LECTURE/PRESENTATION DATE: 05TH November 2015

TOPIC : THE PULSE OXIMETER/OXIMETRY

Pulse oximetry is a procedure used to measure the oxygen level (or oxygen saturation) in
the blood. It is considered to be a non-invasive, painless, and a general indicator of oxygen
delivery to the peripheral tissues (such as the finger, earlobe, or nose).

HOW DOES PULSE OXIMETRY WORK

Oxygen in the air is breathed into the lungs. The oxygen then passes into the blood where the
majority of the oxygen attaches to haemoglobin (a protein located inside the red blood cell) for
transport in the bloodstream. The oxygenated blood circulates to the tissues.
Pulse oximetry technology utilizes the light absorptive characteristics of haemoglobin and the
pulsating nature of blood flow in the arteries to aid in determining the oxygenation status in the
body. First, there is a colour difference between arterial haemoglobin saturated with oxygen,
which is bright red, and venous haemoglobin without oxygen, which is darker.
Second, with each pulsation or heartbeat there is a slight increase in the volume of blood flowing
through the arteries. Because of the increase of blood volume, albeit small, there is an associated
increase in oxygen-rich haemoglobin. This represents the maximum amount of oxygen-rich
haemoglobin pulsating through the blood vessels.
A clip-like device called a probe is placed on a body part, such as a finger or ear lobe, to measure
the blood that is still carrying or is saturated with oxygen. The probe houses a light source, a light
detector, and a microprocessor, which compares and calculates the differences in the oxygen-rich
versus oxygen-poor haemoglobin. One side of the probe has a light source with two different types
of light, infrared and red, which are transmitted through the finger to the light detector side of the
probe. The oxygen-rich haemoglobin absorbs more of the infrared light and the haemoglobin
without oxygen absorbs more of the red light. The microprocessor calculates the differences and
converts the information to a digital readout. This information helps the responder assess the
amount of oxygen being carried in the blood and evaluate the need for supplemental oxygen.It is
also useful in measuring your pulse rate.
Use of pulse oximetry in cases of smoke or carbon monoxide inhalation is not helpful because oximetry
cannot distinguish between normal oxygen saturation in the haemoglobin and the
carboxyhaemoglobin saturation of haemoglobin that occurs with inhalation of smoke or carbon
dioxide.
Certain factors or conditions may interfere with the results of the test. These include, but are not
limited to, the following:
Decreased blood flow to the peripheral vessels
Light shining directly on the oximetry probe
Movement of the area to which the probe is attached
Severe anemia (decreased red blood cells)
Extreme warmth or coolness of the area to which the probe is attached
Excessive sweating of the area to which the probe is attached

WHAT DOES SpO2 MEAN? WHAT IS A NORMAL SpO2 LEVEL?

SpO2 stands for peripheral capillary oxygen saturation, an estimate of the amount of oxygen in the
blood. More specifically, it is the percentage of oxygenated haemoglobin (haemoglobin containing
oxygen) compared to the total amount of haemoglobin in the blood (oxygenated and non-oxygenated
haemoglobin).SpO2 is an estimate of arterial oxygen saturation, or SaO2, which refers to the amount
of oxygenated haemoglobin in the blood.Haemoglobin is a protein that carries oxygen in the blood. It
is found inside red blood cells and gives them their red colour.
For a regular healthy person, the normal blood oxygen saturation level (SpO2) should be around
94% to 99%. For patients with mild respiratory diseases, the SpO2 should be 90% or above.
Supplementary oxygen should be used if SpO2 level falls below 90%, which is unacceptable for a
prolonged period of time.

HYPOXIA OR HYPOXEMIA
When your body doesn't have enough oxygen, you could get hypoxemia or hypoxia. These are
dangerous conditions. Without oxygen, your brain,liver, and other organs can be damaged just
minutes after symptoms start.
Hypoxemia (low oxygen in your blood) can cause hypoxia (low oxygen in your tissues) when your blood
doesn't carry enough oxygen to your tissues to meet your body's needs. The word hypoxia is
sometimes used to describe both problems.Some causes are,but not limited to are COPD (Chronic
Obstructive Pulmonary Disease), Pulmonary Edema,Anaemia,Asthma,Bronchitis, Emphysema, and
heart disease.