Master Oxygen Sat question

  1. Thank you, in advance, to all the knowledge here.

    So, when you are attempting to get an accurate O2 sat, and your using the standard "clothes pin" model, and a PT has nerve damage where the fingers and toes are cold....what is the 3rd and 4th and 5th places on the human body to successfully attempt a O2 sat on a PT?

    Ears? Nose? body fold??

    I remember once trying to use my nose, but the reading seemed way off. Please relay any one time experiences of success.
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  2. 22 Comments

  3. by   chicory
    Mario, we use the ear. I work on a floor w/alot of diabetic patients, and if there is poor circulation the ear is the next place to go.
  4. by   Reabock
    If you use the ear, be sure to use the appropriate connection, not the finger probe one on your Oximeter.
  5. by   sharann
    There's a special probe (looks like a flexible band-aid) they use on babies and kids , one brand is called a Nelcor. You can put this to the ear. The other thing about these probes is that they are sensetive to light exposure, so if you cover it you may get a reading. The bridge of the nose is another, but use the flexible, disposable piece (Nelcor type). Also, you can try putting the probe (clip type) on sideways on the finger or toe.
  6. by   mario_ragucci
    I have never thought of putting it on sideways. I'll try that on myself tomorrow. I want to understand hemoglobin and oxygen of each PT. Thank you!

    What about putting the clip in a PT's mouth (cheek), or on the tongue? I want to try that.

    Thank you again so much for the information that makes me think!
    Last edit by mario_ragucci on Sep 7, '02
  7. by   traumarns
    we have a special probe for the forehead. those seem to be the best for our pickers, and wiggle worms.

    we have the disposable ones for the fingers. and depending on hgb, or if they are a vasculopath, they simply dont work. cant get a pleth with an accurate reading.

    try the forehead, see if it works for you.

    good luck.
  8. by   Sleepyeyes
    ...and Mario, would you let us know what happens? You've got me curious now....
  9. by   micro


    the standard clothespin portable pulse ox version....for a spotcheck.........also refer to as you stated to is circulation compromised at this site....etc.

    continuous pulse oximetry.......
    is an absolute necessity with various conditions and patient situations/nursing care....

    but is problematic at the least.....
    sometimes it is the connection to the pulxe oximeter itself......
    sometimes it is the patient and impaired connection for whatever the reason.........skin moisture, poor circulation, just the adhesive wearing off..........
    :chuckle one time, I found that a sheet had a SaO2 level of 82%,
    something wrong with that .........

    which always tells me to look/assess the patient first......
    you can see if the patient truly has desaturated or if it just a problem with the connection or probe.........by assessing if the patient's presentation.........

    another thing you can do, is confirm the continous pulse oximeter with a portable oximeter.....both match.....then picture pretty guaranteed to be true........

    changing the probe sites.....sometimes often.......
    foreheads work most times the best, but for those pickers.....
    they often do not like that "fly" "wire" on their forehead........

    the peds/infant one's.......work great on an adult patient on a lil' toe covered with a sock, etc........(that is if nothing is compromising neurological/circulatory peripheral .........)

    not checking any probe connections for two days.....yee haw!!!!!!!

    micro
  10. by   dawngloves
    Originally posted by mario_ragucci


    What about putting the clip in a PT's mouth (cheek), or on the tongue? I want to try that.
    :roll :roll :roll I'd love to see that!
  11. by   sharann
    [QUOTE]Originally posted by micro
    [B]


    :chuckle one time, I found that a sheet had a SaO2 level of 82%,
    something wrong with that .........



    Hey Micro, was the sheet BLUE or just pale white?
  12. by   Qwiigley
    We had a kid that lost his 4 extremities from meningealcoccemia. We had to use his ear, his nose and even once his penis. We almost lost this poor child. After hemofiltration and ECMO and multiple surgeries; he made it. This all because his grandmother saw that he was getting a "rash" and a fever and gave him some of her antibiotics. With this dz you NEVER give antibiotics without being in an ICU. It just proves that you need to see a doc when kids get sick. Very scary. Kids are not little adults!
  13. by   sunnygirl272
    Originally posted by mario_ragucci
    I have never thought of putting it on sideways. I'll try that on myself tomorrow. I want to understand hemoglobin and oxygen of each PT. Thank you!

    What about putting the clip in a PT's mouth (cheek), or on the tongue? I want to try that.

    Thank you again so much for the information that makes me think!
    would need a condon type device to prevent cross contamination, mr ragucci!!!!!!!!!!!!!!
  14. by   mario_ragucci
    Thank you again very much. I often wonder about cross-contamination from BP cuff. Of course I would use a alcohol wipe/swab. And how could you use a clothes pin type O2 sat on the forhead. It is importand to make sure the leads are properly connected. I wanted to say penis, but figured it was too much. The story of the litle one sounds hard.
    For sure I am going to try cheek tomorrow, and I'll let you know.

    For a poor alter boy like me, can anyone explain, in several breif sentences, the physics of how the pulse oximeter works. How can that simple probe determine the O2 on your hemoglobin with such accuracy? Is it a special light? Does it have to do with the oscillating frequency of oxygen? You don't have to answer. If you do, I will remember your answers very well.

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