GE CARESCAPE - SpO2 troubleshooting

Pulseoximetry
SpO
2
troubleshooting
ProblemSolution
SpO
2
signalispoor
●Checkthesensorandsensorposition.
●Makesurethepatientisnotshivering,moving,ordoesnothavetremors.
●Thepatient’spulsemaybetoolowtomeasure.
Unabletoadjustalarm
limits
Thealarmlimitsarenotadjustablewhenthemeasurementsourceisfroman
externaldeviceconnectedtotheUnityNetworkIDconnectivitydevice.
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.
●Pluggingtheelectrosurgeryunitintoaseparatesetofoutletsfromthemonitor.
Whatdoesmotion
artifactlooklike,what
problemscanitcause,
andhowcanitbe
corrected?
FormodulesusingNellcorOxiMaxandGEMarquettetechnologies,themain
problemmotionartifactcancauseiserroneousSpO
2
readings.
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
216CARESCAPEModularMonitors2062971-001