Tue, 10 Apr 2012|
FIre Engineering EMS Editor Mike McEvoy discusses using pulse oximetry, a method of determining the oxygen level in your patient. Mike also discusses some tips and issues with readings on pulse oximetry devices.
Automatically Generated Transcript (may not be 100% accurate)
Hi welcome to training pants today we're gonna talk about using polls such symmetry which has been attitude the first responder and -- empty curriculum. Paul -- symmetry is a method of determining oxygen level in inpatient. Has many limitations. First thing that we're gonna do is place the probe on the patient so we have a finger probe that we're using with this device. And we're gonna choose a finger that has the best blood flow. Of the fingers on your hand your ring finger tends to be the thing that has the highest blood flow. -- place the probe on the patients ring finger. We could put it on any one of the other fingers prepped for actually one of the reed middle fingers not the bomb not -- -- And then we'll watch the polls sucks and there as it boots up it's going to collect. -- Sox reading what you see is a 100% here and heart rate on the some of the issues -- polls and -- have to do with. Things that it may detect other than oxygen that patient it's looking at the hemoglobin and determining saturation of -- globe oxygen. It could be fooled as firefighters know by carbon monoxide it's unable in conventional pulls out lenders like this device. To be able to tell the difference between seeking -- and -- box seeking -- So if this patient pulled from a fire at a -- -- percent -- -- globe and carbon monoxide level. The -- Sox with 200%. Not recognizing. That 20% that was -- and so that's the first idea about using -- Clearly. If a patient pulled from a fire. And as the polls -- -- using conventional pulls sucks and it can't tell the difference between the globe in a box Goldman. Then the saturation was low but it's there's a problem with that. The other question people often ask is sign. If the patient what time would the -- senator have an effect on the sign. The answer to that seems to be in the polls that senators did not seem to be affected. In their meetings -- levels in the blood -- Next question is. What's the strength of the blood flow to the -- where you place the pro. Now we chose what we believed to be the best blood flow by using the ring finger on this patient. If for some reason -- market in good signal if he had low profusion. May need to place the probe on another -- on hand or perhaps on it -- There are probes that are specially made to put on year -- probes that are made on knows that -- there -- go for. You need to use -- -- that's designed for whatever application using in this case and pro on I think. And this particular scanner which is named by Massimo as well -- senators that are made by a -- native. And by Phillips. We have an indicator of actual profusion on the patient that's called profusion and if you're using a brand -- -- has profusion index. In an adult patient. One point four is a cut off for reliable verses on reliable signal. In this instance. -- profusion index is well over four and so -- profusion to the extremity that we have the -- on X. If you're doing -- and you donate one point 27. Is the threshold for good vs bad profusion. The other question is nail polish. And nail polish interfere with balls. And fact three colors and nail polish actually do throw the pulse Watson entries in -- law. Black blue and Green now. So if -- patient -- wearing nail polish he may use a nail polish remover. A prep had similar to an alcohol that's designed to remove nail polish has acetone non. And the acetone would be used to -- the nail polish off the patients now. You could also position probe so that it -- sideways in the finger. Avoiding -- -- completely. Mean sideways. Would eliminate the effect of black blue or Green male that the patient. Another question is what about ambient light. And there are certain forms of ambient light that could interfere with the -- oxygen and sunlight is long and very bright sunlight may require you to put -- -- Over the extra -- You have a pulse -- -- Lights that endorse such as fluorescent light which he may have in the back here and once when you rescue. Or xenon light. Indian sports stadium -- a place where that's what lightning issues could interfere with the -- signal and again. Putting a towel over the neat company will eliminate that -- appearance from the meetings that are being taken. Some people question whether sickle cell crisis or sickle cell Anemia affects -- meetings the answer to that is now. Sickle cell does not affect the polls -- The other question is what about darkly segmented -- patients so people who are for example African American. Or Indian who -- darker pigmentation to -- can. Paul -- is not affected by darkly pigment patience. And finally hyper bill and -- in -- Patients who for some reason it elevated level of -- movement and -- bloodstream perhaps then liver failure. Or perhaps they have some other condition causing excessive levels and those patients typically have a yellow appearance of skin. That does not interfere with -- Sox. So we talked in another fire engineering video series about using Paul -- an entry to take blood pressure and again. If you're trying to that's that's the blood pressure you could place the probe on extremity. Pump your blood pressure -- up on the saint -- and watch for the pole station. As you let the air out of the blood pressure and get a rough idea of the style there. So those are some tips for using polls not symmetry a common tool something that's been added into our curriculum in the new first responder -- empty curriculum. And it very helpful device to determine. What the -- nation's status of your patience and as oxygen becomes more important and we start to realize some detriment of getting oxygen patients. Who have traumatic conditions such as trauma. -- -- car park or stroke. Where excessive levels of oxygen may actually hurt knee injury to those patients make their conditions worse. -- that it is valuable pool for assessing patients in -- field. Thanks for watching things I'm like in the.