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ECG, saturation, blood pressure and capnography
Where earlier ambulance workers had to rely largely on their own senses — feeling the pulse with their fingers, skin colour, the sound of breathing — you today have access to equipment that can measure many of the same things objectively and continuously. This does not make your clinical assessment unnecessary, but it gives you an extra and more precise basis to act on.
A 12-lead ECG gives a detailed picture of the heart's electrical activity and can reveal signs of for example blood clot in the heart. According to the regulation on ambulances and ambulance personnel training, it is part of the training that you can record and — where the equipment supports it — send a 12-lead ECG on to the hospital so a cardiologist can assess it while you are still en route. This can determine whether the patient should be taken directly to a heart centre rather than the nearest acute reception.
| Scale and dimensions | What it shows | Why it is important |
|---|---|---|
| Pulse oximeter (SpO2) | Oxygen saturation in the blood | Reveals oxygen deficiency, often before the patient notices it |
| Non-invasive blood pressure (NIBT) | Blood pressure via automatic cuff | Follows the evolution in the circuit over time |
| Capnography (EtCO2) | CO2 content in exhaled air | Confirms correct tube placement and shows ventilation efficiency |
| Blood glucose meter | Blood glucose level | Distinguish between too low and too high blood sugar with reduced consciousness |
The defibrillator in the ambulance is not only used to deliver shocks during cardiac arrest. It also functions as a monitor that continuously displays heart rhythm, oxygen saturation and in many cases blood pressure all on one screen, so you can quickly get an overview without having to read several separate devices.
The equipment must work the day it is needed. Therefore it is a standing routine in the ambulance service to test and function check measuring equipment batteries and electrodes at shift start so you do not discover a failure when you are with a critical patient. A spot check with a known value a battery check and a visual inspection of cables and electrodes only takes a few minutes but can be crucial when it counts.
The more familiar you are with the equipment's possibilities and limitations in daily life, the faster you can use it purposefully when you find yourself in an acute situation where there is no time to read an instruction manual.
A large part of the value of modern monitoring equipment lies not only in what you can see on the screen there and then, but in that the measurements can be saved and follow along in the journal or be sent electronically on to the hospital. This means that the receiving staff can see the development of the patient's condition throughout the entire course — not just a single snapshot at arrival — which provides a far better basis for assessing whether the condition is stable, improving or worsening.
Part of the skill in using diagnostic equipment is not only being able to read each individual number but being able to see them in context. A slightly low blood pressure means something different if oxygen saturation falls at the same time than if it stays stable. By comparing multiple readings over time — rather than reacting in isolation to a single number — you get a much more reliable picture of whether the patient's condition is truly stable or is beginning to change in a way that requires faster action.