Acrocyanosis in newborn

[PEDSOBRN]

I have been doing some research on acrocyanosis. I have noticed some babies to have partially purple nailbeds. Do you consider this acrocyanosis? Most things on the internet say it is hands and feet. Also.....when you chart do you chart pink with acrocyanosis? I like to be thorough. Also should you always do a pulse ox if the baby has purple nailbeds? Thanks!

[klone, MSN, RN]

No, I would not do a pulse ox because of purple nail beds. Purple nail beds would be acrocyanosis, along with purple hands and/or feet.

I would do a pulse ox if the baby was grunting, flaring or retracting, or his/her resps were greater than 60ish.

Acrocyanosis is a perfectly normal clinical observation in a newborn.

[Turd Ferguson]

If a newborn has acrocyanosis, where would you perform pulse ox? Earlobe?

[littleneoRN]

If you did need a pulse oximeter measurement in a newborn with acrocyanosis (for some additional reason), you can still do it on the hand or foot. I'm a NICU nurse, and most of our admissions are acrocyanotic since they are newborns. The acrocyanosis has nothing to do with their diagnosis. And we still put the pulse oximeter in the standard places. It's accurate, too. :)

[Kinelle1]

Turd, Klone Summed it up nicely acrocyanosis is a normal finding in a neonate central cyanosis is different story. I believe the most accurate place for a pulse ox is the right palm/hand due to the fact it is pre-ductal therefore it is more indicative of actual saturation.

PS a pulse ox is also used in my institution if the heart rate dips below 100. To better monitor and handle the situation presented.