such as, "I just stole the wallet from the patient" ! upon which you say " THATS NOT COOL "
> 
> 
> I will not speculate on the future, and it is not "with nothing else", the first aid use of oxygen is very specific, for hypoxia, emergency resuscitation.
> 
> Its really not a big deal. Many authorities believe it helps, having it handy isn't going to have any negative effects, but if one day it can help someone that would be great, and if I die before that day comes then so be it.
> 
> It do not demand any kind of return on this "investment" of 60 dollars, I pay more than that for lunch sometimes..


I hope someday you can look back on this thread and realize how ridiculous you sound . I am not tryi to insult you but rather help you( along with everyone else)

I hope you don't get sued or arrested for playing a Ricky rescue someday.

Oh and enjoy your expensive lunches .


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## epipusher

After obtaining your oxygen setup, please post pics as it could be used as an EMS specific meme.


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## ffemt8978

Miscusi said:


> Let me define "Cool" for you as I was using it.
> 
> I mean it as "being a positive"  or "good"
> 
> You probably think I was going to put sunglasses on it.
> 
> Sometimes you will hear the reverse usage of the word cool, such as, "I just stole the wallet from the patient" ! upon which you say " THATS NOT COOL "
> 
> 
> I will not speculate on the future, and it is not "with nothing else", the first aid use of oxygen is very specific, for hypoxia, emergency resuscitation.
> 
> Its really not a big deal. Many authorities believe it helps, having it handy isn't going to have any negative effects, but if one day it can help someone that would be great, and if I die before that day comes then so be it.
> 
> It do not demand any kind of return on this "investment" of 60 dollars, I pay more than that for lunch sometimes..


And many more authorities are starting to believe that oxygen administration does have harmful side effects.

Might I suggest you read through this http://clinicalcenter.nih.gov/ccmd/cctrcs/pdf_docs/Medicinal Gas Therapy/01-Oxygen Therapy.pdf

While it does say that there are no absolute contraindications to oxygen administration (there is one that was discussed in another thread), it goes on to point out some of the harmful effects of administering O2.

Here are some more references to read about the negative effects of O2.
http://en.wikipedia.org/wiki/Oxygen_therapy#Negative_effects
http://www.ncbi.nlm.nih.gov/pubmed/1007238


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## Miscusi

Medic Tim said:


> I hope someday you can look back on this thread and realize how ridiculous you sound . I am not tryi to insult you but rather help you( along with everyone else)
> 
> I hope you don't get sued or arrested for playing a Ricky rescue someday.
> 
> Oh and enjoy your expensive lunches .



I respect your right to free speech, as this is America, ( at least where I am typing) 

however I respectfully disagree, I have been doing first aid for over 25 years, with time in military and law enforcement and most recently EMS.

Why would I ever change my mind about having O2 at home?

My original question was just to see if anyone have a filling spot they like to use. I didn't ask if I can have you all's permission, but many took the question that way regardless.

but what can I say ?  I find that there are a lot of different types of people in EMS, and very few are like me. Its a career thing I suppose. *shrug*


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## Miscusi

epipusher said:


> After obtaining your oxygen setup, please post pics as it could be used as an EMS specific meme.



um.. its just gonna be a D tank in a bag... you already have that don't you?


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## epipusher

I don't believe my fellow members are giving/denying permission. It appears they are looking out for the best interests of any potential patient you may encounter.


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## exodus




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## Miscusi

ffemt8978 said:


> And many more authorities are starting to believe that oxygen administration does have harmful side effects.
> 
> Might I suggest you read through this http://clinicalcenter.nih.gov/ccmd/cctrcs/pdf_docs/Medicinal Gas Therapy/01-Oxygen Therapy.pdf
> 
> While it does say that there are no absolute contraindications to oxygen administration (there is one that was discussed in another thread), it goes on to point out some of the harmful effects of administering O2.
> 
> Here are some more references to read about the negative effects of O2.
> http://en.wikipedia.org/wiki/Oxygen_therapy#Negative_effects
> http://www.ncbi.nlm.nih.gov/pubmed/1007238



As it is... 

Im going with the mainstream. no matter what you encounter in life, there is going to be a little bit of controversy. most recently I encountered the Sea Salt person who claims regular salt is "all chemical" and sea salt is "natural" and yada. there was the diet soda makes you fat person and yada...

If the day comes, that O2 becomes contraindicated for first aid use, that's when I wont consider it's use.


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## Miscusi

epipusher said:


> I don't believe my fellow members are giving/denying permission. It appears they are looking out for the best interests of any potential patient you may encounter.



perhaps "permission" is not the best word, I mean like, I just ask to see if anyone knows of a nice place to fill in my area, and I get all sorts of ......

you know what I mean...


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## ffemt8978

Miscusi said:


> perhaps "permission" is not the best word, I mean like, I just ask to see if anyone knows of a nice place to fill in my area, and I get all sorts of ......
> 
> you know what I mean...



Fair enough, and here is your answer.  You say you are in EMS now, so go to your Medical Director and ask him where he wants you to fill your personal D-cylinder.


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## Tigger

Miscusi said:


> perhaps "permission" is not the best word, I mean like, I just ask to see if anyone knows of a nice place to fill in my area, and I get all sorts of ......
> 
> you know what I mean...



Have you tried contacting the places that you know, fill oxygen tanks in your area? 

Might be a good place to start, I can't imagine many (if any) EMS providers have a go to spot for getting their personal tanks filled because well, they don't actually have personal tanks.


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## PotatoMedic

Miscusi said:


> If the day comes, that O2 becomes contraindicated for first aid use, that's when I wont consider it's use.




In my protocol O2 is contraindicated with anyone who has an SpO2 of 95% or greater.  And anyone who is a CO2 retainer usually is titered between 88-92%. 

And all the paramedics I talk to say they stop at 99 since 100% is not beneficial.

And your "main stream" thinking is 20 years old.


On a side note you should get some IV supplies and some NS .9% for your patients... since fluids never hurt!  I hope you people know I am kidding.


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## Miscusi

I already know where the agency goes, but that place is huge and does big orders, like really big, and Im not sure if they would bother with one customer with one tank.

I'd ask the Medical Director, but I doubt he would know the answer to my question, as I am certain, as it is also said, very rare for an EMT to be filling his own personal tank.

I did call a place, was quoted $11.50 for the fill. I don't know what they would need from me, minimum order? contract? who knows...  I guess I'll find out when the day comes.

I didn't find any other places close by.


*"In my protocol O2 is contraindicated with anyone who has an SpO2 of 95% or greater. And anyone who is a CO2 retainer usually is titered between 88-92%. And all the paramedics I talk to say they shoot for 99% "*

Are you sure you mean "Contraindicated?"  or do they just not do it because its not necessary ?


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## PotatoMedic

From the King county protocol.  "When the patient’s oxygen saturation is 95% or greater,* do not administer oxygen.*"

Let me put in my last word here.  Be very careful.  I know you want to help people and I am happy you are eager.  I recommend if you have the desire to become a paramedic and learn more so you understand why you are doing xyz and not just doing xyz because someone said to.  People these days are very litigious, and just because it is legal it may not be "with do regard" or, as someone else with your training and in a similar situation would do.  I would say if you are going to get your own O2, learn as much as you can about it.  Why is it used, when should it be used, when should it not be used.  Learn how and why it diffused into the body and how hyperoxia (high O2 saturation) can cause damage to tissue.  Use this passion and drive that you have and learn about what you are getting into.  Heck!  Become a MD/DO/NP something and you can have anything you want and you can use it how you want.  I just beg of you to LEARN why.  And WE will help you learn.  WE may be brash, confrontational, blunt, and what not.  But it is because we want you to learn why and know why you do things.  WE are all here to help you even if it does not seem like it.


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## TheLocalMedic




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## Miscusi

*From the King county protocol. "When the patient’s oxygen saturation is 95% or greater, do not administer oxygen."*

That is a nice attitude. It is always good to learn i can agree. 

But that protocol, i think its just so you dont waste your O2. Like, its already 95 % on room air, shrug, I wouldn't use it either.


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## Miscusi

*Oh my!*

Omg


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## Miscusi

FireWA1 said:


> On a side note you should get some IV supplies and some NS .9% for your patients... since fluids never hurt!  I hope you people know I am kidding.



Oh I missed that earlier. Oh HELL NO, thats definitely RX ONLY. Totally NOT in the realm of first aid.  White text is hard to see


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## TransportJockey

Miscusi said:


> Oh I missed that earlier. Oh HELL NO, thats definitely RX ONLY. Totally NOT in the realm of first aid.  White text is hard to see



Medical O2 is Rx only as well. Your point?


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## chaz90

Miscusi said:


> *From the King county protocol. "When the patient’s oxygen saturation is 95% or greater, do not administer oxygen."*
> 
> But that protocol, i think its just so you dont waste your O2. Like, its already 95 % on room air, shrug, I wouldn't use it either.



This isn't why protocols are written. These days, we've hopefully (for the most part) moved past doing things because "shrug, why not" or "I have a feeling." In this case, you're mistaken. EMT courses aren't the font of all knowledge and there is certainly more science behind not administering oxygen when it's not indicated than avoiding waste.


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## Achilles

Are we actually still talking about this? :wacko:


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## NomadicMedic

Actually, we're done beating this dead horse.


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