Pediatric pulse oximeter

[catonmylap]

Can anyone recommend one of those pocket pulse oximeters? I have one for adults but it does not work on the little 6 year old boy I take care of now. I am his nurse at school & would love to check his sat. He has a trach & his lungs never sound good. His little fingers are quite skinny.

[annabeap, MSN, APRN, NP]

Huh, I wonder if you could get the disposable kind- they fit as tight as you'd like.

And if his doc was concerned about his sats, maybe he'd have one for home/school that fits him better- ask mom. She's probably also familiar with his baseline sats.

[catonmylap]

Mom, though she is loving & a good advocate, has no idea. She will not be consistent with his neb drugs & other meds. She often disregards MD orders. No MD orders for sats anyway.

I have very little peds or trach experience and am trying to get a better feel for his baseline before the cold season hits. The OT is sure curious, too. He really put the poor kid through the wringer last week. The mom was able to get a machine with a few disposable sensors but she can be resistant about using something if it will mean reordering supplies.

I drag so much stuff with us to school, I don't think I can fit another thing on that wheel chair. I was looking for the type you can put in your pocket, but my initial internet search results implied that it is difficult to find an accurate one for peds. Thought you might have used/seen a good one.

[liveyourlife747]

we use them on all vent children. not sure if they give them to only trached children, but it would be worth a try to call your local medical supply company to see how to get one. the one that our local medical supply company uses is the nonin which has the option for a sticky probe that works very nicely on all our clients (ages 2-13) they can fit on the big toe for the young ones and the second toe for the older ones.

[Brauer]

Pulse oximetry is seldom used in the home setting as it is a monitoring, not diagnostic tool. More telling would be observation of changes in his respiratory rate and presence, or worsening of, retractions. Also, observe changes in the need for increased suctioning which might indicate developing URI. As for breath sounds, in my experience, almost all kids with trachs tend to sound a bit junky, most of the time having to do with secretions which pool in the upper airway and the inability to clear them with ease. Hope this helps.

[nikkiv723]

I work in pediatric private practice and we use the POx daily for our kids. The unit we use is a Nellcor Oximax which came with a smaller attachment for fingers/toes however with the infants we will attach the sensor directly (typically to the toe) to the PT with a piece of co-lastic wrap.

Wishing your little man well :)

[systoly]

I hear you about schlepping a ton of stuff to school. One bag for the portable suction, one emergency bag (ambu, RX, etc.), and a third bag for personal care and mickey supplies. No room for anything else. While I've never had a home health patient who wasn't on intermittent oximetry, I agree with Brauer. In the absence of symptoms and specific orders, what would you do differently if you knew the exact O2 sat?