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[Music] welcome back everybody I want to talk about pulse ox plus okay so you guys may not know what that is I know some of you do some of you may be thinking what is it some kind of new tool we cant afford but what if I told you this was on probably every monitor you had ever used ever okay lets get into what it is this is clef that pretty little line thats usually right in the center of the co2 and the lead to display on your average monitor would be it like packs oil Philips what-have-you its a line we dont always pay a lot of attention to right weve always been told pulse oximetry was unreliable and it would lie to you and yadda yadda yadda and those statements are not necessarily wrong okay in certain conditions we know we cant trust them but I want to talk a little bit about how valuable this ples is okay so what is plus plus is MOG Rafi all right say that five times fast pluses MOG Rafi is representation of the arterial bulge when our pumps okay so your heart create of co