On or about 01/13/97, Mike Bouser wrote this to All:
 
MB>      One question I have is this: How accurate is the pulse-oximeter at
MB>guaging the saturation of the patient? Are you just reading the patients
MB> finger or is that truly a good indication of overall saturation?
 
The pulse oximeter is generally accurate, but subject to certain
limitations.  Movement (either by the patient or the enviroment in the
case of an ambulance) can produce artifact which would effect the
accuracy, as well as poor perfusion to the finger being used (a very
common problem).
 
Most oximeters have some sort of signal strength indicator.  If you are
getting a good, strong, even waveform which is reading a heart rate fairly
close to the patient's actual heart rate, then chances are it's giving you
a reliable reading.  Otherwise, I would consider the SaO2 to be in
question.
 
Generally speaking, it's better to err on the side of caution and give
the patient oxygen.  If the patient is a _known_ COPD patient and the SaO2
by pulse ox is OK (provided the machine is giving you a good-quality
reading) then you might want to give them low-flow O2 rather than a
non-rebreather mask.  There is the possibility with some COPD patients
that too much oxygen can actually harm them.
 
Hope that is of some help.
 
 
Jim Jeffcoat, RRT
Moderator - Fidonet RCP echo          jim.jeffcoat@healthmidwest.org
 
 
 
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