The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

COMPARISON OF PULSE OXIMETER SIGNAL STRENGTH OBTAINED FROM THREE DIFFERENT SITES IN INDIVIDUALS WITH PROFOUND DEVELOPMENTAL DISABILITIES

W. M. Scicolone1, H. L. Kline1, 2, K. A. Janini1, P. R. Mitchell1, 3


Background: Hattie Larlham Center for Children with Disabilities is a 126 bed Intermediate Care Facility for the Mentally Retarded. As a result of their primary diagnosis, these individuals have frequent medical complications including: seizures, pneumonia, asthma, GERD, spasticity/contractures, obstructive apnea and scoliosis. Additional complications that can compromise the accuracy of pulse oximetry values (SpO2) include: compromised peripheral circulation and low body temperature. A quality improvement project was developed to improve the reliability of SpO2 determinations.

Method: Twenty-five individuals were selected based on chronic difficulty in obtaining SpO2 values. SpO2 was measured at the finger, ear and forehead simultaneously using the Nonin Onyx 2, Nelcor N20, and the Nelcor N560, respectively. The SpO2, heart rate and signal strength were recorded at 45 and 120 seconds. Signal strength was noted on all three devices for each measurement. Descriptive statistics (mean, standard deviation and variance) and correlations were calculated across participants and devices. A Friedman test was conducted to examine differences between devices.

Results: SpO2 measurement could not be obtained for twenty percent of the participants using the finger probe. Saturations for two participants were unobtainable using the ear probe. Measures were obtained for all participants using the forehead probe. Signal strength for each measure was determined, with results summarized in table below.
Variance between subjects was greatest for the finger location, followed by the ear, then forehead. A Friedman test yielded a chi square statistic of 11.382 (df=2), significant at the < 0.01 level.

Conclusion: The results of this quality improvement project revealed that the forehead proved to be the most reliable site for obtaining SpO2 in this population. The findings of this project will enhance decision-making regarding equipment selection and the administration and discontinuance of oxygen therapy.

Signal Strength by Location
  Finger
Nonin Onyx II
Ear
Nelcor N20
Forehead
Nelcor N560
Strong
6 0 13
Moderate 8 14 11
Weak 6 10 1
Unobtainable 5 1 0



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