11-12
11.3.3 Monitoring Procedure
Follow the procedure as below:
1. Power on the monitor.
2. Attach the sensor to the proper site on the patient.
3. Plug the connector of the sensor extension cable into the SpO2 connector on monitor.
The process of SpO
2
plethysmogram measurement is generally the same. But the SpO
2
sensor
selection and placement depend on the patient type. When choosing a site for a sensor, refer to
the directions for that sensor.
11.3.4 Measurement Limitations
If the accuracy of any measurement does not seem reasonable, first check the patient’s vital signs
by an alternate method. Then check the instrument for proper function. Inaccurate measurements
may be caused by:
Incorrect sensor application or use;
Significant levels of dysfunctional hemoglobins (e.g., carboxyhemoglobin or
methemoglobin);
Intravascular dyes such as indocyanine green or methylene blue;
Exposure to excessive illumination, such as surgical lamps (especially ones with a xenon
light source), bilirubin lamps, fluorescent lights, infrared heating lamps, or direct sunlight
(exposure to excessive illumination can be corrected by covering the sensor with a dark
material);
Excessive patient motion;
Venous pulsations;
Placement of a sensor on the same extremity with a blood pressure cuff, arterial catheter, or
intravascular line;
The monitor can be used during defibrillation. However, the readings may take a short
period of time to return to normal.
Loss of pulse signal can occur in the following situations:
The sensor is too tight;
There is excessive illumination from light sources such as a surgical lamp, a bilirubin lamp,
or sunlight;
A blood pressure cuff is inflated on the same extremity as the one with a SpO2 sensor
attached;
The patient has hypotension, severe vasoconstriction, severe anemia, or hypothermia;
There is arterial occlusion proximal to the sensor;
The patient is in cardiac arrest or is in shock.
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