CAN PREHOSPITAL PERSONNEL DETECT HYPOXEMIA WITHOUT THE AID OF PULSE OXIMETERS

Although pulse oximeters have been proven accurate in the prehospital environment, they have not been proven to be necessary, This study was undertaken to determine if emergency medical services (EMS) providers can identity hypoxemia without pulse oximetry. An oximeter was placed at the ambulance entrance to the emergency department (ED), and EMS p ersonnel obtained saturation levels on all patients on arrival, Hypoxe mia was defined as a saturation level of 95% or less, The hypoxemia wa s classified as ''recognized'' if the patient received aggressive inte rvention and ''unrecognized'' if the patient did not, One hundred eigh ty patients were enrolled in the study; 30 had a saturation level of 9 5% or less, Twenty-seven (90%) of those patients had ''unrecognized'' hypoxemia, Twenty-three (85.2%) of the 27 patients with ''unrecognized '' hypoxemia did not complain of respiratory distress, Thus, there are patients whose hypoxemia is unrecognized by EMS providers, and this o ccurs most frequently in patients who do not complain of respiratory d istress. (C) 1996 by W.B. Saunders Company