Not taking 0xygen Saturation on patients...???

[RN2B123]

I am a final year nursing student. I take 02 sats on all my patients as part of routine assessment at the beginning of the shift and then document in their chart the %

I've had some nurses tell me they almost never take routine pulseox on patients, they just look at the patient and document their visual findings. They've basically told me that the pulseox machines are finicky and often give wrong % readings anyways. (Just like if the 02 sat says 80% when you put it on the pt but the pt is pink, talking and alert).

I was wondering if this is usual practice for other nurses to not take 02 sats on their patients???

[leslie :-D]

a lot of people have baseline o2 sats in the 80's..

i'd take an o2 sat in my initial assessment, but unless there are resp symptoms or pathology, no real reason to follow through.

dang, i remember arguing w/a nurse because i had a pt whose resps were in 40's, he was diaphoretic and using access muscles...

yet his o2 sat read (consistently) in the mid 90's.

and this nurse kept on insisting he was "fine" because of the stupid oximeter.

we really do need to look at the pt first and foremost.

and no, you cannot visibly tell if someone is febrile.

leslie

[Murse901, MSN, RN]

Pulseox is nice, but routine monitoring isn't necessary in the majority of cases. If you're working ICU or your pt's chief complaint is respiratory in nature, then sure, you should be doing O2 sats. Otherwise, it's not all that significant other than to have another nice little number to write in your notes. It all just depends on your pt's acuity and setting.

Also, it depends on the equipment available. If I am doing a set of vitals on a DynaMAP or similar with a built-in pulseox, I will go ahead and get the reading because it's there. However, if I'm working in a cheap hospital that has 2 BP machines on a floor of 32 patients, I'm not going to go hunt down a pulseox to get a routine reading on stable patients with no respiratory complaint. Just my .

[Virgo_RN, BSN, RN]

O2 sats are part of our routine VS.

[cherrybreeze, ADN, RN]

I am not sure how to multi quote, but I'll hit some of the high points...

To the person who said they won't check it for a simple c/o that isn't resp related, I can understand that logic, but that's how I ended up with the swollen scrotum pt with sats in the 70's, who further declined after admission....they could have ended up in the appropriate unit in the first place, having been checked.

Some people's baseline sats absolutely are lower, say in the 80's, which is why it IS so important to GET a baseline, like before an elective surgery. We have plenty of pts post op that will run lower, and we don't know if that's normal for them then, or not!

It's no different than any other "number" when taking VS, IMO...a high or low BP doesn't mean much by itself, either. You would NEVER take a number alone for what it is, but it IS important to have as PART of your assessment. Why NOT do something that will only add to your overall clinical picture?

[RNKPCE]

Years ago when hand held O2 sat monitors were only in the hands of respiratory therapists at my hospital I asked one of them to check a sat on a patient I was worried about and the low 02 sat was consistent with the patient assessment. I called the pulmonologist and informed him about the sat and assessment and he got mad at me because I took a 02 sat without an order. He ended up giving me orders that help the patient but had to get mad at me anyways. If I hadn't gotten the sat I would have called him anyways and told him how his patient look and sounded. This was more than 17 years ago. Now they are a routine part of our vital signs. Funny how things change over time.

[MadisonsMomRN, BSN, RN]

O2 sats are a part of our vitals too.

[uscstu4lfe]

no i do not

[chenoaspirit, ASN, RN]

I bought my own personal pocket pulse ox and carry it with me continually. I always check pulse ox at beginning of shift, especially on my respiratory patients. I have had patients with SaO2 in the 70's with no other s/s of hypoxia, rare but it has happened. Pulse Ox is also part of routine vital signs that are done q 4 h. But I want to have every bit of info on my patients.

[Dolce, RN]

Some people's baseline sats absolutely are lower, say in the 80's, which is why it IS so important to GET a baseline, like before an elective surgery. We have plenty of pts post op that will run lower, and we don't know if that's normal for them then, or not!

I agree. We frequently see pre-op outpatients with sats in the high 80s and low 90s. Its helpful to be aware ahead of time that the patient is going to be hard to wean from o2 and probably won't be 99% on RA at discharge.