Pulse Oximetry

1) What are some uses for pulse oximetry? (3 marks) Assessment, Monitoring treatment, Safety during exercise training, guide oxygen therapy, determine effective oxygenation etc. 2) Explain the physiological background behind pulse oximetry by explaining how oxygen is carried around the body and what effects its delivery to tissues? (6marks) Oxygen is carried in the blood in two ways (97% bound to haemoglobin=oxyhaemoglobin, 3% in plasma). Haemogloin is the iron containing protein component or erythrocytes (RBCs), each haem unit is capable of carrying four molecules of oxygen (or in other words 8 atoms of oxygen. It is carried in this way throughout the bodys vascular system to all the cells of the body where oxygen is unloaded into the tissues due to the difference in partial pressure of Oxygen (PaO2. Arterial blood has higher PaO2 and so there is a movement from an area of high concentration to an area of low concentration (Tisues/cells). Oxygen delivery to tissues depends of tissue perfusion, amount of Hb (Haemoglobin), saturation of oxygen to haemoglobin etc. 3) In relation to the oxygen dissociation curve below explain the relationship between the partial pressure of oxygen and its saturation within the body. Why is it important to keep the PaO2 above 60mm/hg? What would happen to the patient to a patient if there oxygen saturation fell below SaO2 85%. If this wasnt returned to normal range what are the possible consequences to the patient and there body?(6 marks) There is a clear relationship between partial pressure and saturation. The safe zone for oxygen saturation is within 95% to 100% Sao2, therefore lying between a PaO2 of approx.80mm/hg. As the partial pressure decreases so does the saturation at an exponential rate. It is important to keep the PaO2 above 60mm/hg because below this the saturation of oxygen drops quickly. If it continues to decrease the patient will show signs of SOB/Dyspnoea, sweating etc eventually due to a lack of Oxygen within the body the patient may faint; a further decrease in O2 to the body can result in body wide organ system failure and eventually result in death if not corrected promptly. 4) Explain how Pulse oximeters work and what can affect the accuracy of its readings? Light of three different wavelengths is transmitted through a finger tip from a Light emitting diode (LED). It is known that Hb bound to O2 absorbs light a different frequencies to those not Bound to O2. The light detector analyses the amount of each wavelength picked up to produces results on oxygen saturation. It can also detect pulse rate. However it cannot give information about CO2 saturation or alveolar ventilation. Accuracy can be affected by movement, nail polish, arrhythmias, ambient light, and carbon monoxide (therefore patients pulled out of a fire will have inaccurate readings)