18 Monitoring SpO2
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Measuring SpO2
During measurement, ensure that the application site:
– has a pulsatile flow, ideally with a signal quality indicator of at least medium.
– has not changed in its thickness (for example, due to edema), causing an improper fit of the
sensor.
WARNING
• For fully conscious pediatric or adult patients, who have a normal function of perfusion and
sensory perception at the measurement site:
To ensure skin quality and correct optical alignment of the sensor, inspect the application site
when the measurement results are suspicious or when the patient complains about pressure at
the application site, but at least every 24 hours. Correct the sensor alignment if necessary.
Move the sensor to another site, if the skin quality changes.
• For all other patients:
Inspect the application site every two to three hours to ensure skin quality and correct optical
alignment. Correct the sensor alignment if necessary. If the skin quality changes, move the
sensor to another site.
Change the application site at least every four hours.
• Injected dyes such as methylene blue, or intravascular dyshemoglobins such as methemoglobin
and carboxyhemoglobin may lead to inaccurate measurements.
• Inaccurate measurements may result when the application site for the sensor is deeply pigmented
or deeply colored, for example, with nail polish, artificial nails, dye or pigmented cream.
• Interference can be caused by:
– High levels of ambient light (including IR warmers) or strobe lights or flashing lights (such as
fire alarm lamps). (Hint: cover application site with opaque material.)
– Another SpO
2
sensor in close proximity (e.g. when more than one SpO
2
measurement is
performed on the same patient). Always cover both sensors with opaque material to reduce
cross-interference.
– Electromagnetic interference, especially at perfusion indicator values below 1.0 or signal
quality indicator below medium.
– Excessive patient movement and vibration.
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