Pulse Oximetry And Measuring Blood Pressure

Question 1

When is oxygen saturation monitoring most commonly used ?

Answer 1

In infants and children at risk of hypoxaemia such as having seizure, suffering respiratory depression or with respiratory illnesses (asthma or bronchiollitis)

Question 2

In acutely ill children what should oxygen saturation be maintained at?

Answer 2

Above 92 percent but some clinicians aim for 94-98 percent

Question 3

What sites should be chosen in younger children to measure pulse oximetry

Answer 3

Warm and well perfused
In younger children place the probe on the palm of the hand close to the base of the little finger or on outer aspect of the foot

Question 4

What sites should be chosen in older children to measure pulse oximetry

Answer 4

Sites include the finger, the big toe and earlobe

Question 5

How to use pulse oximeter

Answer 5

Turn on, ensure device is calibrated
Set limits so whenever patients oxygen saturation goes above or below it sounds an alarm
Check the trace making sure probe is in correct position
Document patients oxygen saturations, pulse rate and other obs on PEWS chart

Question 6

What to do in the case of carbon monoxide poisoning

Answer 6

If carbon monoxide poisoning in suspected, give the child 100% oxygen and take a blood sample to test for carboxyhaemoglobin

Question 7

How to measure blood pressure

Answer 7

Use correct cuff size
Assess arm to be used, don’t place cuff on injured arm
Position child with legs uncrossed
Expose arm and remove tight clothing, locate the brachial artery
Attach cuff 2-3cm above antecubital fossa
Ensure cuff is tight enough to allow you to insert one finger between the cuff and arm
Place arm on a pillow or ask parent to support the arm
Estimate systolic pressure by palpating the brachial artery, inflate the cuff and note the reading
Place stethoscope over brachial artery and apply gentle pressure to skin, steadily inflate cuff, slowly deflate at a rate of 2-3mmHg per second
Whilst holding stethoscope open the control valve and carry on reducing the pressure

Question 8

What are the systolic blood pressure ranges of children from 0 to 12+ years

Answer 8

Birth to 12 months = 65-105
12months- 2years = 70-105
2-5 years = 70-110
5-12 years = 80-120
12+ years = 90-140