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Pulse oximetry: exploring its role, limitations and challenges in clinical practice
1Nursing Standard, RCN, London, England and visiting professor, School of Health Sciences, University of Surrey, Guildford, England.
Nursing Standard (Royal College of Nursing (Great Britain) : 1987)
|June 8, 2026
Summary
Pulse oximetry measures blood oxygen saturation non-invasively. This article details its function, limitations, and use in clinical assessments like ABCDE and NEWS 2, considering patient factors.
Area of Science:
- Medical Devices
- Clinical Monitoring
- Respiratory Medicine
Background:
- Pulse oximetry is a standard non-invasive technique for measuring peripheral oxygen saturation (SpO2).
- It is widely utilized in acute and primary care for patient monitoring.
- The device, typically a fingertip-attached pulse oximeter, provides indirect haemoglobin oxygen saturation data.
Purpose of the Study:
- To explain the working principles of pulse oximetry.
- To critically evaluate the limitations of pulse oximetry as a standalone metric.
- To explore its integration into established clinical assessment frameworks.
Main Methods:
- Descriptive review of pulse oximetry technology.
- Analysis of pulse oximetry's role in the ABCDE assessment.
- Examination of its application within the National Early Warning Score (NEWS) 2 system.
Main Results:
- Pulse oximetry is valuable but has limitations as a single metric.
- Its application extends to ABCDE assessments and NEWS 2.
- Challenges include accuracy issues related to skin tone, circulation, and nail polish, impacting patient comfort and skin integrity.
Conclusions:
- Pulse oximetry is a crucial tool in clinical practice, particularly in respiratory care.
- Understanding its limitations is essential for accurate interpretation and application.
- Further consideration is needed for factors affecting readings and patient experience, especially in chronic obstructive pulmonary disease management.
Related Concept Videos
01:24Pulse Oximetry
Pulse oximetry, or SpO2, is a non-invasive method for continuously monitoring arterial oxygen saturation (SaO2). This procedure involves attaching a probe or sensor to the patient's fingertip, forehead, earlobe, or nose bridge. The sensor works by detecting changes in oxygen saturation levels through light signals generated by the oximeter and reflected by the pulsing blood under the probe.
Purpose
Average SpO2 values are greater than 95%. If the readings fall below 90%, it indicates that...
Purpose
Average SpO2 values are greater than 95%. If the readings fall below 90%, it indicates that...
01:19Special considerations while measuring oxygen saturation
Assessing respiratory rate concurrently with pulse measurement is fundamental to patient care, providing valuable insights into the patient's respiratory function. The normal breathing rate for an adult usually falls within a normal range of 12 to 20 breaths per minute. Abnormal respiratory rates can signal underlying health conditions or the need for immediate intervention.
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is important.
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is important.
01:19Guidelines For Measuring Vital Signs
Following these guidelines can help nurses accurately measure vital signs, assess changes in patient conditions, and provide timely treatment when necessary. Adhering closely to the guidelines ensures the accuracy and reliability of the results.
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.
01:19Respiratory Assessment: Purpose and Indications
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:17Measurement of Blood Pressure
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.
01:17Assessment of Diffusion and Perfusion
Understanding and evaluating diffusion and perfusion is critical in assessing a patient's respiratory and circulatory health. These processes play key roles in maintaining the body's internal environment, ensuring that tissues receive adequate oxygen while waste products are efficiently removed.
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...
The Role of Diffusion in Respiration
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