Pulse Oximeter discrepancy question

[Robinbelle]

I am 2 weeks into my first nursing job (ever) and it happens to be in LTC. This should be a fairly easy question to answer, but my brain is fried and I couldn't find it (or maybe comprehend the answer?) on Google.

So, I bought a Reli-on pulse Oximeter for my patients. My question is this: When I manually take their pulse, there is usually a 20 pt discrepancy between what my o2 sat pulse reads vs. what I get manually.

I know the manual reading is accurate, yet I have 31 patients to medicate, treat, do vitals, blood sugars, etc. I just don't have time to always take their manual pulse. Plus, shouldn't I be able to "reli-on" this pulse ox I had to pay almost $40 out of pocket for??

my coworker dropped it on my first day but I doubt that affected it. What is my dumb-a$$ missing here? A pulse discrepancy of 70 vs 93 is unacceptable to me and I have soooo many other things to learn! Any feedback is much appreciated. I can't ask my coworkers this question. So overwhelmed and wanting to take the best care possible of my patients. Thank you in advance :)

[CapeCodMermaid, RN]

The pulse ox is merely a tool. If the resident was fine but the tool showed a low sat, what would you do? Always rely on what YOU can assess yourself

[Ladyscrubs]

Patient could have low perfusion in their fingers (cold, chubby, affected by booze, smoking) Separate the heart beat from the pulse. Heart rate is beating or contracting of the heart and pulse (think "P" for palpable) is the arterial surge. These monitors are based on light absorption so more surge of arterial blood = more light absorption. It is more complicated than that, but that is the gist of a pulse ox… and ambient light can affect the reading too.

Something else… Pulse ox should be charted with respiratory rate, and if patient is on room air, supplemental O2 (nasal cannula, mask etc). So while you take 30 seconds for respers (remember discreet side glance at the chest), grab a radial pulse. Watch chest rise and assess for anything irregular…good way to assess if they are warm, or cold and clammy.

[Robinbelle]

Thank you so much!

[ktwlpn, LPN]

Also check your facility policy-ours prohibits personal equipment like your pulse odometer,automatic B/ P cuffs,thermometers.People buy second hand junk on eBay,fail to maintain and calibrate,etc. and our admin feels the accuracy of the data collected is questionable.

[CryssyD]

Well, to be honest, it usually takes several seconds for the pulse ox to pick up the pulse and then calculate the saturation rate, and it can take more than 15 seconds to get an accurate reading if the patient has poor circulation or won't hold completely still. I truly don't see an opportunity for saving time, here--just take the pulse manually and move on.