# Pulse oximeter ?



## RESQGUY (Jan 4, 2011)

Hello everyone, what is a good Pulse OX to use day to day. I'm interested in buying one, I'm not a salty EMT yet but, during ride alongs I have been on there were none. I have heard from some friends they buy them. What is a reliable brand? 

Thanks, 
John


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## hocomedic (Jan 4, 2011)

this is the one that we used in my EMT class: http://www.amazon.com/GE-Datex-Ohmeda-Tuffsat-Handheld-Oximeter/dp/B001M5LZ7E

If it could stand up to 12 high school students playing with it every day then it should be sturdy enough. We had 2 different types of pulse ox in our class and this one was the easiest one to use. I would look around and read reviews on other brands, but theres one to consider. I would also ask your friends if they like theirs.


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## socalmedic (Jan 4, 2011)

http://www.amazon.com/CMS-CMS50DL-F...ef=sr_1_4?s=hpc&ie=UTF8&qid=1294124114&sr=1-4

something cheap, if they are un stable to the point where this is not good enough for you it is time to call a paramedic...


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## usafmedic45 (Jan 4, 2011)

RESQGUY said:


> Hello everyone, what is a good Pulse OX to use day to day. I'm interested in buying one, I'm not a salty EMT yet but, during ride alongs I have been on there were none. I have heard from some friends they buy them. What is a reliable brand?
> 
> Thanks,
> John


Why would you need a personal pulse oximeter as an EMT?  Your service should be providing them.


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## hocomedic (Jan 4, 2011)

usafmedic45 said:


> Why would you need a personal pulse oximeter as an EMT?  Your service should be providing them.



I can understand why he would need one. he said that some of the ambo's didn't have one and some times they may not be of the best quality. Just because an ambulance service provides a cheap piece of :excl: stethoscope doesn't mean that you cant go out and get one for your self that you like and can trust. its the same principle. plus spo2 is an important vital sign.


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## usafmedic45 (Jan 4, 2011)

Eh....I guess I see your point.  I just think it's a bit excessive but that could just be burnout talking.


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## hocomedic (Jan 4, 2011)

it may be but you got to have the right gear


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## usafmedic45 (Jan 4, 2011)

Honestly, I think in many ways the overreliance on technology has eroded (or in many cases, prohibited the development of) the once traditional clinical assessment skills that we should possess.  Just my two cents....


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## hocomedic (Jan 4, 2011)

you cant get an spo2 reading with skills you need the right equipment and i agree that technology has decreased the skills that we need to perform. but technology is needed in many aspects of EMS. EMS has come a long way with the help of technology, new things that can help us perform our jobs better and more effective, all tho your right the skills of an EMT can never be replaced with technology.


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## usafmedic45 (Jan 4, 2011)

You might not be able to get a reading, but nothing compares with the experienced eye of someone who has seen the same situation time and again.  Ever worked with someone who goes "Watch it....he's going to crap out on us" and you don't see anything and suddenly the patient goes south with a dropping sat, etc?  Subtle signs that get missed in the rush to "get a reading" are the mark of someone who is truly exceptional at their job.  I've worked with a few in my day and it's a thing of beauty to watch.  Nothing compares with a well honed eye for detail, not even technology.


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## hocomedic (Jan 4, 2011)

i'm not disagreeing with you, i'm just saying it can help with some stuff that skills can't do. And i know you keen sense for when someone is about to "crap out " wont help you out on your PCR with vital signs.


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## usafmedic45 (Jan 4, 2011)

Well, the way my original medical director (MD, NREMT-P, former Green Beret medic in Nam) put it:  "I'd rather you come in here and tell me something's not quite right maybe missing a couple of vitals than for you to walk in here with a full set of vitals and miss something that could have made my job easier and improved the outcome."




> And i know you keen sense for when someone is about to "crap out " wont help you out on your PCR with vital signs



Since when did they get rid of the narrative portion of the run report? 

The reason I brought this up is that there is an "automaton" attitude that if we don't get X, we're not doing something right in EMS especially among the younger providers.  The trick is to learn to assess the patient without the tools so if you don't have them at hand or they are malfunctioning you can still do your job.  I see far too many EMTs and medics that if they lose the use of a pulse ox, their monitor, etc they are completely lost.  

It's not a "kids these days" rant but at the same time, I often feel I'm a rarity in that those who taught me (mostly docs and very experienced EMS and RT personnel) took the time to show me what they were taught in the days before all of the stuff we now teach our students to be reliant upon.  You can diagnose a lot of crap with a stethoscope, your eyes, your ears, your nose and your hands.   Hell, if I don't have a monitor, I can pretty reliably tell you when someone is in atrial fibrillation just by the sound of their heart.  The ability to detectthe early stages of CHF just by palpating the abdomen, etc.....   The "look" of a person who is bleeding internally that can alert you to a problem before the vitals ever change. All of this can be documented just as readily as a set of vitals. Like I said, I'm not against technology (they foreclosed on my shack in Montana....) but I am against an excessive dependence on it or the idea that the need to get the data from it is somehow more important that looking at your patient.   The trick is learning how to balance the two.


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## hocomedic (Jan 4, 2011)

Your totally right i was taught that vital signs and crap are the most important thing, i guess its because i'm younger and thats how their teaching now a days. I have the skills to do my job with out technology, all i'm saying is that for me i need some technology to do some stuff because i'm not experienced enough to tell what a person is going through from a sound from the stethoscope. i never said that narrative portion was taken out i'm just saying that i was taught that you need a COMPLETE set of vitals before you can turn your PCR in


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## usafmedic45 (Jan 4, 2011)

> i never said that narrative portion was taken out i'm just saying that i was taught that you need a COMPLETE set of vitals before you can turn your PCR in


I know about the narrative.  That was my failed attempt at humor.  LOL

So what happens when you're unable to obtain them?  It does happen and we would document that in the narrative.   One of my favorites was the old lady who was sitting up, talking to us with no palpable carotid pulse.  Even after we laid her flat....still nothing.  I remember my partner leaning over and going (completely deadpan mind you) : "I think this must be the Crypt Keeper's sister.  Watch out for that creepy :censored::censored::censored::censored::censored::censored::censored:.  He might be in the hallway waiting on us."  We never did get a BP on her and she was in NSR.  Finally the ER staff found her to have a skyhigh reading of 32/0.   Her only complaint was her feet feeling "funny". 

That was almost a decade ago and I still to this day can't figure out how she was able to stand up, walk to the door to greet us and talk to us like nothing was wrong.


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## hocomedic (Jan 4, 2011)

damn i didn't even know a 32/0 bp was possible


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## usafmedic45 (Jan 4, 2011)

hocomedic said:


> damn i didn't even know a 32/0 bp was possible


I didn't know it was possible to be conscious with that low of a BP until that day.   The lowest I have ever seen with someone still alive was 21/4.  That was recorded on an arterial line in someone we were trying to resuscitate from a cold water drowning.


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