# Why this but not that?



## ironguy321 (Mar 16, 2008)

When I did my ride outs, two different medics had their own pulseox's that they used. I asked them about it and they said most of the medics with the department liked using them. Do medics also use electronic blood cuffs as well? [forgot to ask]


----------



## el Murpharino (Mar 16, 2008)

Does that ambulance not have a pulse-ox on board?  I personally don't like the automatic BP cuffs on the monitors...but I'll admit it's easier on a tough call when you have 3 or 4 things you need to do - just push a button and it takes the BP for you.   But on most calls, I'll do the BP manually.  Heck...these monitors now come with pulse-ox sensors on it.  One-stop shopping when it comes to the monitors nowadays.


----------



## KEVD18 (Mar 16, 2008)

use the search feature. this has been rehashed a hundred times.


----------



## paramedix (Mar 21, 2008)

If you got the bucs to buy your pulse ox, go right ahead, but if it breaks or gets damaged - you will be responsible for the repairs. 

After all, most of our rigs got on-board systems. The only diagnostics you need to supply is your own steth and BP cuff set. Manual or electronic, thats up to you!!! I prefer the manual cuff.


----------



## tydek07 (Apr 7, 2008)

I prefer manual cuffs. The electronic ones may be nice and easy, but can you always trust them? NO! Our service carries the Lifepak 12, and they suck for taking BP's ---WAY OFF most of the time


----------



## emtwacker710 (Apr 28, 2008)

tydek07 said:


> I prefer manual cuffs. The electronic ones may be nice and easy, but can you always trust them? NO! Our service carries the Lifepak 12, and they suck for taking BP's ---WAY OFF most of the time



ha we use them also, they have their good days and bad days lol


----------



## VentMedic (Apr 28, 2008)

paramedix said:


> If you got the bucs to buy your pulse ox, go right ahead, but if it breaks or gets damaged - you will be responsible for the repairs.



Purchasing one's own pulse oximeter can be tricky when it comes to "preventive maintenance" and validity of the data.  Any our electronic equipment must be calibrated every 6 months.   If you treat a patient off numbers given to you by your personal equipment, you may have to show proof that it is regularly calibrated and maintained by a biomed person if any incident occurs.   

Several hospitals' risk managers and attorneys posted memos to all hospital personnel from RNs, RRTs, Flight or EMS based there to not carry their own pulse oximeters unless the Biomed department approved them. 

I have seen some very erroneous numbers on some of the personally owned devices and even the properly maintained ones owned by the hospitals.  Of course one has to be familiar with these devices and PATIENT ASSESSMENT to know the numbers are questionable.   At least it doesn't belong to me and I can just hand it over to the agency's Biomed department. 

Of course, in the prehospital environment, one may not get into too much trouble in a short time.  If they are using the numbers as a guide to intubate or other course of treatment on a borderline patient, then accuracy is nice to have.  Of course, I do not rely on pulse oximeters to determine my course of treatment for the patient either in or out of the hospital.   Too many people waste precious minutes "trying to get a sat" or "I don't *think* it's correlating" or "Let me try all the other fingers to see if I get the same number on them".    

That also applies to the electronic BP cuffs.   Good assessment is knowing when the manual BP cuff is the more appropriate device to use.  
Manual BP cuffs and stethoscopes are not an issue with most biomed people but also should have regular maintenance by you.   However, the manonmeters may need to be calibrated on a regular bases to assure quality results.  

Electronic BP machines must also be calibrated regularly to maintain accuracy.


----------



## Short Bus (Apr 29, 2008)

el Murpharino said:


> Does that ambulance not have a pulse-ox on board?  I personally don't like the automatic BP cuffs on the monitors...but I'll admit it's easier on a tough call when you have 3 or 4 things you need to do - just push a button and it takes the BP for you.   But on most calls, I'll do the BP manually.  Heck...these monitors now come with pulse-ox sensors on it.  One-stop shopping when it comes to the monitors nowadays.



Ditto with everything that was said.


----------



## jordanfstop (Apr 29, 2008)

i'm in a bls ambulance. our medics are a seperate dispatch fly-car with simultaneous response (on every call.) our medics carry lifepak 12's that some of the monitors have an auto-bp cuff (as well as an spO2 port.) most people here prefer manual bp cuffs. i prefer the one-handed cuffs (the bulb and the sphygmometer are in one with a controlled trigger-release for the air.) i can trust my ears over a machine. sometimes when a pt's brachial pulse is far too weak or their bp is too low, they'll bust out the automatic.


----------



## mycrofft (Jul 1, 2008)

*I'm gonna make people mad...again...*

As was said before, patient evaluation is the key here, all else is that second 80% Pareto talked about. Give me good documentation of BP, pulse, breath sounds, temp if it's really needed, and baseline appearance/behavior with list of meds and measures taken; get the basics then get 'em in after the essentials are taken care of.

 I have watched our folks (not the fire-EMS who take our hardest cases to the hospital) stall because of an irksome pulse-ox. Not worth the delay-versus-benefit.

Our local EMS authority forbids prehospital service of anything more complicated than a tongue depressor to be done by a "certified biomedical repair person". I tried to find out what it takes to become one, and I'm convinced that the factory ones are shipping clerks with a rubber stamp that says "rejected" and a form letter advising you that you need a new one, or ship a replacement.


----------

