Pulse Ox to the ear?

[MSDeltaFlt]

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.

I agree whole heartedly. If the pulse ox is not going to read, then it's not going to read. Treat clinically using oral mucosa, conjunctiva, LOC, RR rate/quality, breath sounds, and the like.

But this reminds me of back in my resp days...

ICU nurse went to check her pt. Vitals were all reading within normal range. Even the pulse ox showed a beautiful saw tooth waveform. She looked at the monitor (including the pleth), and noticed the pt's hands had no pulse ox probe on any of his fingers. So, she followed the pulse ox wire from the monitor searching where the probe was and found out that the pt, in his altered stated, had placed the probe on another appendage of approximate size. I heard her shout, "Mr So and So! It doesn't go there!"

I laughed so hard I shot coffee out of my nose.

[VentMedic]

I sometimes mess with 1st year residents by putting a pulse ox probe on my favorite patient, Ted E. Bear, in the PICU. With the probe positioned to pick up the light in the room, I can catch the young doctors in focusing on the monitor and not the patient.

[Ecnalubma08]

Yes...I have heard of this being done. Typically on pts with .Raynaud's Disease.

[EMS49393]

Masimo is a thorn in my ambulance. My last service had lifepaks with all nelcor probes. I rarely had any trouble obtaining a pulse ox. My current service has the lifepak with the two hundred and fifty-five foot cord attached to a rigid probe that states it's for pediatric use.

Flame me all you care to. Honestly, I rarely use the pulse ox anymore because it's a peice of garbage. I get tired of positioning, repositioning, and internally cursing masimo. I rely on visual assessment of the patient, lung sounds, and capnography. I do my best with substandard equipment.

Go ahead and have at, I've got pretty thick skin.

[VentMedic]

EMS49393,

I don't really care how thick or thin your skin it or if you consider my posts a flame.

I just want people to understand the equipment they use when it is applied to patients. Too many skip the formality of reading the manual or a clinical rep inservice because the equipment looks self explanatory.

Masimo takes pulse oximetry technology to a whole new level and has a steeper learning curve than other brands. Even those of us who utilize pulse oximetry extensively for many applications need extra training to fully understand and appreciate Masimo's pulse oximeter sophistication in analyzing data.

Masimo is just one of serveral pulse oximeter brands on the market, each with their own unique quirks that one must be aware of for proper use.

[Ecnalubma08]

I rely on visual assessment of the patient, lung sounds, and capnography. I do my best with substandard equipment.

Go ahead and have at, I've got pretty thick skin.

This is good! Pulse Ox machines can just get in your way (I'm not sayin it's not good to use them). It's just that it can be deceiving to newbies. I get pissed of when EMTs are sitting with a pt who is obviously having dyspnea and you're like...why isn't that dude on O2?...and they're like...ummm his SPO2 was like 98!....Just give the pt some damn O2! :wink:

[DwayneEMTP]

Yeah, man. I've come to HATE those friggin things.

They very consitently contradict my assessments, and rarely work consitently. Like the monitor BP cuff (I once got a bp from fire of 199/196...and he was very concerned!)...I can't really imagine using them to draw any conclusions...support them perhaps, but not draw them.

I have found that they do have two vital functions. Giving me a number to put in the PCR...or allowing me to avoid the "Why didn't you get an SPO2 on this COPD/DOB/trauma/medicated patient?" for the 10th time of the day....

Now as I reread Vent's post I'm thinking that perhaps, OK...probably, I'm just not very good at using them...and for now I guess I'm ok with that....or not...hell, I don't know. I just don't like mechanized vitals. (Understand that most of my transports are less than 20-25 mins on the long side, 15 or so on average. So I'm not suggesting that those that need to trend for hours are boneheads, simply that I prefer to get my own within this time frame)

Dwayne

[VentMedic]

You are so right Dwayne.

Even in the ICU, we realize that the pulse ox may not work every time with perfusion deficits, pressors and the hypothermia protocol. I do hate to not get my data especially when we're working on a research project and at times wonder why we spent $thousands$ out of our budget to upgrade to the latest and greatest.

[Scaramedic]

Actually you do not need any special probes if you just remove the ear from the head. :shock:

[JPINFV]

Actually you do not need any special probes if you just remove the ear from the head. :shock:

Sounds like putting a tourniquet around the neck to prevent air from escaping.