GE CARESCAPE ONE - SpO2 troubleshooting

SpO₂
SpO
2
troubleshooting
ProblemSolution
SpO
2
signalispoor
●Checkthesensorandsensorposition.
●Makesurethepatientisnotshivering,moving,ordoesnothavetremors.
●Thepatient’spulsemaybetooweaktomeasure.
DeactivatedSpO
2
probe
offalarmkeepsalarming
whenthesensoris
disconnectedfromthe
patient.
Ensurethatthesensorisprotectedfromambientlight.
Whydoesthepulse
oximetersometimesread
differentlythanablood
gasanalyzer?
BloodgasanalyzerscalculatetheO
2
saturationbasedonnormalvaluesforpH,
PaCO
2
,Hb,temperature,etc.(i.e.,anormaloxyhemoglobindissociationcurve).
Dependingonthepatient’sphysiologicandmetabolicstatus,thiscurveandall
valuesmaybeshiftedawayfromnormal.Thustheoximeter,whichmeasuresO
2
saturation,maynotagreewiththebloodgas.
Whateffectcanambient
lighthaveonpulse
oximetrymonitoring?
Lightsourcessuchassurgicallamps,bilirubinlamps,uorescentlights,infrared
heatinglamps,andsunlightcancausepoorwaveformqualityandinaccurate
readings.Errormessagesarepossible.Shieldingthesensorwithopaquetape,the
poseywrap,orotherdarkoropaquematerialcanincreaseoximetryaccuracy,
veriedbygoodwaveformandsignalstrength.
Whatdoes
electrosurgical
interferencelooklikeand
howcanitbeminimized?
Electrosurgicalinterferenceismostobviousonthedisplayedwaveform.Itisavery
spiky,erraticlookingwaveformcausedbytheelectrosurgicalunit’soverwhelming
interference.Itcanresultingrosslyinaccuratepulseoximeterresults.
Electrosurgicalinterferencecanbeminimizedby:
●Makingsurethepulseoximetersensorisasfarawayfromthereturnpad
andoperatingsiteaspossible.
●Makingsurethesensorisnotbetweenthereturnpadandoperatingsite.
●Keepingthepowercordandsensorcableawayfromthepowercordofthe
electrosurgicalunit.
●Pluggingtheelectrosurgeryunitintoaseparatesetofoutletsfromthe
monitoringdevice.
Whatdoesmotion
artifactlooklike,what
problemscanitcause,
andhowcanitbe
corrected?
Motionartifactoccurswithexcessivemotionofthesensor,thecableleadingto
thesensor,orthecable/sensorjunction.Inotherwords,anythingthatcausesany
ofthesethingstomove,likethepatientmovinghishands,orthecablelying
acrosstheventilatortubingandbeingmovedwitheverycycle,cancausemotion
artifact.Anon-arterial,oftenerraticlookingwaveformandapulseratethatdoes
notcoincidewiththeheartrateontheECGwillresult.
Motionartifactcanbereduced,ifnoteliminated,byselectinga“quieter”siteon
thepatient.Anearsensorifthehandsdonotremainstill,anadhesivesensor
onthetoe,oranadhesivesensoronthelittlengerforanadultoronthesoleof
thefootinanewborncanhelpgreatly.
Cablemovementcanbereducedbyapplyingthesensorwiththecableleading
towardthepatient,thentapingthecabletothesideofthehandorfoot.The
cableandsensorcanalsobestabilizedwithastressloopnearthesensor.Tape
thestresslooptothepatient(excludingchildren).Inthecaseofthebuttery
sensor,thetapewasdesignedtosecurethecabletothenger.
2094480-001CARESCAPEONE151
CARESCAPE ONE User Manual DRAFT 26 October 2017