Newbie Question

[MedicJon88]

Not really....it's pretty damn simple: use the lowest amount of oxygen for the shortest amount of time to get the saturation to a level sufficient to support life (>90% as a general rule) and try to correct or minimize the underlying problem as fast as possible.

I was referring to the line of thinking involving free-radicals... just like the opposite word "antioxidant"; People know these words- just not why one is bad and one is good.

And considering that they don't even trust EMTs with Pulse-Oxymetry- how would they go about titrating the o2 to >90%?

 

[JPINFV]

1. Being limited in the amount of medical intervention EMT-Basics can administer- O2 is like a wonder drug- Respiratory distress- have more O2 in the air for inhalation. Chest pain with possible ACS- Have more O2 and lower the cardiac stress- Status post seizure/postictal- have some O2, CVA- have some O2....
It at least makes it look like something is done- and sometimes the placebo effect does the rest.

Just because all you have is a hammer doesn't make everything else a nail.

 

[Bullets]

Just because all you have is a hammer doesn't make everything else a nail.

unforunatley, thats how most Basic courses are taught. O2 is my hammer


And as far as the noob question, finish the EMT-B Course, then come back here and read some of the info, follow blogs, and look on PubMed (medical study database) to really educate yourself

 

[usafmedic45]

And considering that they don't even trust EMTs with Pulse-Oxymetry- how would they go about titrating the o2 to >90%?

Our medical director required them as part of first responder level kits. When the state questioned it, his response involved telling them to go do something anatomically impossible because (and I quote because I was standing there when he said it) "The moment it's your medical license on the line, you can start dictating what I let my EMS providers do. Understood? Good....now get out of my office."

 

[JPINFV]

"The moment it's your medical license on the line, you can start dictating what I let my EMS providers do. Understood? Good....now get out of my office."

 

[MedicJon88]

Our medical director required them as part of first responder level kits. When the state questioned it, his response involved telling them to go do something anatomically impossible because (and I quote because I was standing there when he said it) "The moment it's your medical license on the line, you can start dictating what I let my EMS providers do. Understood? Good....now get out of my office."

He can be my medical director any day.

 

[epipusher]

He can be my medical director any day.

Curious if this was an Indiana medical director USAF is referring too?

 

[usafmedic45]

Curious if this was an Indiana medical director USAF is referring too?

He worked as a medical director in both Indiana and Illinois.

He can be my medical director any day.

Sadly, he retired several years ago.

 

[Handsome Robb]

And considering that they don't even trust EMTs with Pulse-Oxymetry- how would they go about titrating the o2 to >90%?

You might not be able to put an exact number on it, but are they cyanotic? What about mentation and cap refill, although it's not a good indicator in adults.

If they aren't blue and are A&O unless there is some underlying cause reducing their mentation I'd be willing to bet that their SpO2 is sufficient.

Also pulse-oximetry can be skewed, it's just a percentage of how saturated the blood is, it doesn't tell you what it's saturated with, but I'm sure you know that.

 

[MedicJon88]

You might not be able to put an exact number on it, but are they cyanotic? What about mentation and cap refill, although it's not a good indicator in adults.

Respiratory distress seems pretty evident without the need for me to utilize cap refill... accessory muscle use and tripoding will probably give that away...

If they aren't blue and are A&O unless there is some underlying cause reducing their mentation I'd be willing to bet that their SpO2 is sufficient.

huh?

Also pulse-oximetry can be skewed, it's just a percentage of how saturated the blood is, it doesn't tell you what it's saturated with, but I'm sure you know that.

yep- cyanide poisoning, carbon monoxide poisoning, temperature, perfusion.... movement... its horribly unreliable even in the hospital... but its still a great diagnostic adjunct... the saying goes "treat the patient not the pulseox"...

 

[MedicJon88]

Sadly, he retired several years ago.

Why do the good ones always leave? the bad ones always seem like they stay till they die or can't pratice anymore... several Attendings here i'd wish would just drop dead or get their license revoked already....