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Pulse oximeters - A reliable technique to monitor oxygenatio

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"The truth is that our race survived ignorance; it is our scientific genius that will do us in."

Pulse oximeter is a useful method of monitoring patients in many circumstances, and in the face of limited resources, the pulse ox meter may represent a wise choice of monitor, as with training it allows for the assessment of several different patient parameters. It is a most important tool in modern anesthesia practice.

 Pulse oximetry is a non-invasive method allowing the monitoring of the saturation of a patient's hemoglobin. Two light-emitting diodes, red and infrared, are positioned so that they are opposite their respective detectors through 5-10 mm of tissue. Probes are usually positioned on the fingertip, although earlobes and forehead are sometimes used as alternatives. .

 Pulse oximeter is useful in any setting where a patient's oxygenation is unstable, including intensive care, operating, recovery, emergency and hospital ward settings, pilots in unpressurized aircraft, for assessment of any patient's oxygenation, and determining the effectiveness of or need for supplemental oxygen. Assessing a patient's need for oxygen is the most essential element to life; no human life thrives in the absence of oxygen. Because of their simplicity of use and the ability to provide continuous and immediate oxygen saturation values, pulse oximeters are of critical importance in emergency medicine and are also very useful for patients with respiratory or cardiac problems, especially COPD, or for diagnosis of some sleep disorders such as apnea and hyperpnoea. Portable battery-operated pulse oximeters are useful for pilots operating in a non-pressurized aircraft above 10,000 feet.  Where supplemental oxygen is required.

Portable pulse oximeters are also useful for mountain climbers and athletes whose oxygen levels may decrease at high altitudes or with exercise. Some portable pulse oximeters employ software that charts a patient's blood oxygen and pulse, serving as a reminder to check blood oxygen levels.

Pulse oximetry can replace blood gas analysis in many clinical situations. It is cheaper, easier to perform, less painful and can be more accurate where the patient is conscious. Pulse oximetry allows accurate use of O2 and avoids wastage. For example, in patients with respiratory failure, rather than limit the use of O2 to maintain hypoxic ventilatory drive, it can be adjusted to a saturation of 90% which is clinically acceptable.


What precautions can you take? Follow these recommendations to avoid injuries when using a pulse oximeter:

•Make sure your patient has stable peripheral vascular function before you place a pulse oximeter sensor

 A pulse oximeter can only work when a strong detectable peripheral pulse is available. If the pulse is weak, the obtained pulse oximetry reading is not reliable. Patients with irregular heartbeats will also give false readings. Avoid the presence of bright light when taking a reading because this can interfere with the light transmitted through the meter. Movement can also affect the light so patients must hold still for an accurate reading to be obtained. Because of these limitations, a pulse oximetry level should only be considered normal after several readings.

•If necessary, secure the sensor loosely using paper tape; never tape it tightly.

•Check the site immediately after applying the sensor to ensure that circulation is adequate.

•Change the pulse oximeter site every 2 hours or according to your institution's protocol.

•Closely monitor patients with fragile skin, such as infants or elderly adults.

•Make sure you're current on how to use any pulse oximeter you're working with, including setting and maintaining all alarms


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