{"id":915,"date":"2017-10-05T13:59:03","date_gmt":"2017-10-05T17:59:03","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/why-is-pulse-oximetry-used\/"},"modified":"2024-06-29T13:21:59","modified_gmt":"2024-06-29T17:21:59","slug":"why-is-pulse-oximetry-used","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/why-is-pulse-oximetry-used\/","title":{"raw":"Oxygen Saturation","rendered":"Oxygen Saturation"},"content":{"raw":"<h2>What is Oxygen Saturation?<\/h2>\r\nOxygen saturation refers to the percentage of hemoglobin molecules saturated with oxygen. Hemoglobin molecules can each carry four oxygen molecules; the oxygen binds or attaches to hemoglobin molecules. Oxygen saturation provides information about how much hemoglobin is carrying oxygen, compared to how much hemoglobin is not carrying oxygen.\r\n<h2><strong>Why is Oxygen Saturation Measured?<\/strong><\/h2>\r\nHealthcare providers measure oxygen saturation because it provides information about a client\u2019s state of health. The body\u2019s tissues and organs require oxygen for metabolism, and oxygen saturation can reveal whether there is sufficient oxygen in the blood or whether the client is in a state called hypoxemia (insufficient oxygen in the blood).\r\n\r\nOxygen saturation levels can influence clinical decisions about whether the client is receiving sufficient oxygen and\/or requires supplemental oxygen. Oxygen saturation levels are also monitored during and after surgeries and treatments and to assess a client\u2019s capacity for increased activity.\r\n<h2>How is Oxygen Saturation Measured?<\/h2>\r\nOxygen saturation can be measured using a pulse oximetry device. See <strong>Figure 9<\/strong>\u00a0for a pulse oximeter. It is a non-invasive method that gives an instant estimate of arterial oxygen saturation levels. In critically ill clients, a more accurate, but invasive approach is drawing arterial blood or using a continuous monitoring system to measure arterial blood gases through an arterial line. An arterial line is a catheter that is inserted into an artery, usually the radial artery. It provides a way to access blood gases including arterial oxygen saturation (SaO2). Here, we focus on pulse oximetry because it is identified as a vital sign.\r\n\r\n&nbsp;\r\n\r\n[h5p id=\"54\"]\r\n\r\n<strong>Figure 9:<\/strong> A pulse oximeter\r\n\r\nA pulse oximetry device includes a sensor that measures light absorption of hemoglobin and represents arterial SpO2 (OER #1). Oxyhemoglobin and unoxygenated hemoglobin absorb light differently. The sensor measures \u201cthe relative amount of light absorbed by oxyhemoglobin and unoxygenated (reduced) hemoglobin\u201d and compares the amount of \u201clight emitted to light absorbed\u201d (Jarvis, 2014, p. 164). This comparison is then converted to a ratio and is expressed as a percentage of Sp02.\r\n<div class=\"bcc-box bcc-success\">\r\n<h3><strong>Points to Consider<\/strong><\/h3>\r\nA pulse oximeter reading reflects arterial oxygen saturation levels, as opposed to venous oxygen saturation levels, because the device only measures light absorption of pulsatile flow: the <strong>\u2018p\u2019 in Sp02 refers to pulse or pulsatile flow<\/strong>. If pulsatile flow is limited or obstructed, an oxygen saturation level will not be accurate. For example, the compression of a blood pressure cuff will obliterate the pulsatile flow so blood pressure and pulse oximetry should not be taken simultaneously on the same limb.\r\n\r\n<\/div>\r\nThe sensor is attached using various devices. One is a spring-loaded clip attached to a finger or toe as shown previously in <strong>Figure 9<\/strong>. It is used when an intermittent measurement is required. However, this clip is too large for newborns and young children, so for this population, the sensor is taped to a finger or toe. See <strong>Figure 10<\/strong>. This technique is also used for clients who require continuous monitoring.\r\n<div class=\"textbox\"><img src=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/02-Sat-Apparatus-2-1536x1024-1-300x200.jpg\" alt=\"Pulse oximeter with sensor taped around finger.\" width=\"932\" height=\"621\" class=\"alignnone wp-image-2854\" \/><\/div>\r\n<strong>Figure 10:<\/strong> Pulse oximeter with sensor taped around finger\r\n\r\nAn earlobe clip is another useful device for clients who cannot tolerate the finger or toe clip or have a condition that could affect the results, such as vasoconstriction and poor peripheral perfusion. Another type of device is taped across the forehead and left in place for continuous monitoring. See <strong>Figure 11<\/strong>.\r\n<div class=\"textbox\"><img src=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/Oxygen-saturation-device-forehea-300x199.jpg\" alt=\"Pulse oximeter with sensor taped across forehead.\" width=\"928\" height=\"617\" class=\"alignnone wp-image-2856\" \/><\/div>\r\n<strong>Figure 11: <\/strong>Pulse oximeter with device across forehead\r\n\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n__________________________________________________\r\n\r\nPart of this content was adapted from OER #1 (as noted in brackets above):\r\n\r\n\u00a9 2015\u00a0British Columbia Institute of Technology (BCIT). Clinical Procedures for Safer Patient Care\u00a0by\u00a0Glynda Rees Doyle and Jodie Anita McCutcheon, British Columbia Institute of Technology. Licensed under a\u00a0<a href=\"http:\/\/creativecommons.org\/licenses\/by\/4.0\/\">Creative Commons Attribution 4.0 International License<\/a>, except where otherwise noted. Download this book for free at\u00a0<a href=\"http:\/\/open.bccampus.ca\">http:\/\/open.bccampus.ca<\/a>\r\n\r\n&nbsp;","rendered":"<h2>What is Oxygen Saturation?<\/h2>\n<p>Oxygen saturation refers to the percentage of hemoglobin molecules saturated with oxygen. Hemoglobin molecules can each carry four oxygen molecules; the oxygen binds or attaches to hemoglobin molecules. Oxygen saturation provides information about how much hemoglobin is carrying oxygen, compared to how much hemoglobin is not carrying oxygen.<\/p>\n<h2><strong>Why is Oxygen Saturation Measured?<\/strong><\/h2>\n<p>Healthcare providers measure oxygen saturation because it provides information about a client\u2019s state of health. The body\u2019s tissues and organs require oxygen for metabolism, and oxygen saturation can reveal whether there is sufficient oxygen in the blood or whether the client is in a state called hypoxemia (insufficient oxygen in the blood).<\/p>\n<p>Oxygen saturation levels can influence clinical decisions about whether the client is receiving sufficient oxygen and\/or requires supplemental oxygen. Oxygen saturation levels are also monitored during and after surgeries and treatments and to assess a client\u2019s capacity for increased activity.<\/p>\n<h2>How is Oxygen Saturation Measured?<\/h2>\n<p>Oxygen saturation can be measured using a pulse oximetry device. See <strong>Figure 9<\/strong>\u00a0for a pulse oximeter. It is a non-invasive method that gives an instant estimate of arterial oxygen saturation levels. In critically ill clients, a more accurate, but invasive approach is drawing arterial blood or using a continuous monitoring system to measure arterial blood gases through an arterial line. An arterial line is a catheter that is inserted into an artery, usually the radial artery. It provides a way to access blood gases including arterial oxygen saturation (SaO2). Here, we focus on pulse oximetry because it is identified as a vital sign.<\/p>\n<p>&nbsp;<\/p>\n<div id=\"h5p-54\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-54\" class=\"h5p-iframe\" data-content-id=\"54\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"O2 monitor info\"><\/iframe><\/div>\n<\/div>\n<p><strong>Figure 9:<\/strong> A pulse oximeter<\/p>\n<p>A pulse oximetry device includes a sensor that measures light absorption of hemoglobin and represents arterial SpO2 (OER #1). Oxyhemoglobin and unoxygenated hemoglobin absorb light differently. The sensor measures \u201cthe relative amount of light absorbed by oxyhemoglobin and unoxygenated (reduced) hemoglobin\u201d and compares the amount of \u201clight emitted to light absorbed\u201d (Jarvis, 2014, p. 164). This comparison is then converted to a ratio and is expressed as a percentage of Sp02.<\/p>\n<div class=\"bcc-box bcc-success\">\n<h3><strong>Points to Consider<\/strong><\/h3>\n<p>A pulse oximeter reading reflects arterial oxygen saturation levels, as opposed to venous oxygen saturation levels, because the device only measures light absorption of pulsatile flow: the <strong>\u2018p\u2019 in Sp02 refers to pulse or pulsatile flow<\/strong>. If pulsatile flow is limited or obstructed, an oxygen saturation level will not be accurate. For example, the compression of a blood pressure cuff will obliterate the pulsatile flow so blood pressure and pulse oximetry should not be taken simultaneously on the same limb.<\/p>\n<\/div>\n<p>The sensor is attached using various devices. One is a spring-loaded clip attached to a finger or toe as shown previously in <strong>Figure 9<\/strong>. It is used when an intermittent measurement is required. However, this clip is too large for newborns and young children, so for this population, the sensor is taped to a finger or toe. See <strong>Figure 10<\/strong>. This technique is also used for clients who require continuous monitoring.<\/p>\n<div class=\"textbox\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/02-Sat-Apparatus-2-1536x1024-1-300x200.jpg\" alt=\"Pulse oximeter with sensor taped around finger.\" width=\"932\" height=\"621\" class=\"alignnone wp-image-2854\" srcset=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/02-Sat-Apparatus-2-1536x1024-1-300x200.jpg 300w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/02-Sat-Apparatus-2-1536x1024-1-1024x683.jpg 1024w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/02-Sat-Apparatus-2-1536x1024-1-768x512.jpg 768w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/02-Sat-Apparatus-2-1536x1024-1-65x43.jpg 65w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/02-Sat-Apparatus-2-1536x1024-1-225x150.jpg 225w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/02-Sat-Apparatus-2-1536x1024-1-350x233.jpg 350w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/02-Sat-Apparatus-2-1536x1024-1.jpg 1536w\" sizes=\"auto, (max-width: 932px) 100vw, 932px\" \/><\/div>\n<p><strong>Figure 10:<\/strong> Pulse oximeter with sensor taped around finger<\/p>\n<p>An earlobe clip is another useful device for clients who cannot tolerate the finger or toe clip or have a condition that could affect the results, such as vasoconstriction and poor peripheral perfusion. Another type of device is taped across the forehead and left in place for continuous monitoring. See <strong>Figure 11<\/strong>.<\/p>\n<div class=\"textbox\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/Oxygen-saturation-device-forehea-300x199.jpg\" alt=\"Pulse oximeter with sensor taped across forehead.\" width=\"928\" height=\"617\" class=\"alignnone wp-image-2856\" srcset=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/Oxygen-saturation-device-forehea-300x199.jpg 300w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/Oxygen-saturation-device-forehea-1024x681.jpg 1024w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/Oxygen-saturation-device-forehea-768x510.jpg 768w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/Oxygen-saturation-device-forehea-65x43.jpg 65w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/Oxygen-saturation-device-forehea-225x150.jpg 225w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/Oxygen-saturation-device-forehea-350x233.jpg 350w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2017\/10\/Oxygen-saturation-device-forehea.jpg 1500w\" sizes=\"auto, (max-width: 928px) 100vw, 928px\" \/><\/div>\n<p><strong>Figure 11: <\/strong>Pulse oximeter with device across forehead<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>__________________________________________________<\/p>\n<p>Part of this content was adapted from OER #1 (as noted in brackets above):<\/p>\n<p>\u00a9 2015\u00a0British Columbia Institute of Technology (BCIT). Clinical Procedures for Safer Patient Care\u00a0by\u00a0Glynda Rees Doyle and Jodie Anita McCutcheon, British Columbia Institute of Technology. Licensed under a\u00a0<a href=\"http:\/\/creativecommons.org\/licenses\/by\/4.0\/\">Creative Commons Attribution 4.0 International License<\/a>, except where otherwise noted. Download this book for free at\u00a0<a href=\"http:\/\/open.bccampus.ca\">http:\/\/open.bccampus.ca<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"author":34,"menu_order":12,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by-nc"},"chapter-type":[49],"contributor":[84,80,81,83,82],"license":[56],"class_list":["post-915","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","contributor-andy-tan","contributor-jennifer-l-lapum","contributor-margaret-verkuyl-iojpniovfw","contributor-oona-st-amant-qmby8ihl0i","contributor-wendy-garcia-xwldzusnjr","license-cc-by-nc"],"part":873,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/915","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/users\/34"}],"version-history":[{"count":11,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/915\/revisions"}],"predecessor-version":[{"id":2855,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/915\/revisions\/2855"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/parts\/873"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/915\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/media?parent=915"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapter-type?post=915"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/contributor?post=915"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/license?post=915"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}