Determine O2 without a pulse oximeter available

[Joni's Mom]

Hi,

Question: How can a nurse determine the O2 sat is adequate if there is no pulse oximeter available?

I wrote that a nurse can look at the arterial blood gas and the PaO2 levels; PaO2 >60 would indicate Sat levels 90 or above. Also the nurse would assess hypoxia looking for restlessness, dyspnea, hypertension, tachycardia, diaphoresis, cyanosis, and monitoring lungs sounds.

If anyone has a better answer please let me know.

I can't seem to find anything better in the books that I have.

Thanks

[deeDawntee, RN]

Pink warm skin.

No signs or symptoms of dyspnea, tachypnea, shortness of breath or air hunger...

Normal pulse.

Also, I would think that all the signs that indicate good perfusion would also be indicators of good oxygenation, because that won't be the case for long if the oxygenation is really bad. (like good urine output, etc)

[locolorenzo22, BSN, RN]

Immediate capillary refill, clear breath sounds, no complaints of difficulty by patient, no gasping, ability to talk and ambulate without difficulty...etc...there's a few.

[Natkat, BSN, MSN, RN]

Yep. Remember to look at the patient. Sometimes we get so caught up in the facts and data that we forget that our eyes and ears are sometimes are best diagnostic tools.

[Achoo!, LPN]

Don't forget LOC- hypoxia can cause cinfusion and lead to delerium. Start with your head to toe and work your way down the systems.

[Conrad283, BSN, RN]

If the patient can hold a conversation for a few sentences, I think that they are adequately oxygenated.

[franciscangypsy]

according to my med/surg professor, the first sign of hypoxemia would be anxiety and restlessness. so if your patient is at risk for being hypoxemic and he is acting concerned, while you are asking him what's wrong, check his respiration, pulse, and feel his skin temp.

if he is having trouble breathing, not only will he tell you, but his resp. will go up and his heart will start beating faster. if he has gotten to a point of hypoxemia, his extremities are likely to be drastically more cool than the rest of his body, too.

that's my thinking anyway...

[CarrieH]

Hi,

Question: How can a nurse determine the O2 sat is adequate if there is no pulse oximeter available?

I wrote that a nurse can look at the arterial blood gas and the PaO2 levels; PaO2 >60 would indicate Sat levels 90 or above. Also the nurse would assess hypoxia looking for restlessness, dyspnea, hypertension, tachycardia, diaphoresis, cyanosis, and monitoring lungs sounds.

If anyone has a better answer please let me know.

I can't seem to find anything better in the books that I have.

Thanks

That's about it... look and listen. After a while, you can pretty much guess what the pulse ox is going to read just by looking at the patient and listening. If you can hear stuff rumbling around in the lungs without a stethoscope, their mouth is open and gasping for air, lips and fingernails blue, hunched over and struggling to breath... O2 is probably low.

On a patient with COPD, it's usually safe to assume that their O2 on a good day is going to be between 94-96%, lower on a bad day. How the patient looks and feels is more important than the actual number.