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Pulse Oximetry - Aconcagua - Is it needed?

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Pulse Oximetry - Aconcagua - Is it needed?

Postby Pyroman9 » Thu Jun 18, 2009 9:57 pm

I am a EMT and planning to hike Aconcagua. I am taking care of the medical side of things for me and my climbing partner.

Do you think that a pulse oximeter is helpful to carry? Or should i just stick to the lines of if you can walk and talk, your doing ok?

What would be the lowest that you should expect a pulse oximetry at the summit?
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Postby radson » Thu Jun 18, 2009 10:29 pm

Pulse-ox's are certainly fun and a good way to pass the time as everyone compares their reading.

On the other hand I had a Pulse-Ox of 80 at 5,300m while having full-on HACE. My wife had a reading of 37 at 7,200 m and seemed fine.

From memory Aconcagua medics are fairly hard core with their pulse-ox, to the point of not letting people pass Plaza de Mulas if readings are too low.
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Postby Pyroman9 » Fri Jun 19, 2009 2:55 am

heh. Well considering they are not always accurate...

cold hands.. poor circulation... nail polish... bad wires... hell you can be CO poisoned and it will still read 100% O2 reading.... lol

i am still considering getting a small hand held one though.
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Postby Nikolas_A » Fri Jun 19, 2009 9:47 pm

IAND, but from what I've read, it's more the trend that matters than the value itself.
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Postby Day Hiker » Wed Jul 08, 2009 7:26 pm

radson wrote:My wife had a reading of 37 at 7,200 m and seemed fine.


That had to be an incorrect reading. I hope someone who is more knowledgeable than me with medicine can verify my thoughts. Please do. But I think an accurate reading of 37 means you're pretty fucked and showing it.
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Postby HeyItsBen » Wed Jul 08, 2009 9:42 pm

Day Hiker wrote:
radson wrote:My wife had a reading of 37 at 7,200 m and seemed fine.


That had to be an incorrect reading. I hope someone who is more knowledgeable than me with medicine can verify my thoughts. Please do. But I think an accurate reading of 37 means you're pretty fucked and showing it.


I was gonna say the same thing. I think a reading in the low 60s is not unheard of at serious altitude, but 37, DAMN!

A little fun fact, I believe a Dr. will put a patient on Os at readings below 90.
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Postby radson » Wed Jul 08, 2009 10:21 pm

Day Hiker wrote:
radson wrote:My wife had a reading of 37 at 7,200 m and seemed fine.


That had to be an incorrect reading. I hope someone who is more knowledgeable than me with medicine can verify my thoughts. Please do. But I think an accurate reading of 37 means you're pretty fucked and showing it.



Yeah I dont know, she always has pretty screwy readings, may have something to do with low blood pressure. I remember we cross checked the device by putting it on myself and from memory the reading was reasonably normal.

The lesson for me is to not base too much importance on the puls-ox.
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Postby peterline » Sat Jul 18, 2009 5:46 am

Put it that way mate, if you are at 6000m, feeling horrible in your tent with pretty big headache, a pulse oxymeter could be the only toy that can let you know if this is sort of normal (i.e. you have an ox sat above 65) or if you're having HACE (i.e. ox sat of 60 or below)

Now like any tech, it has some flaws but could def be your best friend
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Postby Pyroman9 » Fri Jul 24, 2009 8:05 pm

As a EMT anything under 94 I put a pt on oxygen.

37 is not accurate.

The problem with pulse ox's is at high altitudes, its cold. Cold fingers have worse circulation... which means the reading is not as accurate.

I can imagine it is lower higher up but not dramatically. I would assume it would always be about 70%.
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Postby stevepack » Sun Aug 16, 2009 8:21 pm

A pulse oximeter is a handy tool if you get accurate information. Many factors can alter the accuracy of the reading. In the mountain environment with a person who was previously healthy the main factors may be cold extremities, vasoconstriction from cold or dehydration and carbon monoxide poisoning from cooking in tents.

In the ER/ICU/Pre-hospital environments I correlate the reading with the patient's pulse and the pulse waveform on the monitor. If these correspond then the reading is likely accurate. Most finger pulse oximeters do not have a waveform, only an LED. If the LED is green then the reading is considered accurate.

I started as an EMT before there were pulse oximeters in the field (yep old fart...22 yrs Paramedic/RN) and in those days we actually looked at the patient and gave oxygen based on signs and symptoms. It is a good tool if it gives accurate information.

For those with the medical training or inclination to learn, I would recommend a stethoscope for listening for pulmonary edema in addition to the pulse oximeter. The bad cases of edema don't need a stethoscope, but you can pick up early edema with one.

Just my $0.02, no absolute right or wrong answers...that's why they call it "practicing" medicine.
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Postby timfoltz » Wed Feb 03, 2010 6:23 pm

Assuming you are taking the standard route up Acon you really dont NEED one, as the medics at each camp are pretty stringent about taking your readings, checking your permit and giving the no go, or go ahead based on your conditions. HOWEVER, they are a very fun little toy and can inspire some friendly competition between you and your tent mates. I probably wouldnt have based any medical decisions off of it, but it was helpful for monitoring your progress (or degression) as you went along. In short, if you have the money allocated in your budget for the trip, go ahead and pick one up, but i wouldnt break the bank for it.
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Postby e-doc » Wed Feb 03, 2010 11:05 pm

Day Hiker wrote:
radson wrote:My wife had a reading of 37 at 7,200 m and seemed fine.


That had to be an incorrect reading. I hope someone who is more knowledgeable than me with medicine can verify my thoughts. Please do. But I think an accurate reading of 37 means you're pretty fucked and showing it.


Unless you're an anaerobe
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