BLS WITH OUT PULSE OX AND OR AED. SHOULDNT THEY HAVE ONE ?

[MariB]

Ugly et al:

Thats The reason to carry a RAD -57 and check every ones carboxyhemoglobin in addition to Oxygen saturation level.

Especially this time of year when homes are closed up tight and various heating sources are in use.

We all get those calls where the CC is weakness , general illness, Just not feeling right, possible having a headache for a couple days,

Yes most providers would suspect Carbon monoxide poisoning.

But how high a level???

With a quantitative level provided by the RAD -57 transport decisions are made with intelligence and knowledge of whether they need to go to a facility with hyperbaric medicine availability or not.

How many services are spending the money for this technology??

We bought ours 7 years ago when they came onto the market.

Also every Firefighter gets checked on the rehab scene as well as any occupants .

Again It is just a tool and shouldn't be how you decide they have elevated CO levels, as we should ALL recognize the S&S of it, but a laboratory quality means of providing information to the ER docs and possibly change our destination to the appropriate facility.

We actually have these. We do fire rehab. We are also a volunteer service, but my director felt it was an important piece of equipment. Believe it or not, I have used it quite a bit.

[zippyRN]

I will take issue with you on this. I know how to use a pulse ox properly and I understand its meaning. I pride myself on doing proper patient assessments and that includes looking at patient presentation. I don't need a machine to tell me that a patient isn't getting enough oxygen.

As for your argument "if the machine didn't serve a purpose, it wouldn't be created" there are plenty of devices in EMS that have been created that are not useful. The most prominent right now being the backboard. Just because something is there doesn't mean it is the end all. I have seen pulse ox be wrong on numerous occassions and I have seen nurses and doctors stymied when they can't figure out why it is wrong or what to do now.

I once went into an ER and got chewed out by an RN and a doc because the triage pulse ox said the patient was sating in the low 80's and had a very high pulse rate and I didn't have the patient on Oxygen. I told both of them that those vitals were wrong and the patient wasn't that bad. While the doctor was chewing my butt the RN got a different vital tree and it was discovered that the original vital tree was broken and I was spot on with my assessment.

Pulse ox, AED's and other devices have their place but only if users understand how to properly use them and understand what to do if they fail. I would like to have a pulse ox on board just because it would be a little easier, but I don't miss it and I am not going to be affected without it. Just like an AED isn't going to change the fact that I do CPR. If I have an AED with me, great I will deploy it, if not then its compressions until ALS gets on scene. An AED, however, isn't appropriate in every case of Cardiac Arrest.

The bottom line is this; an EMT or Paramedic needs to be patient focused, not machine focused. Machines are useful and do have their place in EMS but the provider needs to look at the whole picture not just what the machine says.

an AED is an appropriate device to be carried on every ambulance, even those doing purely PTS work . my 'saves' from suddent cardiac arrest have all be charactierised by one thing - early CPR ( starting at the point of collapse) and early Defib ( within seconds to a minute or two)

From what other posters have said the US has caught up with the European guidelines on Oxygen adminstration and the approrpaite use of SpO2 to guide therapy goals .

others have brought up the issue of the long extrication board and it;s misuse as a evdience of equipment being designed without a purpose or use - rather than the problem being the misuse or oversue of something as part of a dumbed down system of training as preparation for practice rather than education ( for Health Professional providers) or a balance between education and training ( for first responders , assistant grades and associate practitioners)

[Chief1C]

Pulse Oximeters and AED's have become so inexpensive (for EMS terms) that it's strange not to have one. In fact, Penna. requires them. We have three different pulse oximeters, on just one ambulance. A tiny one, finger size, because. Just because. A Masimo Rad 57 and a monitor mounted in the mod, that has a pulse ox. And a baggy of assorted devices to attach to various sized patients. Mostly because I wanted the new EMS for Children Certification. Good PR, but already had all the required stuff. I was shocked it wasn't required, it just made sense to have on hand. Used the national EMSC standards list.

Now if I could just have my MAST, back....