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SJA - AFA > Pulse Oximetery > Flashcards

Pulse Oximetery Flashcards

1
Q

Pulse oximetry is…

A

a simple non-invasive method of monitoring the percentage of Haemoglobin (iron pigment that carries O2) which is saturated with Oxygen.

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2
Q

Indications for use of pulse oximetry:

A
  • The human eye is poor at recognising hypoxia.
  • Even under ideal conditions, skilled observers cannot consistently detect hypoxaemia until the saturations are below 80%.
  • It is a useful non-invasive indicator of the patients’ cardio-respiratory status.
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3
Q

What percentage of the total o2 is bound to haemoglobin in arterial blood?

A

98%

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4
Q

What percentage of the total o2 is dissolved in the plasma?

A

2% - tested by arterial blood gas.

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5
Q

How does blood travel around the body?

A
  • Oxygenated blood - starts in the lungs, travels to the heart and is pumped to the body. The oxygen is consumed.
  • Deoxygenated blood - deoxygenated blood travels from the body to the heart where it is pumped to the lungs and is reoxygenated. The process starts again.
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6
Q

A pulse oximeter…

A

measures the total amount of haemoglobin saturated with oxygen in arterial blood as this is approximately equal to the total oxygen content. (98% ≈ 100%)

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7
Q

How does a pulse oximeter work?

A
  • A source of light originates from the probe at two different wave lengths.
  • The pulse oximeter is dependent on a pulsative flow and produces a graph of the quality of the flow.
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8
Q

Systole…

A
  • Artery - Pulsatile Tissue
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9
Q

Diastole…

A
  • Non-Arterial - Non-Pulsatile Tissue
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10
Q

What does an erratic reading on a pulse oximeter mean?

A
  • It means poor flow.
  • This is usually poor pulsatile flow due to hypovolaemia or vasoconstriction.
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11
Q

Procedure for SPo2 use:

A
  • Initiate DR ABC.
  • Explain procedure and gain consent.
  • Normal sized finger clip sensors are designed to be used on patients’ weighing > 30kg. Paediatric sensors are available.
  • Place sensor on index, middle or ring finger. The finger should be clean, warm and free of nail polish or nicotine staining. A sensor can also be placed on toes or on the ear lobe.
  • Allow several seconds for the device to detect.
  • Ensure good wave form.
  • Read off the SPo2 and pulse.
  • Administer o2 and then alert an HCP, if necessary.
  • Record reading as “room air” (RA) or on room air or on o2.
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12
Q

Factors affecting SPo2 accuracy:

A
  • Abnormal haemoglobins
  • Carboxyhaemoglobin - Carbon Monoxide Poisoning - haemoglobin likes Carbon Monoxide more than o2.
  • Dyes and pigments - e.g. Nail varnish
  • Bright of fluctuating light levels
  • Exposure to cold causing vasoconstriction and shivering.
  • Cardiac Failure and Severe Hypertension
  • Rare Cardiac Defects - e.g. Valve Problems
  • Anaemia
  • Dark Skin
    *
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13
Q

What does not affect a reading on a pulse oximeter?

A
  • Jaundice
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14
Q

Normal healthy adult SPo2:

A
  • 94% - 98%
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15
Q

What SPo2 reading suggests hypoxia?

A
  • < 94%
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16
Q

What SPo2 reading suggests critical hypoxia?

A
  • < 85%
17
Q

A reading of 100% while taking an SPo2 is not normal unless. There are two exceptions. What are they?

A
  • The patient if hyperventilating.
  • The patient is receiving O2 therapy
18
Q

What is COPD?

A
  • COPD describes a group of lung conditions that make it difficult to empty air out of the lungs because your airways have been narrowed.
  • The alveoli in the lungs are permanently damaged. This will prevent proper exchange of gases.
19
Q

What do COPD patients rely on?

A
  • Hypoxic Drive
20
Q

What is hypoxic drive?

A
  • The hypoxic drive is a form of respiratory drive in which the body uses oxygen chemoreceptors instead of carbon dioxide receptors to regulate the respiratory cycle.
21
Q

Explain the normal stimulus to breathe:

A
  • The normal stimulus to breath is triggered by an increased level of CO2.
22
Q

What is the SPo2 target range for hypoxic drive?

A
  • 88% - 92%
23
Q

What SPo2 suggests hypoxia in a patient who relies on hypoxic drive?

A
  • 88% - Administer o2.
24
Q

Should you withhold o2 from a patient who has an SPo2 of 100%?

A
  • No - Carbon Monoxide Poisoning.

SJA - AFA (3 decks)

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