Question

A client is alert and oriented. However, the oxygen saturation read via a probe on index finger shows 88%. On examination, you find that the client's hand is cold. Client is talking to you comfortably. There is no shortness of breath. Resp rate is 20/mt. Is the reading correct? How would you verify?

Answer 1

Ans) A pulse oximeter is a handy medical device that uses two frequencies of light – red and infrared – to determine the percentage of hemoglobin in the blood that is saturated with oxygen, or oxygen saturation level.

- When oxygen saturation is measured using a pulse oximeter, it is referred to as Sp02.  

- Oxygen saturation level is dependent upon a number of factors including the health condition, breathing rate and activity level.

- Normal oxygen levels range between 95-100 percent. Values under 90% are considered low.

- To get the most accurate reading from your pulse oximeter, there needs to be enough blood flow to the hand and finger wearing the device. This means the best reading occurs when your hand is warm, relaxed and below the level of your heart.

In this case, SPO² is 88% and Resp rate is 20/min & patient is comfortable but client's hand is cold-

A reading may be less accurate if a client has poor circulation and/or cold hands.

- So, Warm the client's hands by placing them inside a warm towel or under warm, running water.

- Try alternative probe site, different probe, different SPO2 machine.

- Poor perfusion (due to cold or hypotension) is the main cause of an inadequate pulse wave.

- We can verify this as sharp waveform with a dicrotic notch indicates good perfusion whilst a sine wave-like waveform suggests poor perfusion.

- Oximeter accuracy should be checked by obtaining at least one simultaneous blood gas, although this rarely happens.