What are the benefits or advantages of pulse oximetry?
Allows early detection of desaturation
Probe may be placed in various places
What are the negatives and or inaccuracies of pulse oximetry?
Susceptible to artifact
Risk of burns in poor perfusion states
Unable to detect pulsatile blood flow in hypothermic/vasoconstricted patients.
Some nail polish pigments interfere with accurate estimates
During high FiO2 delivery, V/Q abnormalities may be masked
(PaO2 of 100 mmHg & 500 mmHg both read at 100%)
Doesn't measure respiratory rate
How does pulse ox work?
A sensor containing a light source (2 or 3 LEDs) & a light detector transilluminate perfused tissues. Oxygenated versus deoxygenated hgb are detected in this manner via changes in light absorption. The ratio of light absorption provided a saturation.
Whose law is the basis of pulse oximetry?
the intensity of transmitted light passing through a vascular bed decreases exponentially as a function of the concentration of absorbing substances & the distance from the source of the light to the detector
It = Ii x e-DCa
What are the absorption wavelengths utilized in pulse oximetry?
Oxygenated hgb = 940 nm
Deoxygenated hgb = 660 nm
What is the isobestic point?
It is when Iso is your Best choice...
A spectroscopic wavelength at which the absorbance of two substances, one of which can be converted into the other, is the same.
What are the lag times for finger? Ear? Toe?
Finger: 20-35 sec
Ear: 20 sec
Toe: 40-70 sec
SaO2 of 90% equals PaO2 of ______ mmHg.
When does cyanosis occur?
SpO2 of 70% (PaO2 of 40 mmHg)
Why does cyanosis occur?
Conformational changes occur in hgb molecules depending on the state of oxygen binding. When hgb is full of O's, it reflects a lighter red wavelength, when hgb if devoid of O's, it reflects a dark red/blue wavelength.
(This is why to exhibit cyanosis, one must have adequate amounts of hgb.)
Does acidosis shift the oxyhemoglobin dissociation curve to the left or the right?
Does this aid or hinder oxygen offloading?
Aids (decreased affinity for oxygen, thus pushing it's lazy-bum ass off the Blood Train into the surrounding tissues)
SaO2 of 70% = PaO2 of _____ mmHg