The Variation in Accuracy of Different SpO2 Sites on the Body in Healthy Individuals

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The Variation in Accuracy of Different SpO2 Sites on the Body in Healthy Individuals

Background: Pulse oximetry is an important tool for determining oxygen saturation. Hypoxemia can be fatal. The purpose of this study is to identify the best reliable and accurate site for taking SpO2 readings.

Methods: The study utilized a convenient sample of 12 participants to make SpO2 on their middle toe, index finger, and the earlobe. Readings were also made on polished finger and toe nails. Data was analyzed using MS Excel tool.

Results: The earlobe and the index fingers are good in giving highest reading of oxygen saturation levels but the earlobe is the best site for getting the most accurate and reliable readings.

Conclusion: There need to be practice change from the current practice in which oxygen saturation are measured on the fingers to the use of earlobes due to their highest level of accuracy and reliability.

Key Terms: Pulse oximetry, oxygen saturation,STDEV.s – standard deviation of the sample., peripheral oxygen saturation.

 

 

 

 

 

 

 

 

Introduction

When a patient comes to the hospital, it is almost always expect that a saturation probe will be placed around his/her finger to monitor saturation of oxygen in the blood. Depending on what brings the patient to the hospital the initial reading will determine how long the monitor will be on the patient. Bhogal and Mani (2017) state that pulse oximetry is routinely utilized for monitoring of patient’s level of oxygen saturation. It increases the rate of detection of hypoxemia. Pulse oximetry helps to reduce the need for invasive procedures for monitoring oxygen saturation such as the invasive arterial blood gases analysis (Bhogal & Mani, 2017). In most cases, if the patient cannot stay on room air for more than four hours they will continuously wear the saturation probe. No matter the patient’s age, weight, height, or race the patient they will have a saturation probe on them to at least spontaneously check throughout their stay at a hospital, clinic, or rehabilitation center/clinic. Pulse oximeter is can be place on the finger, toe or earlobe but these sites are characterized by a wide range of variability of readings with time.

When attaching a saturation probe to a patient usually the nurse or physician will go for the finger, and usually the index finger to be exact. In cases of infants sometimes the saturation probe is placed on the right wrist, or possibly around the foot if the hand is too small, or a reading cannot be obtained on the hand. For a large population of children and adults the probe is usually placed on the index finger but it is not clear whether this is the best site for accurate determination of oxygen saturation. Oxygen saturation is considered as a highly variable physiological parameter (Bhogal & Mani, 2017). SpO2 monitors are not always accurate in determining the saturation of the oxygen in a patient’s blood. There are multiple sites on a patient’s body where the SpO2 monitor can be placed and some are thought to be more accurate than others. This study will aim to identify the site for monitoring oxygen saturation with a narrow range of variability of values with time. These sites include the index finger with and without polish, the toe, and the earlobe. Maestri et al. (2019) are of the idea that the earlobe is likely to be the best site for measuring oxygen saturation due to its proximity to the carotid chemoreceptors; however, most healthcare practitioners almost invariably use finger probes. This compares the toe, index finger, and the earlobe in terms of increased accuracy readings with time. It is important we have a clear and accurate reading to identify patients in need of oxygen therapy.

Research PICOT Question: In hospitalized patients (P), does monitoring of SpO2 levels by placing the pulse oximeter on the ear lobe (I) compared to the ear lobe, index finger (with or without nail polish) or toe (with/without nail polish) (C) will give reliable readings with less degree of variability (O) during the length of the hospital stay?

Aims and Objectives

The aim of this study is to identify the site for taking accurate SpO2 readings.

Objectives

To determine variability of SpO2 levels in the index finger, toe, and ear lobe.
To identify the site with the least variability in SpO2

Methods

Participants and Study Design

Participants: Participants in this study were recruited from the Respiratory Therapy Program at the University of Kansas Medical Center during the 2021-2022 academic school year. The student’s ages ranged from 20-46 and all were considered to be healthy individuals. Interested individuals were given a brief explanation of the study and were given the opportunity to sign up for participation in the study. All participation was voluntary and informed consent was given by each participant before any data was collected.

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