PRESENTED BY ELECTA AWANGA

SEMINAR OBJECTIVES
After reading the PowerPoint presentation viewers will be able to: -Define Pulse oximetry -Conginental heart disease -State the indications on how to use the pulse oximetry -State the advantages of Pulse oximetry -State the effect on newborn -State when to perform the pulse oximetry -State how the pulse oximetry is perform

Definition of Pulse Oximetry

A blood-oxygen monitor displays the percentage of arterial hemoglobin in the oxyhemoglobin configuration. Acceptable normal ranges for patients without COPD with a hypoxic drive problem are from 95 to 99 percent, those with a hypoxic drive problem would expect values to be between 88 to 94 percent, values of 100 percent can indicate carbon monoxide poisoning. For a patient breathing room air, at not far above sea level , an estimate of arterial pO2 can be made from the bloodoxygen monitor SpO2 reading.

Definition of Conginental Heart Disease

Congenital heart disease (CHD) is the most common birth defect. Infants with CHD have abnormal structure to their heart which creates abnormal blood flow patterns. Approximately eight of every 1,000 infants born have a form of CHD. Some forms of CHD cause no or very few problems in the health, growth, and development of the baby. However, critical CHD can bring a significant risk of morbidity and mortality if not diagnosed soon after birth. Failing to detect critical CHD while in the newborn nursery may lead to critical events such as cardiogenic shock or death. Survivors who present late are at greater risk for neurologic injury and subsequent developmental delay.

Indications on the use of pulse oximetry

Pulse oximetry is a particularly convenient noninvasive measurement method. Typically it utilizes a pair of small lightemitting diodes (LEDs) facing a photodiode through a translucent part of the patient's body, usually a fingertip or an earlobe. One LED is red, with wavelength of 660 nm, and the other is infrared, 905, 910, or 940 nm. Absorption at these wavelengths differs significantly between oxyhemoglobin and its deoxygenated form; therefore, the oxy/deoxyhemoglobin ratio can be calculated from the ratio of the absorption of the red and infrared light. The absorbance of oxyhemoglobin and deoxyhemoglobin is the same (isosbestic point) for the wavelengths of 590 and 805 nm; earlier equipment used these wavelengths for correction of hemoglobin concentration.

Advantage of using the Pulse Oximetry

-A pulse oximeter is useful in any setting where a patient's oxygenation is unstable, including intensive care, operating, recovery, emergency and hospital ward settings, pilots in unpressurized aircraft, for assessment of any patient's oxygenation, and determining the effectiveness of or need for supplemental oxygen.). -Used to detect abnormalities in ventilation.

Effects of Pulse Oximetry on newborn

The pulse ox test is non-invasive and painless. It usually does not hurt the baby

When to use the Pulse Oximetry

The pulse ox test will be done after the baby is born when he or she is older than 24 hours. The pulse ox test will be done if the baby isnt already thought to have a problem with the heart or lungs. Pulse ox screening should be performed while the infant is in the newborn nursery, before he or she goes home.

How to use the pulse Oximetry

Pulse oximetry measures solely oxygenation, not ventilation and is not a complete measure of respiratory sufficiency. It is not a substitute for blood gases checked in a laboratory, because it gives no indication of base deficit, carbon dioxide levels, blood pH, or bicarbonate HCO3-concentration. The metabolism of oxygen can be readily measured by monitoring expired CO2, but saturation figures give no information about blood oxygen content. Most of the oxygen in the blood is carried by hemoglobin; in severe anemia, the blood will carry less total oxygen, despite the hemoglobin being 100% saturated. Erroneously low readings may be caused by hypoperfusion of the extremity being used for monitoring (often due to a limb being cold, or from vasoconstriction secondary to the use of vasopressor agents); incorrect sensor application; highly calloused skin; or movement (such as shivering), especially during hypoperfusion. To ensure accuracy, the sensor should return a steady pulse and/or pulse waveform. Pulse oximetry technologies differ in their abilities to provide accurate data during conditions of motion and low perfusion

How to use the Pulse Oximetry

The pulse ox is placed by a sticky strip, like a band-aid, with a small red light, or probe, on the babys hand or foot. The probe is attached to a wire, which is attached to a special monitor that shows the pulse ox reading. The pulse ox test takes just a few minutes to perform. You can help comfort your baby and keep him or her warm, calm, and quiet while the test is being performed.

References
Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and metaanalysis. Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Source Women's Health Research Unit, Centre for Primary Care and Public Health, Barts and the London School of Medicine an Dentistry, Queen Mary University of London, London, UK. s.thangaratinam@qmul.ac.uk