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DM DOC 040 Rev 1.0
Even with a plethysmographic waveform obscured by artifact, D-MAS locates the arterial
pulsation. The pulse tone (when enabled) coincides with the vertical line of the Signal IQ.
The height of the vertical line of the Signal IQ indicates the quality of the measured signal. A high
vertical bar indicates that the SpO2 measurement is based on a good quality signal. A small
vertical bar indicates that the SpO2 measurement is based on data with low signal quality.
When the signal quality is very low the accuracy of the SpO2 measurement may be
compromised, and a Low Signal IQ message is displayed.
When the Low Signal IQ message appears proceed with caution and do the following:
Assess the patient
Check the sensor and ensure proper sensor application. The sensor must be well
secured to the site to maintain accurate readings. Also,misalignment of the sensor’s
emitter and detector can result in smaller signals
Determine if an extreme change in the patient’s physiology and blood flow at the
monitoring site occurred, (e.g. an inflated blood pressure cuff, a squeezing motion,
sampling of an arterial blood specimen from the hand containing the pulse oximetry
sensor, severe hypotension, peripheral vasoconstriction in response to hypothermia,
medications, or a spell of Raynaud’s syndrome.)
LOW PERFUSION
D-MAS displays a “Low Perfusion” message when there are very low amplitude arterial
pulsations. It has been suggested that at extremely low perfusion levels, pulse oximeters can
measure peripheral saturation, which may differ from central arterial saturation
1
.
This “localized hypoxemia” may result from the metabolic demands of other tissues extracting
oxygen proximal to the monitoring site under conditions of sustained peripheral hypoperfusion.
(This may occur even with a pulse rate that correlates with the ECG heart rate.)
CAUTION:
IF THE LOW PERFUSION MESSAGE IS FREQUENTLY DISPLAYED, FIND A
BETTER-PERFUSED MONITORING SITE. IN THE INTERIM, ASSESS THE
PATIENT AND, IF INDICATED, VERIFY OXYGENATION STATUS THROUGH
OTHER MEANS.
1
Severinghaus JW, Spellman MJ. Pulse Oximeter Failure Thresholds in Hypotension and
Vasoconstriction. Anesthesiology 1990; 73:532-537
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