E. Pulse Oximetry our physician asks you to measure the oxygen saturation level
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Question
E. Pulse Oximetry our physician asks you to measure the oxygen saturation level of the patients listed. For each situation, answer the What would you do in each situation to prevent an inaccurate pulse oximetry reading? b. a. What occurs with each of these situations and how does it affect the SpO, reading? 1. Kelly Collins, a patient with chronic bronchitis, , is wearing navy blue nail polish. 2. Melvin Hosey has Parkinson's disease and is having difficulty controlling tremors in his hands 3. Scott Kimes, a patient with emphysema, frequently experiences periods of prolonged coughing. 319 Chapter 19 Vital Signs Inc. All Rights ©2016,Explanation / Answer
a. What would you do in each situation to prevent inaccurate pulse oxymetry reading?
b. what occurs with each of these situations and how does it affect SPO2 reading
Pulse oxymetry is used in a number of clinical settings including emergency departments to monitor the patient completely. The principle of Pulse oxymetry is spectrophotometry. It is based on the absorption of red and infrared lights by oxygenated and deoxygenated hemoglobin. Oxygenated hemoglobin absorbs more infrared light and allows the passage of more red light and vice versa. Transmission and reflectance method is used in different types of pulse oxymetry. Transmission method is most commonly used. In which a transmitter and photo detector is used to measure R/IR ratio.
The Pulse oxymetry is the measurement of oxygenated hemoglobin circulating in the peripheral arterial circulation. It is presented as the percentage of total hemoglobin present. However, ABG measurement is more accurate than pulse oxymetry.
Factors to be considered are a presence of atmospheric oxygen available for inhalation and any conditions that affect the inhalation and exhalation. Pulse oxymetry can be used to monitor respiratory condition of patients with known or suspected respiratory conditions.
1.
a. Nail polish can be removed to obtain an accurate measurement.
b. Some studies support the removal of nail polish to obtain an accurate pulse oxymetry measurement. They suggest the colours black, blue and green nail polish has the significant impact on pulse oxymetry. The presence of nail polish can decrease the pulse oxymetry reading to 3%-6%.1
Some researches suggest the minimal or no effect of nail polish on modern-day pulse oximeter reading.2
2.
a. Place the pulse oxymetry probe on the less affected part , like the ear.
Coordinate the findings with other clinical symptoms.
b. Motion artifacts can change the accuracy of the reading. A continuous movement like uncontrollable tremors in Parkinson’s disease can cause inaccurate pulse oxymetry reading.
3. Emphysema and prolonged cough
a. Pulse oxymetry reading may not be affected by the prolonged cough.
b. In emphysema patient, the human interference like a cough may not change the pulse oxymetry reading.
References:
1. Cote CJ, Goldstein EA, Fuchsman NH, Hoaglin DC. The effect of nail polish on pulse oximetry. Anesth Anal 1988; 67:683-686
2. Brand TM, Brand ME, Jay GD. Enamel nail polish does not interfere with pulse oximetry among normoxic volunteers., J Clin Monit Comput. 2002 Feb;17(2):93-6
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