Anyone using CO Pulse Oximetry?

nurse2033, MSN, RN · Mar 17, 2011

I use it at my paramedic job but not my ER job (RN). It is useful to see the level of exposure to CO. We also use it to rehab firefighters in the field.

GreyGull · Mar 17, 2011

We use the pulse oximeters from Masimo which are available with a variety of different measurements.

The ones that can be used for SpCO and SpMet are kept in the Respiratory Therapy department for use on call anywhere in the hospital. The RTs can do an initial screening and then follow through with a co-oximetry blood gas as needed. This documentation and trending will then be established to follow the patient throughout their course of treatment in whatever area of the hospital they might go which can be the floors, ICU and/or HBO with Repiratory Therapy and Pulmonary following the patient on their service and protocols.

The SpMet also has it uses for screening or monitoring different patient using certain meds or gases such as NO (nitric oxide). It is particularly useful for monitoring SpMet for NO users either in the home or on transports.

The regular SpO2 pulse oximeters are throughout the hospital for the CNAs and nurses to use.

danh3190 · Mar 17, 2011

We don't have them on our ambulances though I'd like to. As for where to get them, I've seen lots of ads in paramedic journals for them.

GreyGull · Mar 17, 2011

In the U.S. and throughout the world Masimo is the leader of this technology.

Many ED and ICU monitoring systems are now using Masimo products as part of their systems so it is not difficult to get information through their rep.

The Masimo RAD-57 is the one most commonly used in fire departments which can be used by their firefighters during rehab or by their EMS units.

http://www.masimo.com/subindex.htm

There are a couple of other European companies but I have not heard anything lately about their studies for approval for use in broader clinical settings.

AnnieOaklyRN, BSN, RN, EMT-P · Mar 18, 2011

Anyone have comments/recommendations re: pulse oximetry for carbon monoxide? I've heard about these devices, want to know if other EDs are using (EMS, too!) because we're checking into getting one and there doesn't seem to be a lot of options out there.
I'm talking about (lighted/finger) pulse oximetry, NOT capnography (we already have/use that) and of course we have lots of regular pulse ox readers (in every room).
THANKS!!

I use it as a paramedic. We use Zoll and they are built right into our E Series monitors; however our monitors cost about 34,000.00 a peice (yes, I know, shocking that a monitor could cost more than your average new car!) because of all of the other options on them. I am guessiing you just want a portable CO only oximeter, I would go with Masimo they seem to be the best at making those.

Just be careful, they couuld easily walk away if they are too portable! When I worked in an ER we lost TWO fetal heart monitors and a handful of thermometers to theft amoung other things...

I just don't know that I could see the CO Oximeter being that useful in an ER when you can test carboxyhemaglobin in the blood, which I am sure is more accurate, especially for the smokers. I know its a painful stick, but...

Happy

GreyGull · Mar 18, 2011

I use it as a paramedic. We use Zoll and they are built right into our E Series monitors; however our monitors cost about 34,000.00 a peice (yes, I know, shocking that a monitor could cost more than your average new car!) because of all of the other options on them. I am guessiing you just want a portable CO only oximeter, I would go with Masimo they seem to be the best at making those.

ZOLL uses Masimo for their CO monitoring unit just as the ICU and ED systems have integrated into their systems. That can also explain part of the cost.

Just be careful, they couuld easily walk away if they are too portable! When I worked in an ER we lost TWO fetal heart monitors and a handful of thermometers to theft amoung other things...
How true! We've thought about GPS locators for these devices. We've also found some of our equipment and that of other hospitals on the ambulances and on eBAY. They can be easily identified by the serial number. Someone was even selling O2 regulators on an EMS forum with the serial number visible.
I just don't know that I could see the CO Oximeter being that useful in an ER when you can test carboxyhemaglobin in the blood, which I am sure is more accurate, especially for the smokers. I know its a painful stick, but...
Happy
Depending on the equipment the RT department has, a capilary sample can be used and obtained with the glucose check. We do this in the PFT labs for all testing to determine CO levels for PFTs and for smokers whose doctor expects the lab to determine by "SpO2" the correct amount of oxygen. Of course once a baseline is established, the monitors capable of recognizing CO make the walk or threadmill protocol that much easier.