![]() Provide an objective indication of the severity of an acute respiratory episode and need for hospital admission – for example, exacerbation of chronic obstructive pulmonary disease, asthma (British Thoracic Society and Scottish Intercollegiate Guidelines Network, 2014 National Institute for Health and Care Excellence, 2010) or pneumonia (NICE, 2014).Assess breathless patients or those who are acutely ill, including those who have acute confusion. ![]() Pulse oximetry should be available for use in all clinical settings where hypoxaemia may occur and is used to: Factors such as ambient light, skin pigmentation and peripheral perfusion all affect the ability to identify cyanosis but pulse oximetry enables clinically important low-tissue oxygenation to be identified earlier. At this level, organ function, including brain, heart and kidneys, may be compromised. Indications for useĬyanosis was traditionally the primary clinical sign of hypoxaemia but early studies found that even skilled observers are not consistently able to detect central cyanosis (a blue tinge to the lips, tongue and mucus membranes) until oxyhaemoglobin saturation is <80% (Hanning and Alexander-Williams, 1995). By the early 1980s, more accurate devices were developed, which led to pulse oximeters being introduced into clinical practice. However, early devices were cumbersome, inaccurate and prohibitively expensive (Tremper 1989). In the 1970s it was discovered that red/infrared wavelength absorption could be calculated from pulsatile blood flow and the term “pulse oximeter” was coined. Deoxygenated haemoglobin absorbs more red light and oxygenated haemoglobin absorbs more infrared light. Multiple measurements are made every second and the ratio of red to infrared light is calculated to determine the peripheral oxygen saturation (SpO2). Pulse oximetry is a simple, non-invasive method of measuring oxygen levels and can be useful in a variety of clinical settings to continuously or intermittently monitor oxygenation.Īn oximeter is a device that emits red and infrared light, shone through a capillary bed (usually in a fingertip or earlobe) onto a sensor (Fig 1, attached). Scroll down to read the article or download a print-friendly PDF here.This article has been double-blind peer reviewed.Nursing Times 112: 16, 12-13.Īuthors: Sandra Olive is a respiratory nurse specialist at the Norfolk and Norwich University Hospital, Norwich. This article outlines the procedure and its limitations, as well as the circumstances in which it should be used.Ĭitation: Olive S (2016) Using pulse oximetry to assess oxygen levels. Pulse oximetry can be undertaken to measure a patient’s oxygen levels and help identify earlier when action must be taken. Detecting low oxygen levels in patients is important but not always easy central cyanosis – when a patient’s lips, tongue and mucus membranes acquire a blue tinge – can be missed, even by skilled observers, until significant hypoxaemia is present.
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