Pulse Oximetry

 

Clinical Indications:

 

  • Patients with suspected hypoxemia.

 

Procedure:

 

  1. Apply probe to patient’s finger or any other digit as recommended by the device manufacturer.
  2. Allow machine to register saturation level.
  3. Record time and initial saturation percent on room air if possible on/with the patient care report (PCR).
  4. Verify pulse rate on machine with actual pulse of the patient.
  5. Monitor critical patients continuously until arrival at the hospital. If recording a one-time reading, monitor patients for a few minutes as oxygen saturation can vary.
  6. Document percent of oxygen saturation every time vital signs are recorded and in response to therapy to correct hypoxemia.
  7. In general, normal saturation is 97% - 99%. Below 92% - 94%, suspect a respiratory compromise, which may or may not be a chronic condition (e.g., COPD)
  8. Use the pulse oximetry as an added tool for patient evaluation. Treat the patient, not the data provided by the device.
  9. The pulse oximeter reading should never be used to withhold oxygen from a patient in respiratory distress or when it is the standard of care to apply oxygen despite good pulse oximetry readings, such as chest pain. Supplemental Oxygen is not required if the oxyhemoglobin saturation is greater than or equal to 94%.  If there are obvious signs of ischemia heart failure dyspnea, or hypoxia, the goal is to maintain saturation between 90% - 99% depending on patient condition.
  10. Factors which may reduce the reliability of the pulse oximetry reading include:
    1. Poor peripheral circulation (blood volume, hypotension, hypothermia)
    2. Excessive pulse oximeter sensor motion
    3. Fingernail polish (may be removed with acetone pad)
    4. Carbon monoxide bound to hemoglobin
    5. Irregular heart rhythms (atrial fibrillation, SVT, etc.)
    6. Jaundice
    7. Placement of BP cuff on same extremity as pulse ox probe

 

Certification Requirements:

 

  • Maintain knowledge of the indications, contraindications technique, and possible complications of the procedure.  Assessment of this knowledge may be accomplished via quality assurance mechanisms, classroom demonstrations, skills stations or other mechanisms as deemed appropriate by medical control.