Pulse Ox to the ear?

[dahlio]

On a run the other day, ALS couldn't get a proper reading with their pulse ox off of the lifepak 12. They pretty much tried every finger, and one of the medics said try the ear. Didn't work, but I was convinced it was the equipment. Anyway, has anyone ever heard or done that?

[ccmedoc]

Yep..works quite well, with the right probes..

[zzyzx]

Works great!

[Richard B the EMT]

With a patient in cuffs by the LEOs, I have seen the ER Triage Nurses do that numerous times.

[VentMedic]

With the CORRECT probe, you can get a pulse ox reading from the fingers, ears, forehead or nose. However, DO NOT adapt a probe designed for the finger to the ear, nose or forehead. It may give you a reading but not with accuracy.

[EMS49393]

I do the same thing the local ER nurses do with patients they can't obtain an acurate pulse ox on, I use a disposable sticky pediatic probe. It's small enough to fit nice and snug on the earlobe.

I feel that the lifepak 12 has the worst pulse ox in the free world. I like the ease of use of the lifepak, but unfortunately, they have fallen from grace at my service. We are testing other monitors as I type.

If I can't obtain any type of reasonable pulse ox on a patient, or they are altered mental status (unresponsive, postictal, etc) I'll opt to use capnography in conjunction with the pulse ox. If the pulse ox is way off, I document equipment failure and move on. I also like my capnography on patients I give narcotic pain medications to. I like to trend ventilation on these patients, particular the elderly patients.

[VentMedic]

I do the same thing the local ER nurses do with patients they can't obtain an acurate pulse ox on, I use a disposable sticky pediatic probe. It's small enough to fit nice and snug on the earlobe.

Because a probe "fits" does not mean it is the correct technology, as in transmittance or reflective, for that particular site. A lack of understanding how the technology works has burned more than one professional in court.

For some manufacturers, the neonatal probe, which is designed to be placed on the infant's foot may be used on an adult finger. Almost all manufacturers discourage the use of finger probes on the ear lobe or forehead.

Nellcor and Masimo went to great lengths to explain the discreptancies between the different probes when used in ways they were not intended. The ear probe was not invented just for the company to make another sale.

So do your patients a favor and read your manual and/or consult that specific equipment's clinical representative to learn the probe's intended application. Just because you have seen "everyone" do something, does not always mean they received the correct training but rather went with the "it fits" mentality.

[zzyzx]

I misread the original post...I've never tried using the regularprobe off the Lifepak or some other pulse ox. Rather, I used disposable type designed to be taped around a finger. Many times when I was unable to get a reading with the normal probe on a finger, I was able to get one with the disposable probe taped to the patient's ear.

[AnthonyM83]

People always suggest it when we can't get a reading, but honestly, it's pretty hard to get our hard-plastic concave finger probe to close tight enough around an earlobe.

Is the disparity in readings based on the size of blood vessels? Bone?

[VentMedic]

People always suggest it when we can't get a reading, but honestly, it's pretty hard to get our hard-plastic concave finger probe to close tight enough around an earlobe.

Is the disparity in readings based on the size of blood vessels? Bone?

Absolutely!

That is why there are different probes for different applications. There are differences in wavelengths, transmittance and reflective properties as I mentioned earlier. A false high reading can lead to believing oxygenation is better than it actually is especially if one is relying on the machine and not the patient. Wasting time to adapt equipment for other than its intended purpose is also not recommended.