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Pulse oximetry
SpO
2
troubleshooting
Problem Solution
SpO
2
signal is poor
●
Check the sensor and sensor position.
●
Make sure the patient is not shivering, moving, or does not have tremors.
●
The patient’s pulse may be too low to measure.
Unable to adjust alarm
limits The alarm limits are not adjustable when the measurement source is from an
external device connected to the Unity Network ID connectivity device.
Deactivated SpO
2
probe
off alarm keeps alarming
when the sensor is
disconnected from the
patient.
●
Ensure that the sensor is protected from ambient light.
Why does the pulse
oximeter sometimes read
differently than a blood
gas analyzer?
Blood gas analyzers calculate the O
2
saturation based on normal values for pH,
PaCO
2
, Hb, temperature, etc. (i.e., a normal oxyhemoglobin dissociation curve).
Depending on the patient’s physiologic and metabolic status, this curve and all
values may be shifted away from normal. Thus the oximeter, which measures O
2
saturation, may not agree with the blood gas.
What effect can ambient
light have on pulse
oximetry monitoring?
Light sources such as surgical lamps, bilirubin lamps, fluorescent lights, infrared
heating lamps, and sunlight can cause poor waveform quality and inaccurate
readings. Error messages are possible. Shielding the sensor with opaque tape, the
posey wrap, or other dark or opaque material can increase oximetry accuracy,
verified by good waveform and signal strength.
What does
electrosurgical
interference look like and
how can it be minimized?
Electrosurgical interference is most obvious on the displayed waveform. It is a very
spiky, erratic looking waveform caused by the electrosurgical unit’s overwhelming
interference. It can result in grossly inaccurate pulse oximeter results.
Electrosurgical interference can be minimized by:
●
Making sure the pulse oximeter sensor is as far away from the return pad
and operating site as possible.
●
Making sure the sensor is not between the return pad and operating site.
●
Keeping the power cord and sensor cable away from the power cord of the
electrosurgical unit.
●
Plugging the electrosurgery unit into a separate set of outlets from the monitor.
What does motion
artifact look like, what
problems can it cause,
and how can it be
corrected?
For modules using Nellcor OxiMax and GE Marquette technologies, the main
problem motion artifact can cause is erroneous SpO
2
readings.
Motion artifact occurs with excessive motion of the sensor, the cable leading to
the sensor, or the cable/sensor junction. In other words, anything that causes any
of these things to move, like the patient moving his hands, or the cable lying
across the ventilator tubing and being moved with every cycle, can cause motion
artifact. A non-arterial, often erratic looking waveform and a pulse rate that does
not coincide with the heart rate on the ECG will result.
Motion artifact can be reduced, if not eliminated, by selecting a “quieter” site on
the patient. An ear sensor if the hands do not remain still, an adhesive sensor
on the toe, or an adhesive sensor on the little finger for an adult or on the sole of
the foot in a newborn can help greatly.
Cable movement can be reduced by applying the sensor with the cable leading
toward the patient, then taping the cable to the side of the hand or foot. The
cable and sensor can also be stabilized with a stress loop near the sensor. Tape
216 CARESCAPE Modular Monitors 2062971-001