Emergency pulse oximeter

[maxviz]

Hi All, Wondering if the purchase of a finger pulse oximeter would be a good addition to our clubs oxygen kit. In the case of having to administer O2 would the reading be helpful in monitoring the delivery of O2. Would it be something that a paramedic or diving specialist doc need to know in assessing patients symptoms?

 

[Seaweed Doc]

I'd sort of recommend it. I had a fit, 43 year old marathoner get pulmonary edema on her first open water dive. Since then, she won a half-marathon (a month later) and has been told by a pulmonologist never to dive again. You never know who'll get this.

It would have been really handy to have on the beach while giving her oxygen. Turns out she was at 80% saturation AFTER she'd been on oxygen a few minutes as determined by EMS. By the time she got to the hospital (still breathing oxygen) she was up to 85%.

The only downside, and I suspect this'll affect you in Tasmania, is that you have to have really good circulation in the finger to make these units work. This might not be possible if the patient's hand is really cold. My patient couldn't get a reading until we had her hold her hand in warm water for awhile to restore good circulation to her hand. We'd been diving in 12C water.

 

[Resqdivemedic]

I think its one of those things that's nice to have but it's not a need to have. Being a paramedic I use pulse oximetry on a daily basis and use it as part of my patient assessment but its only one of many things I utilize and evaluate to paint a picture of what is going on. A few things to think about is that when we treat a possible DCS or the diving injury we want to give the highest concentration possible of oxygen. The pulse ox may read 100% but we still need to administer the oxygen to benefit the patient. Another thing to realize about pulse oximetry is it lags behind what is actually going on in the body by about + or - 5 minutes. A person can be decompensating and going into respiratory failure but still have pulse ox readings over 95%. If it's going to help then go for it.

 

[tbone1004]

We don’t administer O2 in most diving accidents because the O2 saturation is low.
It’s probably more useful to have for the pulse than the ox in most diving accidents. They’re cheap so I keep one in my med kit in my truck but it’s really low on my priority list for a dive accident

 

[Capt Jim Wyatt]

We are going to administer O2 for a diving accident. Knowing the O2 saturation level would be interesting information but it will not change the first-aid of administering O2.

 

[Duke Dive Medicine]

Hi All, Wondering if the purchase of a finger pulse oximeter would be a good addition to our clubs oxygen kit. In the case of having to administer O2 would the reading be helpful in monitoring the delivery of O2. Would it be something that a paramedic or diving specialist doc need to know in assessing patients symptoms?

Hi @maxviz ,

As @Capt Jim Wyatt said, first aid for a diver with suspected DCS or AGE 100% high-flow O2. You won't titrate that down based on pulse ox readings. If you're considering the idea of giving oxygen for something besides a diving injury, a pulse ox could be useful, but you would need to have someone on hand who could interpret the reading in the context of the presumptive diagnosis and then intervene appropriately.

Best regards,
DDM

 

[Doc Harry]

We don’t administer O2 in most diving accidents because the O2 saturation is low.

Huh? What??
Glad I live in the civilized part of the USA, not South Carolina

 

[tbone1004]

Huh? What??
Glad I live in the civilized part of the USA, not South Carolina

That may have been worded poorly. The intent was "we don't administer O2 because we believe the O2 saturation is low", we are administering it for other reasons because the assumption is if the patient is breathing, they were exposed to a ppO2 higher than that at the surface. Obviously the exception being if they were on a rebreather or made a bad switch to a hypoxic gas mix.

 

[rjack321]

Huh? What??
Glad I live in the civilized part of the USA, not South Carolina

A conscious DCS patient is almost never going to have a low O2 saturation in their fingertip. In a particular tissue that has occluded vasculature sure, but the pulse oximeter isn't useful in that case anyway.

 

[DeepSeaDan]

If you do plan to purchase / use one, understand that bright light can affect it's ability to scan, as will fingernail polish; further, it can't distinguish between O2 molecules & CO molecules, thus giving a false reading if the patient is CO toxic.