Does your oximeter work for all of your patients?
How can you know?
COPD patients often present with complex co-morbidities
Up to 49.5% of COPD discharges have congestive heart failure
(CHF) and/or coronary artery disease (CAD).
Pulse Wave Distortions can cause inaccurate oximeter readings
When a COPD patient is desaturating, the following may be present:
• Low pulse strength – poor blood circulation can result in low pulse strength. Cold hands from a variety of reasons/conditions can also result in low pulse strength.
• Little or no oxygen reserve – COPD patients have little or no oxygen reserve capacity in their lungs and can be living on the edge of hypoxemia.
• Labored breathing – dyspnea can cause labored breathing and chest heaving, which can create pulse wave distortions.
As a result… it becomes harder for the oximeter to find the true pulse, particularly when the patient’s oxygen level is dropping.
Which oximeters are accurate in tracking desaturations?
Following Nonin Medical’s invention of the fingertip oximeter in 1995 there has been a proliferation of brands introduced.
Many of the new oximeters are made by two manufacturers:
• Beijing Choice Electronic Technology Co Ltd. (Beijing, China)
• Contec Medical Systems Co Ltd. (Qinhuangdao, China)
These two companies make over 30 different oximeter brands and models - major retailer brands, distributor brands, and internet brands. Some are FDA-cleared while some are “health and wellness” devices.
Current Accuracy Assessment Methods Can be Flawed
• Often clinicians assess an oximeter by comparing the oximeter to a tabletop or multi-parameter oximeter using a healthy individual or a COPD patient who is in stable condition.
• Accuracy assessment is most relevant when done on a COPD patient who is desaturating with associated labored breathing (dyspnea) and low pulse strength.