Today our topic of discussion is Oxygen Saturation Procedure.
Oxygen Saturation Procedure
Procedure
- Ensure oximeter is in good condition and probe sensor is cleaned according to local infection control policy/ manufacturer’s guidance.
- Explain procedure to the patient and gain consent where possible.
- Select the most appropriate probe for the site chosen; in adult patients, the most common sites are the fingertip and earlobe. Using the incorrect probe will lead to inaccuracies in the readings obtained.
- Consider choice of device:
– Fingertip devices with integrated sensor and display may be appropriate for spot checks of SpO,
-Handheld devices with detachable sensor allow the most appropriate probe to be selected.
-Wrist-worn devices have a sensor attached by a short cable and are useful for overnight oximetry and exercise testing. Desktop/bedside devices may be more appropriate in the acute setting for continuous monitoring.
-Ensure the chosen site is warm and well perfused Apply the probe to the site, ensuring the sensor is correctly positioned.
-Ask the patient to rest the hand with the sensor on it down gently to reduce interference of motion.
-Check the pulse strength signal and ensure the pulse-rate reading correlates with the manual pulse.
-Allow the pulse oximeter to remain in situ for at least five minutes to ensure it equilibrates.
-Document the reading, noting whether the patient is breathing room air or oxygen, then record the oxygen delivery device used and flow rate or percentage. Note any other factors that may influence accuracy, such as movement, cold hands, etc.
-In acute illness, resting saturations are usually most useful, but in non-acute settings, oximetry may be used during exercise testing to determine exertional desaturation. Record whether the readings have been taken at rest or during/after activity in addition to inspired oxygen/air.
Competencies
- A range of competencies relate to the safe undertaking of pulse oximetry:
- Be aware of, and understand, local infection control policy/guidelines in relation to monitoring equipment
- Demonstrate a basic understanding of how oxygen saturations are derived
- Be able to discuss the indications for, and limitations of, pulse oximetry
- Demonstrate an ability to use a pulse oximeter safely and effectively, selecting the appropriate probe and device for the clinical situation
- Demonstrate accurate documentation of results.
Limitations
Pulse oximetry requires a good pulsatile blood flow and no interference with measurement of light absorption and detection. Pulse strength can be checked by ensuring the recorded heart rate correlates with a manual pulse rate;
Some devices have a pulse amplitude indicator in addition to a pulse detector. Where a good signal is obtained, pulse oximetry readings are accurate within saturation range of 70-100% but cannot be relied on outside of this range.
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