Standards Procedure (Skill)
Clinical Indications: Levels: EMT-B, EMT- D,
EMT-I, EMT-P
Ø Patients with suspected hypoxemia
Ø All patient to get a base line pulse oximetry reading
Procedure:
a. Turn the machine and allow for self-tests.
b. Apply probe to patient’s finger or any other digit as recommended by the manufacturer.
c. Allow the machine to register a saturation level.
d. Record the time and the initial saturation percent on room air if possible on the ACR.
e. Verify the patient’s pulse with the corresponding pulse reading on the oximeter.
f. Monitor critical patients continuously until arrival at the hospital. If recording a one-time reading, monitor patients for a few minutes as oxygen saturation can vary.
g. Documented percent of oxygen saturation every time vital signs are recorded and in response to therapy to correct hypoxemia.
h. In general, normal saturation is 97-99%. Below 94%, suspect a respiratory compromise.
i. Use the pulse oximetry as an additional tool for patient evaluation. Treat the patient not the data provide by the device.
j. The pulse oximetry reading should never be used to withhold oxygen from a patient in respiratory distress or when it is the standard of care to apply oxygen despite a good oximetry reading, such as in the case of chest pain.
k. Factors which may reduce the reliability of the pulse oximetry reading may include:
1. Poor peripheral circulation (blood volume, hypotension, hypothermia)
2. Excessive pulse oximetry sensor motion
3. Finger nail polish (may be removed with acetone)
4. False finger nails
5. Carbon monoxide bound to hemoglobin
6. Irregular heart rhythms (atrial fibrillation, SVT, etc.)
7. Jaundice
Certification Requirements:
Successfully complete an annual skill evaluation including the indications, contraindications, technique, and possible complications of the procedure.