Pulse oximetry is commonly used to assess arterial oxygen saturation (SaO2) non-invasively and to determine oxygen needs for patients at rest, during exercise, and during sleep. Oximetry SaO2 is acceptable documentation for Medicare home oxygen reimbursement. To ensure accuracy, a systematic oximetry protocol should be used that includes calibrating the oximeter properly, establishing stable readings, evaluating the patient's carboxyhemoglobin (HbCO) level, and assessing the perfusion to the measuring site or the strength of the pulse signal as indicated by the oximeter. During oxygen titration, adequate time should be allowed for hemoglobin equilibration at new oxygen levels. Quality control should include routine comparison of oximeter readings to actual SaO2 values.
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References
1.
YeldermanN, NewW.Evaluation of pulse oximetry. Anesthesiology1983;59:349–352.
2.
KochanskyM.Ear oximetry as a method of determining home oxygen prescriptions. Respir Care1984;29:1211–1220.
3.
BurnettRW, NoonanDC. Calculations and correction factors used in determination of blood pH and blood gases. Clin Chem1974;20:1499–1506.
4.
DouglasNJ, BrashHM, WraithPK. Accuracy, sensitivity to carboxyhemoglobin, and speed response to the Hewlett-Packard 47201A ear oximeter. Am Rev Respir Dis1979;119:311–313.
5.
ScogginC, NettL, PettyTL. Clinical evaluation of a new ear oximeter. Heart Lung1977;6:121–126.
National Conference on Oxygen Therapy-American College of Chest Physicians. National Heart, Lung and Blood Institute. FulmerJD, Chairman. Chest1984;2:234–247.
9.
Department of Health and Human Services Medicare Program. Coverage of oxygen for use in a patient's home; Final notice. Fed Reg1985. Apr 5;66:12742–13750.
10.
Nocturnal Oxygen Therapy Trial Group. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive disease. A clinical trial. Ann Intern Med1980;93:391–398.
11.
PettersonMT, WintersJG, RudolphCD, CecilWT. Clinical evaluation of the Biox IIA ear oximeter in adult intensive care and post-open heart surgery patients (abstract). Respir Care1983;28:1348.
12.
RebuckAS, ChapmanKR, D'UrzoA.The accuracy and response characteristics of a simplified ear oximeter. Chest1983;83:860–864.
13.
CecilWT, PettersonMT, LamoonpunS, RudolphCD. Clinical evaluation of the Biox IIA ear oximeter in the critical care environment. Respir Care1985;30:179–183.
14.
ShippyMB, PettersonMT, WhitmanRA, ShiversCR. A clinical evaluation of the BTI Biox II ear oximeter. Respir Care1984;29:730–735.
15.
SjostrandT.Endogenous formation of carbon monoxide in man under normal and pathological conditions. Scand J Clin Lab Invest1949;1:201–214.
