The traditional method of blood oxygen detection is arterial blood delivery, which is traumatic in operation and results are not returned in time. Blood oxygen saturation is monitored by blood oxygen probe produced by Pray-med, which is convenient to operate and can provide continuous dynamic detection indicators for early detection of hypoxia and disease changes. The application of blood oxygen saturation and degree monitoring can avoid the pain caused by repeated arterial blood and reduce the workload of nursing, so it is widely used in ICU. However, it is easy to be interfered by many factors, which leads to the inconsistency between the test results and the results of arterial blood gas analysis, and affects the medical staff's judgment of the disease. Satisfactory results can be obtained by adjusting the influencing factors in time.
1. Causes and measures affecting the results of blood oxygen saturation
(1) Fingersleeve displacement: The measurement principle of blood oxygen saturation is based on the characteristics of hemoglobin absorption spectrum. If the nail bed is not in positive red light and the probe is too deep, too shallow or too loose, the changes in blood oxygen saturation cannot be sensed, so that the reading of blood oxygen saturation is low or not displayed. The position of finger and finger sleeve can be adjusted, so that the red light is on the nail bed to adjust the size of the finger sleeve, and fixed with adhesive cloth.
(2) the tip of the finger skin cold: intraoperative long exposure time, causes the patient | ice cold chills, skin and lead to low blood oxygen saturation value in reading through your fingers or don't show. Should pay attention to body warm, keep room temperature, when necessary cover quilt or hot water bag warm.
(3) Abnormal finger skin or color: nail polish, dirt on the finger, thick middle bed, gray nails, etc., will affect the accuracy of blood oxygen saturation. The nails should be cleaned during monitoring
(4) Monitoring of limb oxygen disorders: Frequent blood pressure measurement, excessive use of restraint bands in patients with agitation, excessive limb bending, and long-term fixation on one finger monitoring will all block electrical flow and affect the monitoring results of blood oxygen saturation. Blood oxygen saturation should be monitored at the same time as the pressure measuring limb. Fingers should be changed frequently during detection, and the tightness of the restraint band should be appropriate.
(5) Application of vasoactive drugs: extravasation of vasoactive drugs leads to tissue redness and swelling. Should promptly observe whether the infusion site exudation, redness and swelling, timely replacement
(6) Poor contact with the subject: When the patient turned over and changed the position, the cable of the blood oxygen probe was partially pulled loose. Align it with the slot and insert it properly.
(7) Oxygen tubes are blocked or semi-blocked by secretions; Oxygen does not enter or does not enter the alveoli smoothly, resulting in tissue hypoxia or ineffective oxygen supply, resulting in a decrease in blood oxygen saturation. Should be replaced on time, timely cleaning oxygen pipe.
(8) The location of oxygen trachea should be fixed in time if the oxygen trachea exits after coughing.
(9) The oxygen pipe is bent and twisted after the patient turns over. It should be timely checked whether the position of the oxygen pipe is unobstructed.
2 . Factors affecting pulse oxygen saturation reading (1) Mechanical: the probe position is wrong; Probe or wire off; Mechanical failure. (2) Patients: such as cardiopulmonary bypass, cardiac arrest in critically ill patients. No pulse can't be detected. Diabetes mellitus, arteriosclerosis, pulse blood flow decreased, pulse oxygen saturation decreased.
3 . Summary When critically ill patients and elderly patients perform continuous pulse oxygen saturation monitoring, it is necessary to take good care of finger skin and select a pulse monitoring probe suitable for the skin condition of patients. During the monitoring process, the tightness and position of the probe should be checked frequently to reduce or avoid local skin damage caused by probe compression.