Thought's on Pulse Oximeters

[Missedcue]

I really am more interested in having one for sat readings the pulse is just a bonus. I'm thinking on inter facility transports with a stable patient. Diving in for a carotid pulse is unnecessarily invasive just so that I have numbers to put on my report. In this instance I trust the little machine enough.

thanks for the brand suggestions.

 

[Flight-LP]

Checking a pulse is by no means invasive.

So if you have an obese patient and are unable to palpate a radial pulse, you would then elect to skip obtaining vitals as part of an appropriate assessment and document what may or may not accurate on the patients medical record?!? A stable IFT is a great example of the patient you should be putting your hands on to improve proficiency in you assessment and diagnostic skills. Just saying.............Personal opinion of playing this EMS game for a while now is that your thought process is slightly backwards.

 

[xrsm002]

Treat the patient NOT the monitor, pulse ox etc!!! They did EMS for years without a Pulse ox and were fine. Though I did find a 50.00 one at walgreens

 

[JPINFV]

Treat the patient NOT the monitor, pulse ox etc!!! They did EMS for years without a Pulse ox and were fine. Though I did find a 50.00 one at walgreens

See point 1:
http://emtmedicalstudent.wordpress....es-that-should-never-be-said-on-an-ambulance/

Furthermore, EMS does not do fine, and never has, when it comes to monitoring oxygenation status and oxygen administration. Without a pulse ox, you can't titrate for effect, which means you're left throwing darts or playing the "NRBs for EVERYONE!" game.

 

[Handsome Robb]

Treat the patient NOT the monitor, pulse ox etc!!! They did EMS for years without a Pulse ox and were fine. Though I did find a 50.00 one at walgreens

You just opened up a huge can of worms on here with that statement.

Two words: clinical correlation.

 

[18G]

Treat the patient NOT the monitor, pulse ox etc!!! They did EMS for years without a Pulse ox and were fine. Though I did find a 50.00 one at walgreens

Here are a few for $19.

https://encrypted.google.com/#q=pul....,cf.osb&fp=9fde92560e9c7f95&biw=1366&bih=643

 

[seanm028]

h34r:h34r: Wow how can we top that? Somewhere between 4 and 5 should be easy. Really breaks my heart.

I don't mean to sound like a jerk by correcting you, and I mean that from the bottom of my heart, but I think maybe you mixed up your directions.

 

[Handsome Robb]

I don't mean to sound like a jerk by correcting you, and I mean that from the bottom of my heart, but I think maybe you mixed up your directions.

Not to sound like a jerk by correcting you but the apex of the heart is actually inferior hence what he is talking about. The heart is "upside down" so to speak. Just sayin'...


Thank you for your service, by the way.

 

[xrsm002]

I'm just saying what my paramedic instructor has been drilling into our heads for the semester during cardiology, talking about cardiac monitors when a patient has PEA which monitors could still show a NSR in a patient with PEA. We usually refer to a systolic bp when titrating to effect at least that's what my school and med director say

 

[Handsome Robb]

I'm just saying what my paramedic instructor has been drilling into our heads for the semester during cardiology, talking about cardiac monitors when a patient has PEA which monitors could still show a NSR in a patient with PEA. We usually refer to a systolic bp when titrating to effect at least that's what my school and med director say

So if the patient's systolic is 90s/x does that automatically mean they are borderline hypotensive? What's their baseline? I'll say it again, clinical correlation.

I know where you are coming from, it is a common phrase in education. Although not the most appropriate.

 

[seanm028]

Not to sound like a jerk by correcting you but the apex of the heart is actually inferior hence what he is talking about. The heart is "upside down" so to speak. Just sayin'...


Thank you for your service, by the way.

You're right, I read top and assumed he meant superior. Guess I dug my own grave on that one <_<

And you're welcome - it's my pleasure to serve.

 

[usalsfyre]

Two words: clinical correlation.

My heart just warmed .

 

[usalsfyre]

I'm just saying what my paramedic instructor has been drilling into our heads for the semester during cardiology, talking about cardiac monitors when a patient has PEA which monitors could still show a NSR in a patient with PEA. We usually refer to a systolic bp when titrating to effect at least that's what my school and med director say

Your instructor chooses to rely on old EMS wives' tales rather than actually instructing you in the art of patient assessment, probably because he was never taught how to assess a patient himself. If the patient is in PEA there's probably going to be clues before "OMG, HE DOESN'T HAVE A PULSE!!!"

You should really be tittering things by MAP, but I don't think that's in the current paramedic curriculum.

 

[medic417]

You're right, I read top and assumed he meant superior. Guess I dug my own grave on that one <_<

And you're welcome - it's my pleasure to serve.

Thus the 4/5 statement. Where you should listen with stethoscope.

 

[Bullets]

Your instructor chooses to rely on old EMS wives' tales rather than actually instructing you in the art of patient assessment, probably because he was never taught how to assess a patient himself. If the patient is in PEA there's probably going to be clues before "OMG, HE DOESN'T HAVE A PULSE!!!"

You should really be tittering things by MAP, but I don't think that's in the current paramedic curriculum.

WHOA WHOA WHOA Buck Rodgers, MAP? who do you think you are? Some kind of educated provider? calm down


Seriously, ive had ER docs look at me funny when i mention an abnormal MAP

 

[Handsome Robb]

My heart just warmed .

This real smart guy taught me about it once, can't remember who it was though

We actually had a pretty interesting lecture in class about MAP, ICP and CPP in closed head injuries. I'm no expert by any means but I definitely understand the correlation. On that note, only 9 more class days until my final then out to clinicals and internship! It can't come soon enough.