Emergency pulse oximeter

[Duke Dive Medicine]

@DeepSeaDan good point about the carboxyhemoglobin and oxyhemoglobin. This is rarely encountered outside of EMS/health care, but if someone does have occasion to use a home pulse oximeter in the setting of suspected CO poisoning, the results cannot be considered reliable.

Best regards,
DDM

 

[DeepSeaDan]

@DeepSeaDan good point about the carboxyhemoglobin and oxyhemoglobin. This is rarely encountered outside EMS and health care, but if someone does have occasion to use a home pulse oximeter in the setting of suspected CO poisoning, the results cannot be considered reliable.

Yes indeed, I see your point. In my Firefighter-Medic response career we did have instances of CO poisoning due to a number of causes. In recreational diving, I could see an instance where contaminated air and it's subsequent consequences for a Diver who breathed it might interfere with the accuracy of a pulse-ox, should one be used.

 

[Duke Dive Medicine]

Yes indeed, I see your point. In my Firefighter-Medic response career we did have instances of CO poisoning due to a number of causes. In recreational diving, I could see an instance where contaminated air and it's subsequent consequences for a Diver who breathed it might interfere with the accuracy of a pulse-ox, should one be used.

Really good point!

Best regards,
DDM

 

[GF99/99]

Just out of curiosity from my very very limited medical knowledge and especially from a rebreather standpoint wouldn't with the exception of diving with hypoxic mix you get a really high o2 saturation level reading from a pulse ox. Especially if you have just spend the last hour or hours on o2/high ppo2 1.4-1.6 depending on your deco methodology.

 

[tbone1004]

Just out of curiosity from my very very limited medical knowledge and especially from a rebreather standpoint wouldn't with the exception of diving with hypoxic mix you get a really high o2 saturation level reading from a pulse ox. Especially if you have just spend the last hour or hours on o2/high ppo2 1.4-1.6 depending on your deco methodology.

it would on OC as well. Your body is designed for 100% saturation with a ppO2 of ~.21, any sort of diving is going to have a ppO2 higher than that.
With hypoxic mixes you use a travel gas so you'd never see a ppO2 lower than 0.21

 

[Zef]

This discussion reminds me of an occasion years ago in the navy prior to becoming commissioned when I was a Hospital Corpsman.

While monitoring the commands physical readiness test in sunny Mt View California, we had one of our older sailors fall out after completing the run. My colleagues rushed over to the guy and started taking vital signs to include strapping a blood pressure cuff on the guy and pulling out a stethoscope. Although the junior guy present, I had the most medical experience and reminded them that his blood pressure didn't really matter as one can treat for shock regardless of blood pressure. I also reminded them that one can treat for heat exhaustion/heat stroke too and the prudent thing was to get the guy in the shade, cool his body, and treat for shock...once stable one can then entertain curiosities like blood pressure....more important would be to assess whether intravenous fluids are warranted and further activate EMS.

It is easy to deceive oneself that more apparatus is good, but the reality is that it can lead to a cognitive bias that steers us away from just administering good old fashion first-aid protocols.

In the case of DCI/DCS the first-aid protocol is administer 100% O2...if the pulse-ox is low the general protocol is to administer 100% O2....if one is already doing that then there really is no need for an extra gadget out in the field...perhaps spend your money on larger or 2nd O2 cylinder as the small emergency bottles don't last very long.

-Z

 

[DogDiver]

Unless you have a medical background and are fluent in interpreting the reading the numbers will be useless. Retired ER Trauma RN here.

 

[michael-fisch]

Unless you have a medical background and are fluent in interpreting the reading the numbers will be useless. Retired ER Trauma RN here.

Gotta disagree, a pulse-ox below 96% is not normal, and pulse-ox's below 90% require immediate medical intervention (enough LPM of O2 to restore a pulse-ox above 96%). If DCS or AGE is suspected, breathing pure O2 is the way to go until a Diving Medical Doctor changes the therapy. Fried lungs will heal, dead brain cells won't.
Michael

 

[TravelGas]

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?

Pulse oximetry is one of 5 vital signs and is always helpful to have. A lay person can use it. $25 well spent addition to any Trauma kit. Unreliable if Patients hands are cold, finger nails are painted, etc.
Pulse: Rate & Quality
Breathing: Rate & Quality
Blood Pressure
Skin: Color, Temperature & Moisture
Pulse O2

 

[Zef]

Pulse oximetry is one of 5 vital signs and is always helpful to have. A lay person can use it. $25 well spent addition to any Trauma kit. Unreliable if Patients hands are cold, finger nails are painted, etc.
Pulse: Rate & Quality
Breathing: Rate & Quality
Blood Pressure
Skin: Color, Temperature & Moisture
Pulse O2

Please explain what advantage knowing pulse O2 in the field will provide for one administering first aid on site for dive related issue (not talking about EMS)?

If one has O2 to administer then it should be administered, if one does not have O2 to administer then one can ponder obtaining/purchasing O2 for the future while administering other first aid protocols.

What would you expect a first responder to do differently knowing pulse O2 levels that they would not already be doing?

The tendency with gadgets like this is tunnel vision, where the responder spends more time looking at what the device is indicating and thinking about how they should respond to it than just provide sound first aid based on established protocols.

Your money is better spent on CPR/First aid/O2 Administration certification or recertification than on pulseoximeter.

Knowing pulseO2 changes nothing in the field from a first responder/patient care perspective. In fact responding specifically to PO2 levels indicated by pulseoximeter by first responder who does not have more advanced medical/emergency response training can open the first responder to liability issues for administering care beyond their training. If the OP fell into the category of advanced medical/emergency response they would not have asked the question in the first place.

Bottom line is that one can spend their money on any gear/equipment/gadget they want, but there really is nothing useful or practical that a pulseoximeter and it’s readings bring to a first responder scenario…perhaps use that money to invest in a portable AED, much more useful when the occasion for use presents itself.

-Z