1. #1
    MembersZone Subscriber

    Join Date
    Jan 2005
    Posts
    3,745

    Lightbulb Pulse CO-Oximetry

    Looks like we will have excess funds from the AED purchase. One idea is purchasing a Pulse CO-Oximetry for CO calls. I have researched the equipment and just trying to get some input. I believe the equipment is not cheap, I was told it is about $3500/unit.

    If you use this equipment:

    What brand do you use?
    How much did it cost?
    Has the unit performed to expectations?
    Any issues?
    Anything else you would like to pass along?

    Any info will be appreciated. Thanks.

  2. #2
    MembersZone Subscriber

    Join Date
    May 2000
    Location
    SW MO
    Posts
    4,249

    Default

    I don't recall how much they ran, but we use the Masimo RAD-57 at my career department. It cost enough that we only have one, kept on the Batt Chief's Tahoe.

    It seems to work pretty well. I don't think we use it enough, is my issue. The idea was that we were going to assess anyone that came out of a smoke-present structure fire, as well as do some studying of our personnel after overhaul. Basically, to see how things correlated between our atmospheric CO monitoring (has to be below 20 ppm before we go without packs) and our SpCO levels after coming out.

    When we in-serviced everyone, we put it on some smokers to show them their CO level, which was surprising.

  3. #3
    Forum Member

    Join Date
    Nov 2005
    Location
    Kansasville Wisconsin
    Posts
    219

    Default sounds like alot

    Sound like alot of money for a piece of equiptment that is going to give you information that isn't real usefull. In CO patient all you are doing in treating symptoms and applying high flow oxygen. Let us know what you find out though. How a new stair chair with the tracks on it for stairs. Now that is worth every penny.

  4. #4
    MembersZone Subscriber

    Join Date
    Nov 2008
    Location
    Columbia, TN
    Posts
    126

    Default

    Not trying to get all medical........but: I feel like a CO monitor to test firefighters CO levels is worth every penny. I think it's funny to see firemen wearing pulse ox's that is reading 98% plus and thinking they are fine when really all it is picking up is the CO that has attached to the hemoglobin in their blood. That's the fault with pulse ox's is that they cannot differ between O2 or CO molecules which have attached themselves to the hemoglobin. Plus, CO will bind with hemoglobin more readily then O2 will. I know our Chief has been begging our EMS service(hospital based) to try to buy just one of these monitors because of their cost. I believe they run around $10,000, but I could definately wrong on that #. I am including one of these monitors in this years AFG.

  5. #5
    Forum Member
    islandfire03's Avatar
    Join Date
    Oct 2006
    Posts
    2,586

    Default

    Quote Originally Posted by mcfdrichey25 View Post
    Not trying to get all medical........but: I feel like a CO monitor to test firefighters CO levels is worth every penny. I think it's funny to see firemen wearing pulse ox's that is reading 98% plus and thinking they are fine when really all it is picking up is the CO that has attached to the hemoglobin in their blood. That's the fault with pulse ox's is that they cannot differ between O2 or CO molecules which have attached themselves to the hemoglobin. Plus, CO will bind with hemoglobin more readily then O2 will. I know our Chief has been begging our EMS service(hospital based) to try to buy just one of these monitors because of their cost. I believe they run around $10,000, but I could definately wrong on that #. I am including one of these monitors in this years AFG.
    You are 100% correct on the issues with only using a pulse ox meter.
    We have the Masimo rad 57 and we use it on every FF when they come out to change air bottles for both blood oxygenation level and carbon monoxide levels. They work extremely well are basically FF proof and need nothing other than an occasional battery change.

    Bugle : I will dig through my records and get you the contact name at Masimo. We bought ours three years ago and they gave us a discount for trading in a non working pulse-ox we had. The most recent cost I've seen is around 4k. Boundtree carries it , but you might be able to do better factory direct as I did.

  6. #6
    Forum Member
    Not2L84U2's Avatar
    Join Date
    Sep 2004
    Location
    Catlin, IL, USA
    Posts
    958

    Default

    Andy, talked to some of the guys involved in MABAS in IL. I know MABAS purchased a TON of these units for all of the divisions. Can't remember what the brand name is and haven't heard how it works yet.

  7. #7
    MembersZone Subscriber

    Join Date
    Feb 2006
    Location
    Rochester, NY, USA
    Posts
    105

    Default

    My department also considered buying one of these. We could not justify the cost for one reason. New York EMS protocols do not address co-oximetry. In other words, there is no protocol for safe vs. unsafe levels, no protocol for treatment based on the levels you find, and patient care would not change regardless of what the meter says. Thus we did not buy one. But that is us.

  8. #8
    Forum Member
    islandfire03's Avatar
    Join Date
    Oct 2006
    Posts
    2,586

    Default

    We didn't have a protocol for it either. We went to our medical director and asked what criteria they used in the emergency room for CO poisoning. What levels of the bloodwork testing would lead them to go beyond simple O2 therapy and cause them to send a pt to the hyperbaric chamber.
    Those levels of carboxyhemoglobin were what we used to make determination of simple or severe CO poisoning.

    Bugle : E-mail headed your way
    Last edited by islandfire03; 01-31-2009 at 09:41 PM.

  9. #9
    MembersZone Subscriber

    Join Date
    May 2000
    Location
    SW MO
    Posts
    4,249

    Default

    Quote Originally Posted by hoserbt View Post
    Sound like alot of money for a piece of equiptment that is going to give you information that isn't real usefull. In CO patient all you are doing in treating symptoms and applying high flow oxygen. Let us know what you find out though. How a new stair chair with the tracks on it for stairs. Now that is worth every penny.
    A little of the usefulness depends on the dynamics of your department. Part of the reasoning behind our machine is to determine the CO levels on scene, prior to transport. If they're elevated, the nearest hyperbaric chamber is an hour, with the next closest being an hour and a half. Instead of sending them to the ER for a couple of hours (at least a couple), we can get them on a helicopter and on their way there.

  10. #10
    MembersZone Subscriber

    Join Date
    Jan 2005
    Posts
    3,745

    Default

    Thanks for the info guys.

    My reasoning for this falls in line with what islandfire and Catch have posted. Replaying past incidents has shown that the unit would have been a valuable tool in determing CO in firefighters/patients.

    The most significant was an MCI (I was the IC) with 21 patients exposed to extremely high levels of CO (over 900 ppm in the basement to over 300 ppm on the third floor of a huge mansion). Even though the technology may not have been available then (6 years ago), being able to triage based on CO levels than just triaging based on S&S would provide improved medical care.

  11. #11
    Forum Member

    Join Date
    Sep 2005
    Posts
    790

    Default

    Bugle, You may also want to check with your local medical society, they have been very helpful ($$$) in making purchases toward firefighter rehab. Got AED's for all of the trucks from them as well.

  12. #12
    Forum Member

    Join Date
    Nov 2005
    Location
    Kansasville Wisconsin
    Posts
    219

    Default i assume the worst

    The problem with the co detection is that it shows the concentration of availible hemoglobin saturated. What scares me is that if a patient has low hemoglobin and i don't know it they might not be prioritized correctly. I assume the worst all the time with CO and send them to bariatric chanber facility. Just a thought I do see the benifit to the information and i guess i would have to retract me statement about it not being worth the money
    Stay safe

  13. #13
    Forum Member

    Join Date
    Sep 2005
    Posts
    790

    Default

    Been a medic for 14 years now, and he best piece of advice/education I ever got out of my class or since then is Treat your patient not your monitors. If they show signs and symptoms, I treat for them even if the monitors are not showing anything.

  14. #14
    MembersZone Subscriber

    Join Date
    May 2000
    Location
    SW MO
    Posts
    4,249

    Default

    Quote Originally Posted by Limeforever View Post
    Been a medic for 14 years now, and he best piece of advice/education I ever got out of my class or since then is Treat your patient not your monitors. If they show signs and symptoms, I treat for them even if the monitors are not showing anything.
    I've heard that many times myself, and probably said it even more. The monitors are just a tool to help you find out what's wrong. If the protocol is set up right and the caregiver has his head out of his tail, anyone with signs of CO poisoning is sent to definitive care, the monitor is just for those clarifying or helping diagnose those that aren't showing the tell-tale signs.

  15. #15
    Forum Member
    islandfire03's Avatar
    Join Date
    Oct 2006
    Posts
    2,586

    Default

    Quote Originally Posted by Limeforever View Post
    Been a medic for 14 years now, and he best piece of advice/education I ever got out of my class or since then is Treat your patient not your monitors. If they show signs and symptoms, I treat for them even if the monitors are not showing anything.
    I agree 100% on treating the pt's based on presentation. The Rad 57 is just another tool in the arsenal to allow us earlier detection of elevated levels that are not visible and allow us to pull someone out earlier to get them treated, prior to becoming critical. We check all non specific pt's this time of year that are presenting with general malaise and dizziness that can be confused with the flu or viral symptoms. Anyone burning wood or coal for supplemental heat
    has an elevated risk of CO effects. More of a tool to rule out CO as a cause, and to allow us to determine if they need to make the hour & 1/2 trip to the hyperbaric chamber vs. being treated locally.

  16. #16
    Forum Member

    Join Date
    Sep 2008
    Posts
    5

    Default

    RAD 57's are great. In duxbury we were the 1st in Southeastern Massachusetts to buy one. They did stories on all stations about them. Within a few months of purchase we had a CO poisoning where we had two critically ill patients. One that we flew out had readings of 53ppm. We knew this guy was critical but this tool was huge. We use it on a regular basis not only at fires but medicals when people have flu like symptoms and everyone else in the house is sick. The docs at the hospital love when we come in and are able to eliminate something else!

    http://www.town.duxbury.ma.us/public...MA_FireDept/co

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Log in

Click here to log in or register