ABSTRACTS
Pulse Oximetry DocumentationAuthor: Mitchel Reuter MSEMS, CCEMT - P, NRP | EMS Instructor | University of Wisconsin Hospital and Clinics Associate Authors: Powell, Jonathan, R. MPA, NRP (Affiliation: ImageTrend Inc.)
Introduction Pulse oximetry (SpO2) is an important pre-hospital diagnostic tool used to measure the percentage of hemoglobin in blood that is assumed to be saturated with oxygen. While considered colloquially ubiquitous and a pillar of pre-hospital assessment, its documented use in emergency medical services (EMS) care delivery is poorly described. Our objective was to quantify the documented use of pulse oximetry, overall and among common impressions and airway device usage, in a national EMS dataset Methods We conducted a retrospective, descriptive evaluation of the 2023 ImageTrend Collaborate dataset. We included 9-1-1 dispatched EMS activations with advanced life support capability that resulted in treatment and transport. We classified primary and secondary EMS clinician impressions into investigator-driven a priori categories of respiratory distress, non-traumatic pain, congestive heart failure, non-traumatic shock, trauma, and diabetes-related activations. We further investigated documented use across activations with positive pressure ventilation delivery (endotracheal tube, supraglottic, bag-valve mask only). We used descriptive statistics for prevalence of documented use (yes/no) and used STATA MP 18 for all analyses. Results We included 4,023,594 activations for analysis. Overall, 3,807,857 (95%) activations documented SpO2 use. Among EMS clinician impressions we noted a high prevalence of documented SpO2 use: respiratory distress (98%), heart failure (98%), non-traumatic shock (97%), non-traumatic pain (95%), trauma (94%), and diabetes (95%). We interestingly noted lower documentation of SpO2 use when positive pressure ventilation was applied: endotracheal tube (67%), laryngeal tube (57%), and bag-valve mask only (88%). Conclusion Our analysis revealed differential documentation of SpO2 by EMS clinicians across a national EMS activation dataset. These findings suggest that strategies for retrospective evaluations of airway management may be impacted if SpO2 is used as required entry criteria, especially among advanced airway device use.
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