Pulse oximetry: exploring its role, limitations and challenges in clinical practice
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1Nursing Standard, RCN, London, England and visiting professor, School of Health Sciences, University of Surrey, Guildford, England.
Abstract:
Pulse oximetry is a non-invasive method of obtaining an indirect measure of a patient's peripheral oxygen saturation of haemoglobin in the blood (SpO 2 ), and is commonly used in acute and primary care settings. Obtaining an SpO 2 measurement involves the use of a pulse oximeter, which is typically attached to the patient's fingertip. This article describes how pulse oximetry works, discusses its limitations as a single metric and explores its applicability to the airway, breathing, circulation, disability and exposure (ABCDE) assessment approach and to the National Early Warning Score (NEWS) 2 'track and trigger' tool. The article also discusses the use of pulse oximetry in patients with chronic obstructive pulmonary disease and considers some of the challenges associated with its use, specifically in relation to skin integrity and patient comfort, skin tone, suboptimal peripheral circulation and the effects of nail polish on the accuracy of readings.
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