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Monitoring Vitals
Im wondering what everyones take is on basics using the lifepack to monitor vitals not cardiac just BP and pulse and O2 saturation on transfers and 911..... im getting conflicting information from one certain a individual on the volli service I Volunteer for, as aposed to what everyone on the paid service i work for tells me. The paid service tells me that it is ok to use this to monitor Pt vitals and this individual pardon my french gets butt hurt and has a shit fit about basics using the lifepack for this. i have told this individual to show me in writing in our dept and in regional protocols this but i have yet to see any evidence say yay or nay on this matter. I have even looked for myself in the regional protocols but have found nothing saying either way. So i was wondering what everyones take on this was.
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Replies to This Discussion
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Permalink Reply by Jason Brooks on
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Who cares how you accomplish this task. A basic can always apply a monitor to a patient, they just can't interpret or treat the rhythm. If you use a machine to take your vitals, you are freeing yourself up to do something else at the same time. The person that is telling you otherwise, is being a prick and trying to prove that they no more than you.
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Permalink Reply by Joe Stoltz on
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Interesting you should post this... yesterday we had a call for a man seizing. I got a BP of about 140/90 in his left arm, the ALS tech's machine read 162/115. This disparity continued all the way to the hospital. Just before getting out of the rig, we measured with the same bp cuff - about 140/90.
Hospital got similar readings.
Until that time I've never had to question the accuracy of one of those Lifepaks with built-in BP monitoring. -
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Permalink Reply by Ben Waller on
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There is nothing wrong with EMT-B's using a non-invasive BLS technology to monitor a patient's vital signs, even if the BLS monitor is attached to an ALS monitor. As long as the EMT doesn't attach the cardiac leads or do anything else beyond his/her scope of practice, using a vital sign monitor is fine.
That said, I believe that every EMT and Pramedic should take the first set of vitals manually, because there are things that can trick automatic BP monitors. If you can't confirm the initial BP with a secondary source (like your ears) then it's just a number on the monitor screen.
Here's another point that might make your individual with the Division 3 issues is that Physio Control makes a Lifepak 12 that can be used in both BLS (AED) and ALS (visual lead interpretation) mode for monitoring CPR patients.
If you have that style of monitor/defibrillator, an EMT-B can deliver the shocks on a CPR while the Paramedic starts the IV, pushes drugs, intubates, etc.
Bottom line, if the Lifepak has a non-invasive BLS vital signs monitor built into it, it's OK for an EMT-B to use it. -
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Permalink Reply by John on
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Our Dept. allows basics to use the lifepack 12 monitor for vitals and since our medics run with a paramedic on board they will even allow us to place the patient on the cardiac monitor part be it a 12 lead or basic 4 lead strip we just are not allowed to interpet the rythm.
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John,
Even if the paramedic isn't on board, using the BP and pulse ox monitors is OK for an EMT.
Unless you hook up the cardiac leads, you're not using the "cardiac monitor". You're just using a BP monitor that happens to be co-located in the same plastic housing.
Ben -
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Permalink Reply by united 289..{Dave} on
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I personally don't like the technology to take a BP. I prefer the manual way. The only time I will use a automatic BP machine is when I can't hear a BP or able to palpate a pressure. Even then I will use my pulses at the radial, femoral and carotid. My capillary refill. The pulse ox is just a tool to use. If you have a pulse ox of say 92. Is that person o2 sat to low? maybe, maybe not. My point is you need to treat the patient not the machine. I have seen emt's flood patients with o2 just because the there pulse ox had a reading of 90 when they are profusion well with good color. They was treating a machine.
I guess what I saying I am old school. We shouldn't relay on machines to judge how we treat patients. Learn to treat with what is being presented to you by the patient and manual BP readings and not a machine is telling. -
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Good point Dave, we try to take a manual BP first then follow up with the monitor BP and pulse ox.
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I meant that in our department we cannot hook the cardiac leads up unless the medic is on board otherwise we can use the monitor for bp and pulse-ox
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Permalink Reply by Jeff on
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The amublance that I run with uses the lifepack religiously on every call to monitor the patients vitals. We have always found it to be very accurate in comparison to checking the patients vital manually. I dont see a problem with a basic using the machine as long as they are trained to use it. And if your doubting the accuracy of the machine its not difficult to manually doublecheck the vitals just to be sure....
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Permalink Reply by Allen on
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You need to send it in and have it Recalibrated. I have seen them off before and thats all it was. you know if it was a LP10 or 12? either way, that is probably all it needs.
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There is nothing wrong with using a LP to do your BP and O2 sats. However if it is an easy call and you have time, grab the ole fassion ears and trusty wrist watch and use your skills. Its good to keep in practice and you know it is correct. Now if it is a true MOI/NOI and your running Code 3 then, let the LP do the easy stuff while you are pushing your meds, running lines, CPR, or what ever the case may be. But again, it never hurts to keep in practice, esp if you second guess the LP or any other monitor.
As for the lead placement that i see others talking about. As long as the EMT-B Has ACLS or PALS or has been properly shown how to place the leads, i do not see a problem with them putting them on. As for the translation of the P,Q,R,S,T, segments, yeah leave that to the ones that know what they are looking at. Just my opion.
Everyone stay safe out there tonight, its going to be busy for us as it always is for us at this time of the year.
AS -
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Permalink Reply by Justin Westmoreland on
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Thanks guys for you insight on this. A little side note on this person i speak he has ran off sever great medics from this service. Im just not sure how to react, since he is our only Emt above the basic lever, things are so messed up our own EMS director wont stand up to him. Any who I hope everyone has a safe and happy new years
Be Safe
Justin -
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