different pulse oximetry question - application to forehead

[koki]

Hi:

While working over the past year, I have seen the disposable finger "sticky" pulse oximeters applied to the forehead of patients who where not satting well in emergency situations various times.

Now I commonly apply the oximeter to the head if the patient is not satting well - that is if the finger sat is poor.

Recently a PA and MD- resident/intern -, said something to me.

A patient had been kept an extra day in the hospital because low sats- nothing else, pt was asymptomatic. However, when the oximeter was applied to the head, the pt satted 97%-100%. On finger 88-90%. Pt didn't have copd. I told the PA and the PA told the resident/intern (i really don't know which b/c I work nights and never deal with this particular MD). The intern/resident said the head wasn't accurate. However, the pt was sent home the next day.

Another occassion a PA looked questioned why I applied the pulse ox to the forehead of a pt. She is new to the profession, so I really didn't pay attention to her comment. The way she looked at me, however, I will never forget. It was what the hell are you doing kinda look.

So my question, all things aside, does using a finger, "sticky" pulse ox on the forehead provide an accurate reading?

[Be_Moore]

No. Applying it to the forehead requires a special type of oximeter that is built for measuring the O2 sat in close proximity to the skull, which can cause bounce-back of signal, giving an inaccurate reading. It can be taken on the forehead, but there is a special forehead probe to use.

[WSU_Ally_RN, BSN, RN]

Why wouldn't they just get an ABG to see if the pulse ox on the fingers or forehead correlated better instead of just keeping the pt for a whole extra day??? I've personally never seen a regular "sticky" pulse ox probe used on the forehead, so I'm not sure if it would work right or not...

[Sunflowerinsc, ADN, RN]

The sticky ones we use are applied to the ear lobe, can't say I have ever seen one on the forehead.