PulseOx for BLS, I need reasons!

[MMiz]

When I first started at this company all of our units carried PulseOx units. Our BLS units started leaving them on scene and losing them, so it was decided that they would be removed from the trucks. Our Paramedic First Responders, ALS, and Critical Care still have them on their LifePak 12s, but we just don't have the individual units ($650 retail).

This company I work for is great, and they always provide us with great equipment. Patient care has never suffered because of not having a PulseOx, but I think it was a great tool to have.

This really isn't about money, we have many backup LifePaks, AEDs, and all that other good stuff. But I do understand not wanting to be wasteful, especially after losing so many units.

Do you think a PulseOx is an essential tool for BLS?

 

[Summit]

Where I am at (high altitude) it is a very usefull tool
AMS
HACE
HAPE
Sickel Cell Trait
Neonates
Emphysema
etc etc etc

 

[emtbuff]

We have a pulse ox on our automated BP cuff machine. We generally start taking a manual BP while in the house and once in the rig we hook the pt up to the automatic and check the pulse ox. Then generally decide if we want to lower the O2 setting or if we need to give them more.

 

[GFD940]

Don't the ER docs complain about not having an initial O2 sat? I know most of mine like to know what it was prior to us loading them up on O2. Then again EMS was going on 20 years ago before we had pulse ox.

 

[PArescueEMT]

Originally posted by emtbuff@Feb 12 2005, 04:30 PM
once in the rig we hook the pt up to the automatic and check the pulse ox. Then generally decide if we want to lower the O2 setting or if we need to give them more.

I love having mine... many reasons behind this, but it is all a personal opinion.

I remember in EMT school, the one thing the instructor always harped on:
"Treat the Patient, Not the machine"

i.e. if the Pt. is asymptomatic for an MI, why treat them for an MI?

 

[shorthairedpunk]

The pulsox is my best friend. ITs a great indicator for change in patient status. Its just one of the many tools available to us, but its easy to use, simple to remove if neccessary, a fireman even showed me once that it works well as an indicator od adequate compressions and oxygenation during CPR.

They are expensive, but in the case of respiratory distress calls it gets you a good baseline on the patient, takes about two seconds to see what their room air sat is, and then you can assess the result of your treatment more thoroughly. The first thing most ERs do when you bring a patient in on O2 is get a room air, for this very reason.

They have that new pulsox out there thats like 2 inches by two inches, that is just begging to get lost

 

[Summit]

Just remember... pulseox lies in CO and cyanide poising cases.

edit: also they may not work with hypothermic pts

 

[Jon]

Originally posted by GFD940@Feb 12 2005, 05:53 PM
Don't the ER docs complain about not having an initial O2 sat? I know most of mine like to know what it was prior to us loading them up on O2. Then again EMS was going on 20 years ago before we had pulse ox.

SPo2 is a nice toy, but not essential. However, if you can, it inver hurts to have another diagnostic tool. (Think 12 lead vs. 3)

What I don't like is the attitude that a patient with a 99 - 100% sat. "Doesn't need O2." as was said, may a thing can fool a pulse ox.

worst case, ask your employer about "chaining" the unit to the truck, like Staples does with the demo digital cameras - won't prevent a determined thief, but will prevent an accidental loss onscene.


Jon

 

[rescuecpt]

Pulse ox also lies with patients on blood thinners (not always, but keep it in mind).

 

[snoslicer8]

PulseOx may be unreliable at times, this much is true...who's up for on-the-go ABGs?!?

 

[Jon]

Originally posted by snoslicer8@Mar 11 2005, 11:25 AM
PulseOx may be unreliable at times, this much is true...who's up for on-the-go ABGs?!?

I wish...

jon

 

[Jon]

Also doesn't work with SEVERE hypotension.


Jon

 

[Summit]

Originally posted by MedicStudentJon@Mar 11 2005, 12:04 PM
Also doesn't work with SEVERE hypotension.


Jon

Saw this the other day. The guys systolic was below 65 (the receiving hospital could barely get it manually with dopplar). Pulseox no workee!

 

[Jon]

Originally posted by Summit+Mar 11 2005, 12:42 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Summit @ Mar 11 2005, 12:42 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MedicStudentJon@Mar 11 2005, 12:04 PM
Also doesn't work with SEVERE hypotension.


Jon

Saw this the other day. The guys systolic was below 65 (the receiving hospital could barely get it manually with dopplar). Pulseox no workee! [/b][/quote]
Had it last night on what the Nursing home had called in to the ED quote charge nurse "they said this was a BS change in mental status."

rest of post HERE:http://www.emtlife.com/index.php?showtopic...st=0&#entry6836

 

[TTLWHKR]

I leave the pulse ox in the cabinet w/ the "Extras".. Extra lifepak, extra suction, cylinders, etc... B/c I have no use for it at all on my BLS rig. Too many BLS providers treat what they see on the screen. If the person is having diff breathing, but are 100%, some won't use oxygen.

We're gonna put O2 on them anyway, can't do any treatments; so I just leave it in the cabinet. I don't think it works half the time anyway. Especially in the winter, e.g. Cold Hands.

Our unit is a combo; Pulse Ox, Auto BP, O/R Thermometer, and has these tiny bands that go on the wrists and work like an EKG. It's a heavy, worthless tool; that was given to them for free by a hospital and they don't want to piss anyone off by throwing it in a closet with other worthless pieces of equipment from the past 40 years. It ranks right up there with the four dozen different, worthless resuscitator units from the 1950's that were donated and haven't been thrown out yet.

 

[Jon]

Originally posted by Blueeighty8@Mar 11 2005, 02:54 PM
I leave the pulse ox in the cabinet w/ the "Extras".. Extra lifepak, extra suction, cylinders, etc... B/c I have no use for it at all on my BLS rig. Too many BLS providers treat what they see on the screen. If the person is having diff breathing, but are 100%, some won't use oxygen.

Yep. Thought school said to treat the PATIENT's signs and symptoms.

Our unit is a combo; Pulse Ox, Auto BP, O/R Thermometer, and has these tiny bands that go on the wrists and work like an EKG. It's a heavy, worthless tool; that was given to them for free by a hospital and they don't want to piss anyone off by throwing it in a closet with other worthless pieces of equipment from the past 40 years.

I'll take it.

It ranks right up there with the four dozen different, worthless resuscitator units from the 1950's that were donated and haven't been thrown out yet.

Do they involve demand valves? I want a demand valve!

jon

 

[Summit]

Originally posted by Blueeighty8@Mar 11 2005, 02:54 PM
I leave the pulse ox in the cabinet w/ the "Extras".. Extra lifepak, extra suction, cylinders, etc... B/c I have no use for it at all on my BLS rig.
Our unit is a combo; Pulse Ox, Auto BP, O/R Thermometer, and has these tiny bands that go on the wrists and work like an EKG. It's a heavy, worthless tool; that was given to them for free by a hospital and they don't want to piss anyone off by throwing it in a closet with other worthless pieces of equipment from the past 40 years.

I'd love to take that off your hands for $20

 

[TTLWHKR]

Originally posted by MedicStudentJon@Mar 11 2005, 04:10 PM

Do they involve demand valves? I want a demand valve!

jon

I may be able to help you with that...

 

[Ray1129]

Originally posted by MedicStudentJon@Feb 13 2005, 05:43 PM
worst case, ask your employer about "chaining" the unit to the truck, like Staples does with the demo digital cameras - won't prevent a determined thief, but will prevent an accidental loss onscene.

*giggles* Isn't the whole point of having an individual pulse-ox machine to take it into the house. I hope you have a REALLY long chain.

 

[rescuecpt]

Something to remember about pulse ox's too... they are most useful when you know a BEFORE 02 and ON 02 reading... the hospital always asks me what they were on room air - so unless the PT is in severe distress I usually take the 2 seconds to check before I put them on high flow.