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'[PICLIST] re [pic]: can you make an oxygen satura'
2001\09\27@202007 by Russell McMahon

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Received this relevant comment re Pulse Oximeters -


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Russell,

You should be aware that while the optically-based blood-oxygen meters are
generally useful, they are not infallible and do not work on all patients.

After completing the round-Taupo cycle race last year Louise collapsed
(apparently due to a combination of dehydration and lack of
sufficient/appropriate pre-race nutrition) and was admitted to Taupo
hospital overnight.  None of the several different types of "clothes peg on
the finger" type blood oxygen monitors could be made to give sensible
results on her though they appeared to work fine on me.  On quizzing the
doctor on duty he said that they fail completely in about 5% of patients and
are probably unreliable in 15-20% of cases.

In Louises case they had to take blood and do a full chemical blood-gas
analysis.

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2001\09\27@205328 by goflo

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Russell McMahon wrote:
> Received this relevant comment re Pulse Oximeters ...

One of a number of things that will fox current pulse
oximeters is a significant CO blood level...

regards, Jack

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2001\09\28@025317 by Kathy Quinlan

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Ok time to speak on this one. First off I have to be careful (as most of us
do) about what I say due to NDA's I signed while working for medical
companies.

Some general comments.

Most Pulse oximeters work with two Led and Photo diode pairs. One pair is
visible and one is IR. I think the reason originally was function , not as
an indicator it is working (although the medical staff will tell you that is
the reason ;o) ). I can not remember the wavelengths.

On the business end (I E as a patient ) I can say yes they are not accurate,
( suffer from chronic Asthma) I have had pO readings of 45% on a Pulse
Oximeter, and the Dr's know it is wrong as the waveform (most of the top
models, esp. in ER's, show the waveform coming off the sensor, trained staff
who use pO's know what the waveform should approximately look like for
different ranges.) was wrong. An ABG (Arterial Blood Gas) analysis is the
most accurate way to tell, but this has a number of problems :

#1 it is expensive to run the tests.
#2 it is not a test that results can be quickly obtained.
#3 it is very painful (from a patients point of view)  as the artery of
choice (atleast in AU) is in the wrist where you measure your pulse, and the
little sharp needle is pushed in perpendicular to the wrist about 1cm

For the above reasons a Po is used, in 90% of people a reading that is
roughly (within 5%) is obtainable, things that interfere with this is (as
jack pointed out) an abnormal CO level (either high or low) bad circulation
(esp. in the elderly) and some skin disorders (some change the
characteristics of the skin i.e. too thick).

As someone pointed out the probe (finger clip) is not the expensive part
(although it is IMHO the most ingenious part) the expensive parts are the
patient isolation system , and the dsp system. As it sands the resultant
waveform from the detector is useless for much more than pulse rate and
pulse regularity (I forget the medical term). A LOT of signal processing is
needed to get the O2 level and try to remove the interference (the
interference is due to other chemicals and gasses in the blood) to help in
this area the signals are combined in various algorithms to obtain the O2
level.



Hope this helps,

No the manual. was not one from work , but was off a website on the net, if
I could find the website I would post a link, as it had service and owner
manuals for all the companies products including most ICU equipment.

Regards,

Kat.

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