A408 SIGNIFICANT DELAYS IN THE DETECTION OF HYPOXEMIA RELATED TO THE SITE OF PULSE OXIMETER PROBE PLACEMENT

Background: Pulse oximetry is a noninvasive technique of measuring oxygenation of the blood that is used worldwide to assess critically ill patients. The accuracy of pulse oximetry reading may be related to the site of pulse oximeter probe placement; but this may be difficult in sick neonates. In neonates, palm and sole are commonly used site for probe placement. Objective: This study was conducted to assess the accuracy of pulse oximeter oxygen saturation (SpO2) from probe placement at wrist and ankle as an alternative to palm and sole in neonates. Methods: This cross sectional study was carried out in SCABU of Dhaka Shishu (Children) Hospital from December 2012 to March 2013. A total of 169 neonates were enrolled in this study. Two pulse oximeters were used for simultaneous paired SpO2 measurements. The SpO2 was measured at 0 sec, then at 30 sec and at 1 min over the palm and ipsilateral wrist, both side and repeated the same procedure over the sole and ipsilateral ankle, both side and were recorded in the case record form. Two tailed, Student’s t-test was performed for analysis of continuous, normally distributed variables. Regression analysis was performed to determine the relationship between paired SpO2 measurements. Results: A total of 169 patients (birth weight 2530.8±772.2 g, gestational age 36.7±3.9 weeks, mean age 7.7 days and age range 1-27 days) were enrolled. There was a good correlation between SpO2 measured at the palm versus the wrist (r= 0.92, p<0.0001 (right); r= 0.88, p< 0.0001 (left)) and between SpO2 measured at the sole versus the ankle (r=0.90, p<0.0001 (right); r= 0.98, p<0.0001 (left)). There was also a good agreement between paired SpO2 measurements from these sites. The bias and precision for SpO2 at the right palm and right wrist was 0.08 ± 0.65% and for the left palm and left wrist 0.05 ± 0.79%. Similarly, the bias and precision for SpO2 at the right sole and right ankle was -0.11 ± 0.63% and for the left sole and left ankle was 0.56 ± 0.32%. Conclusion: The wrist and ankle can be used as alternative sites, to measure SpO2 in newborn infants in place of the routinely used palm or sole.

Download Full-text

Evaluation of pulse oximeter probes and probe placement in healthy dogs

Journal of the American Animal Hospital Association ◽

10.5326/15473317-31-1-9 ◽

1995 ◽

Vol 31 (1) ◽

pp. 9-14 ◽

Cited By ~ 15

Author(s):

BT Huss ◽

MA Anderson ◽

KR Branson ◽

CC Wagner-Mann ◽

FA Mann

Keyword(s):

Pulse Oximeter ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas ◽

Arterial Blood Gas ◽

Arterial Blood ◽

Hemoglobin Saturation ◽

Arterial Blood Gas Analysis ◽

Pulse Oximeter Probe ◽

Probe Placement

Placement of two different pulse oximeter probes, a finger (f) probe and a multisite (s) probe, was evaluated in six healthy, anesthetized beagles. Concurrent arterial blood gas values were compared to determine the most consistent (repeatable) and accurate (compared to calculated hemoglobin saturations) pulse oximeter probe and probe placement sites for subsequent use in awake dogs. Hemoglobin oxygen saturation was determined from arterial blood gas analysis (SaO2) and by pulse oximetry (SpO2) at full hemoglobin saturation (mean, 99.5% SaO2) and at moderate desaturation (mean, 92.9% SaO2). Each probe was evaluated with three independent readings at seven different body sites (Achilles, ear, flank, lip, tail, toe, and tongue). Values for SpO2 obtained with the s probe demonstrated a significant correlation with SaO2 values (p = 0.014, R = 0.712) compared to the SpO2 values obtained with the f probe (p = 0.108). The best probe placement sites for the clip-on probes in this study were on the lip and tongue using the s probe; however, the ear, tail, and toe may be acceptable sites in awake dogs using a probe which maintains good contact across these vascular beds.

Download Full-text

Burning of a Neonate due to a Pulse Oximeter: Arterial Saturation Monitoring

PEDIATRICS ◽

10.1542/peds.89.1.154 ◽

1992 ◽

Vol 89 (1) ◽

pp. 154-155

Author(s):

DANIEL B. SOBEL

Keyword(s):

Mechanical Ventilation ◽

Intensive Care ◽

Case Report ◽

Pulse Oximeter ◽

Distress Syndrome ◽

Pediatric Intensive Care ◽

Supplemental Oxygen ◽

Premature Neonate ◽

Skin Development ◽

Pulse Oximeter Probe

Monitoring of arterial hemoglobin saturations by pulse oximetry has become a fixture in neonatal and pediatric intensive care units, operating rooms, and in other hospital settings. Use with extremely premature neonates is especially beneficial because of their immature skin development and vulnerability to topical damage—whether due to chemicals, tape, or temperature.1,2 This report documents a case of a burn due to a presumed shorting of a pulse oximeter probe cable in an extremely premature neonate. CASE REPORT The patient was a 690-g Hispanic female neonate born prematurely at approximately 25 weeks' gestation with respiratory distress syndrome requiring mechanical ventilation and supplemental oxygen.

Download Full-text