Quote from earle58
one time i had a pt. who was sob, diaphoretic, pale and diminished lung sounds. he was a brittle diabetic w/crf. he was satting at 96% on ra but i sent him out and the emt's gave me such a hard time yelling "HIS 02 SAT IS 96%!!!" I told them to look at him and not the oximeter. they sent him out and he was in acute heart failure. the advice re: looking at the patient and not the numbers is so true. oximeters don't always tell the whole picture.
I recently had to "educate" one of our physicians about that........the other night we had a fresh post-op (liver biopsy) whose Sp02 was 97% on 5 liters, but whose respiratory rate was 40, lungs were coarse & wheezy, and his skin color was gray. He was clearly in distress, yet his BP remained stable and the SP02 never dropped below 95%. I called the MD twice to report his worsening resp. status, and all he wanted to know was "what're his sats?"
Finally, he decided to come in and see what I was nagging about, and suddenly we're pushing Lasix and getting a NRB mask and doing nebulizer treatments. We ended up moving the pt. to ICU after all this......and do you know, the man's sats never did go down during this whole ordeal. But he looked, and was, critically ill.
I was glad we had some students there that evening, as well as a couple of newer nurses who still rely on pulse oximetry to tell them how a patient is doing. They got to see firsthand an example of how you need to look at the PATIENT and not just the monitor!!