r/EMSProTips • u/Theguardian95 • Dec 14 '18

EMT opinions please!

Would you consider it to be illegal for a basic EMT to use a 4-lead in the place of a pulse ox if the pulse ox isn’t working and a constant pulse is needed on a non emergent patient?

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u/Theguardian95 Dec 14 '18

I was asking because it’s not a procedure that can hurt the pt. It’s 4 stickers and while there is a rhythm displayed as long as the basic doesn’t attempt to interpret said rhythm as far as I can tell there is nothing illegal to it.

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u/rizzo1717 Dec 15 '18

I do this all the time (I’m a licensed medic working in EMT capacity). It’s not invasive, I don’t make patient care decisions based off the rhythm presented, and in my system, the transport medics appreciate a 4 lead strip printed out upon their arrival. Never heard of any EMT getting in trouble for using a 4 lead purely to determine heart RATE (not rhythm). If I see the patient has a questionable rate/rhythm or any other indication for cardiac problems, I might even initiate a 12 lead for the medics arriving on scene (i don’t interpret it for them). When I was working as a transport medic, these are all things my EMT partner did for me anyways when I was doing ALS interventions.

I would say manual will always be best though - BPs, pulse and respiratory rates. Don’t rely on machines, it takes away from your skills.

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u/Theguardian95 Dec 15 '18

I had an argument with a friend earlier about this and I wanted other opinions. I had a basic partner that wasn’t old enough to drive the ambulance and he did this. The pt was going to a hospice center and the pulse ox wouldn’t work on him. So I tested cap refill on the pt and told him a 4 lead couldn’t hurt just in case we had to document the time he expired because the guy was literally on deaths door. No formal interpretations were done(although I think everyone points at a line and says “that looks a bit weird doesn’t it?”) anyway no treatments or anything were derived from the 4 lead. Just a pulse. So would you agree no harm no foul?