Pulse Oximetry

1. Pulse Oximetry Optional, AEMT

2. Objectives • Describe importance of oxygen to body metabolism • Understand oximetry assesses oxygen saturation of hemoglobin • Understand oximetry can show effectiveness of interventions • Know oximetry is a routine vital sign • Know procedures of application and reading oximetry • Determine sights for application of oximetry • Define possible complications with oximetry • Describe possible troubleshooting • Describe transport of oxygen in body • Understanding that hemoglobin reflects light differently with and without oxygen

3. Oxygen • Essential for human function • Necessary for proper cellular metabolism • Without oxygen, lactic acid builds from anaerobic metabolism • Oxygen transport • About 2% of oxygen gets dissolved in plasma • Oxygen is bound to hemoglobin in blood(98%) • Hemoglobin changes shape and color with oxygen • Each hemoglobin can carry four oxygen molecules

4. Pulse Oximetry • Measures oxygen saturation of hemoglobin • Infrared and Red light emitted into tissue • Sensor then reads amount returned to photo detector • Hemoglobin reflects light differently when oxygenated vs. not oxygenated • Saturation is measured with each pulse as blood passes

5. Purpose of Pulse Oximetry • Measure oxygenation of blood • Assess the effectiveness of oxygen administration • Assess effectiveness of any other airway or breathing interventions

6. Indications for Pulse Oximetry • Should be routine vital sign • So have a reading with every set of vitals • Continued monitoring should occur in anyone having respiratory compromise • Such as those with: COPD, emphysema, pulmonary edema, airway obstruction, etc.

7. Application of Pulse Oximetry • Consult directions from manufacture for specific application guidelines • General application: • Turn on unit • Select proper sensor • Place proper sensor on an area of thin tissue • Fingers, toes, ear lobes, bridge of nose • Allow a few seconds for monitor to read saturation and pulse

8. Readings of Pulse Oximetry • Readings are measured in SpO2 • ex. SpO2 is 98% • Average reading is 95-99% • Acceptable range is 93-100% • Oximetry will also give a pulse reading

9. Pulse Oximeter Types Finger Tip • Finger tip and hand held are most common on ambulance • Pulse oximeters are made by many companies Hand Held “Table Top” This page does not endorse any company, all pictures are intended for educational purposes only

10. Sensors for Pulse Oximeters Many different sensors for pulse oximeters • Standard finger sensors • Wrap around sticker sensors • Wrap around silicone sensors

11. Complications With Oximetry • Hypoperfusion • Not enough blood in capillary bed to obtain accurate reading • Site is too cold • Patient movement can alter effectiveness • Nail polish • Carbon monoxide poisoning • Hemoglobin gets saturated with compounds other than oxygen

12. Troubleshooting Oximetry • See specific directions from manufactures for your device. Here are some generals: • Will not turn on: check batteries • Not obtaining a reading: • Make sure sensor cable is connected to monitor • Make sure sensor is on warm and thin tissue • Check for nail polish, grease, etc. • Could be a low battery • Blood flow too low (make sure you’re not causing it: BP cuffs, IV tourniquet) • Constant alarms: • Alarm limits may be to high or low

13. Summary • Oxygen is essential to body for metabolism (prevents lactic acid) • Oximetry assesses oxygen saturation of hemoglobin, not sum of oxygen in blood • Oximetry can be used to know if interventions are effective • Oximetry is a vital sign • Oximetry is applied using correct sensor • Normal reading are SpO2 between 95-99%

14. Summary cont. • Oximetry is placed over thin tissue • Oximetry can have many complications • Polish, cold, hypoperfusion, movement . . . • Troubleshoot if monitor not working, or if reading doesn’t seem right • Oxygen is transported by hemoglobin • Hemoglobin changes shape and color causing light to reflect differently

15. Any Questions???