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Presentation Report

               On

  Pulse Oximeter
                 By:
          BISWAS LOHANI
           BMET 6th BATCH
    National Health Training Center
          Teku, Kathmandu
                Nepal
                 2012
HEMOGLOBIN
Hemoglobin
 (abbreviated Hb) is the
 iron-containing oxygen-
 transport metalloprotein
 in the red blood cells of
 vertebrates.
 Hemoglobin transports
 oxygen from the lungs
 to the rest of the body,
 where it releases the
 oxygen for cell use.
What is a Pulse Oximeter?
A Pulse Oximeter is a device used to perform the
  diagnostic procedure for determining the:

Percentage of hemoglobin (Hb) that is saturated
 with oxygen
 The oxygen saturation (SpO2) is a measure of how
 much oxygen the blood is carrying as a percentage
 of the maximum it could carry and is sometimes
 referred to colloquially as the "sats" reading
The heart rate
 The heart rate refers to the number of times that the
 heart contracts in a period of one minute
TYPES OF OXIMETERS
Designs:
Pulse Oximeter as part of an anesthetic
 machine

A portable desktop unit


A finger/mobile pulse Oximeter
Pulse Oximeter as part of an
     anesthetic machine
Pulse Oximeters (continue)
Desktop       Finger/mobile
What does a Pulse Oximeter tell you?

A Pulse Oximeter can detect hypoxia (too little

 oxygen to fulfill the needs of the brain and body)

 before a patient shows signs of becoming cyanotic

 (bluish discoloration of the skin and mucous

 membranes due to not enough oxygen in the

 blood).
Pulse Oximeters may be used in patients:
Undergoing surgical procedure   Undergoing surgical procedure
under general anesthesia        under conscious sedation
Pulse Oximeters may be used in patients:
Emergency situations
 like loss of
 consciousness, trauma
 etc.
After surgery during the
 recovery phase

Monitoring the blood
 oxygen saturation in
 various aviation
 situations
Sport applications –
 e.g. mountaineering
Pulse Oximeters may be used in patients:
 In the ICU, Pulse Oximetry is used
  extensively on mechanically ventilated
  patients, as it can frequently detect
  problems with oxygenation before they
  are noticed clinically, as well as a
  valuable guide for weaning patients off
  ventilation and helping to assess the
  adequacy of a patient's oxygen
  therapy.
 This continuing assessment process has
  been instrumental in the introduction of
  Pulse Oximeter usage within the
  community and homecare
  environment of patients suffering from a
  variety of heart and lung diseases and
  conditions
 Pulse Oximeters are routinely used in
  certain hospital wards and in casualty
  departments for immediate assessment
  of patients
Pulse Oximeter
          reading may not be accurate:
Reduced peripheral
 pulsatile blood flow
Venous congestion
 (partial obstruction of
 the veins) of an arm or
 leg
Bright overhead lights,
 such as in an operating
 theatre
Shivering or significant,
 repeated movement of
 the sensor
Pulse Oximeter
          reading may not be accurate:
Pulse oximetry struggles
 to distinguish between
 different forms of
 hemoglobin, such as
 carboxy-hemoglobin
 (hemoglobin combined
 with carbon monoxide)
Nail varnish may cause
 falsely low readings with
 most pulse Oximeters,
 especially those
 colored blue or black
The following won’t affect the
Pulse Oximeter reading:
Anemia            Jaundice
But what is a "normal" reading?
 Firstly, we would ask "normal for whom"?

 A fit, healthy person should have an oxygen
 saturation level between 95% & 99%. Results
 lower than this, and especially below 90% may
 be caused by problems including lung diseases,
 such as COPD, breathing difficulties, cigarette
 smoking or circulatory problems such as
 excessive bleeding or blood vessel problems.
How does a Pulse Oximeter Work?
The measurements are obtained by          By measuring how much light has been
                                          absorbed by the oxygen in the blood, an
simply shining two wavelengths of light   oxygen saturation or “sats” reading is
(1 is a visible red beam, the other an    established and displayed as a
invisible infrared beam) at e.g. the      percentage of the maximum amount of
                                          oxygen the blood could carry.
fingertip.
Q1 If a patient’s saturation is
unacceptably low, what are your
immediate actions?
 Check
 Airways,
 Breathing and
 Circulation
 (ABC)
Q1 If a patient’s saturation is
unacceptably low, what are your
immediate actions?
 Check
 Airways,
 Breathing and
 Circulation
 (ABC)
Q2 An elderly patient is admitted with pneumonia and
has a pulse oximetry reading of 75% breathing air. With
oxygen 6L per min, saturation improves to 85%. What
are the implications of this oximetry reading?
Q2 An elderly patient is admitted with pneumonia and
has a pulse oximetry reading of 75% breathing air. With
oxygen 6L per min, saturation improves to 85%. What
are the implications of this oximetry reading?

  The patient was
  severely hypoxic
  (Lack of Oxygen)


  Increase
  oxygen flow
Q3 What happens to the pulse Oximeter reading
of a patient immediately after a cardiac arrest?


 The pulse would
 be lost (causing
 the alarm to
 sound) and the
 saturations will
 decrease
Q3 What happens to the pulse Oximeter
reading of a patient immediately after a
cardiac arrest?
 The pulse would
 be lost (causing
 the alarm to
 sound) and the
 saturations will
 decrease
Q4 What happens to the Pulse Oximeter
reading of a patient immediately after a
respiratory arrest?

 The saturations
  decrease until
  cardiac arrest
  occurs
Q4 What happens to the Pulse Oximeter
reading of a patient immediately after a
respiratory arrest?

 The saturations
  decrease until
  cardiac arrest
  occurs
In conclusion…
Pulse Oximetry is a useful modality for assessing
 a patient’s pulse rate and Hemoglobin Oxygen
 saturation in a number of routine and
 emergency medical situations
The clinician should be aware of the limitations
 of Pulse Oximetry and the various factors that
 may produce a falsely low or high reading
Always keep the basics principles of medicine in
 mind, and keep a high level of suspicion -
 especially when the figures don’t make sense!
Preventive maintenance
Qualitative Tests
 Chassis - verify physical integrity, cleanliness.
 Mount/Fasterners – verify physical integrity of mounts
 AC Plug - verify integrity.
 Line Cord - verify proper insulation and integrity.
 Strain Reliefs - verify physical integrity at both ends of line cord.
 Circuit Breaker/Fuse – verify integrity of external circuit breaker
  and/or value of external fuse.
 Cables - inspect patient cable and leads.
Quantitative Tests

For double insulated devices, indicate “DI” in place of
 resistance and leakage current values.
Grounding Resistance [< 0.5 ohm]
2.2 Chassis Leakage [< 300 microamps]
THANK YOU for
your undivided
attention!!!

I appreciate the
opportunity to
invest into your
lives!!

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Pulseoximetry fianl

  • 1. A Presentation Report On Pulse Oximeter By: BISWAS LOHANI BMET 6th BATCH National Health Training Center Teku, Kathmandu Nepal 2012
  • 2. HEMOGLOBIN Hemoglobin (abbreviated Hb) is the iron-containing oxygen- transport metalloprotein in the red blood cells of vertebrates. Hemoglobin transports oxygen from the lungs to the rest of the body, where it releases the oxygen for cell use.
  • 3. What is a Pulse Oximeter? A Pulse Oximeter is a device used to perform the diagnostic procedure for determining the: Percentage of hemoglobin (Hb) that is saturated with oxygen The oxygen saturation (SpO2) is a measure of how much oxygen the blood is carrying as a percentage of the maximum it could carry and is sometimes referred to colloquially as the "sats" reading The heart rate The heart rate refers to the number of times that the heart contracts in a period of one minute
  • 4. TYPES OF OXIMETERS Designs: Pulse Oximeter as part of an anesthetic machine A portable desktop unit A finger/mobile pulse Oximeter
  • 5. Pulse Oximeter as part of an anesthetic machine
  • 7. What does a Pulse Oximeter tell you? A Pulse Oximeter can detect hypoxia (too little oxygen to fulfill the needs of the brain and body) before a patient shows signs of becoming cyanotic (bluish discoloration of the skin and mucous membranes due to not enough oxygen in the blood).
  • 8. Pulse Oximeters may be used in patients: Undergoing surgical procedure Undergoing surgical procedure under general anesthesia under conscious sedation
  • 9. Pulse Oximeters may be used in patients: Emergency situations like loss of consciousness, trauma etc. After surgery during the recovery phase Monitoring the blood oxygen saturation in various aviation situations Sport applications – e.g. mountaineering
  • 10. Pulse Oximeters may be used in patients:  In the ICU, Pulse Oximetry is used extensively on mechanically ventilated patients, as it can frequently detect problems with oxygenation before they are noticed clinically, as well as a valuable guide for weaning patients off ventilation and helping to assess the adequacy of a patient's oxygen therapy.  This continuing assessment process has been instrumental in the introduction of Pulse Oximeter usage within the community and homecare environment of patients suffering from a variety of heart and lung diseases and conditions  Pulse Oximeters are routinely used in certain hospital wards and in casualty departments for immediate assessment of patients
  • 11. Pulse Oximeter reading may not be accurate: Reduced peripheral pulsatile blood flow Venous congestion (partial obstruction of the veins) of an arm or leg Bright overhead lights, such as in an operating theatre Shivering or significant, repeated movement of the sensor
  • 12. Pulse Oximeter reading may not be accurate: Pulse oximetry struggles to distinguish between different forms of hemoglobin, such as carboxy-hemoglobin (hemoglobin combined with carbon monoxide) Nail varnish may cause falsely low readings with most pulse Oximeters, especially those colored blue or black
  • 13. The following won’t affect the Pulse Oximeter reading: Anemia Jaundice
  • 14. But what is a "normal" reading? Firstly, we would ask "normal for whom"? A fit, healthy person should have an oxygen saturation level between 95% & 99%. Results lower than this, and especially below 90% may be caused by problems including lung diseases, such as COPD, breathing difficulties, cigarette smoking or circulatory problems such as excessive bleeding or blood vessel problems.
  • 15. How does a Pulse Oximeter Work? The measurements are obtained by By measuring how much light has been absorbed by the oxygen in the blood, an simply shining two wavelengths of light oxygen saturation or “sats” reading is (1 is a visible red beam, the other an established and displayed as a invisible infrared beam) at e.g. the percentage of the maximum amount of oxygen the blood could carry. fingertip.
  • 16. Q1 If a patient’s saturation is unacceptably low, what are your immediate actions? Check Airways, Breathing and Circulation (ABC)
  • 17. Q1 If a patient’s saturation is unacceptably low, what are your immediate actions? Check Airways, Breathing and Circulation (ABC)
  • 18. Q2 An elderly patient is admitted with pneumonia and has a pulse oximetry reading of 75% breathing air. With oxygen 6L per min, saturation improves to 85%. What are the implications of this oximetry reading?
  • 19. Q2 An elderly patient is admitted with pneumonia and has a pulse oximetry reading of 75% breathing air. With oxygen 6L per min, saturation improves to 85%. What are the implications of this oximetry reading? The patient was severely hypoxic (Lack of Oxygen) Increase oxygen flow
  • 20. Q3 What happens to the pulse Oximeter reading of a patient immediately after a cardiac arrest? The pulse would be lost (causing the alarm to sound) and the saturations will decrease
  • 21. Q3 What happens to the pulse Oximeter reading of a patient immediately after a cardiac arrest? The pulse would be lost (causing the alarm to sound) and the saturations will decrease
  • 22. Q4 What happens to the Pulse Oximeter reading of a patient immediately after a respiratory arrest? The saturations decrease until cardiac arrest occurs
  • 23. Q4 What happens to the Pulse Oximeter reading of a patient immediately after a respiratory arrest? The saturations decrease until cardiac arrest occurs
  • 24. In conclusion… Pulse Oximetry is a useful modality for assessing a patient’s pulse rate and Hemoglobin Oxygen saturation in a number of routine and emergency medical situations The clinician should be aware of the limitations of Pulse Oximetry and the various factors that may produce a falsely low or high reading Always keep the basics principles of medicine in mind, and keep a high level of suspicion - especially when the figures don’t make sense!
  • 25. Preventive maintenance Qualitative Tests  Chassis - verify physical integrity, cleanliness.  Mount/Fasterners – verify physical integrity of mounts  AC Plug - verify integrity.  Line Cord - verify proper insulation and integrity.  Strain Reliefs - verify physical integrity at both ends of line cord.  Circuit Breaker/Fuse – verify integrity of external circuit breaker and/or value of external fuse.  Cables - inspect patient cable and leads.
  • 26. Quantitative Tests For double insulated devices, indicate “DI” in place of resistance and leakage current values. Grounding Resistance [< 0.5 ohm] 2.2 Chassis Leakage [< 300 microamps]
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