The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

PROCESS OF SIDE BY SIDE EVALUATION INVOLVING TWO LEADING OXIMETER MANUFACTURERS

J. A. Brewer 1, C. O'Donnell-Boone1, D. Murphy2


Background: Pulse oximetry is a standard monitoring device in the ICU. Our goal was to develop a fair process to evaluate oximeters. Data was taken from 2 contending oximeters and compared to our co-oximeter and EKG HR. Subjective data was also collected.

Method: An oximeter comparison form was developed and included such items as patient’s perfusion status, motion and lighting conditions, and clinical survey questions. We asked representatives (Reps) from both companies to in-service the evaluators. Initial ground rules were; Reps were to stay outside of patient rooms, refrain from distributing literature, and promoting or criticizing either device. Special features were disabled in order to compare standard operating elements. Alarm limits were set at identical values. Our selection criteria were: poor perfusion, and/or actively moving their hands. Each evaluation was up to 4 hours and finger probes were switched at evaluation half-way point. We chose the index and ring fingers for probe placement and a probe wrap over each disposable probe to avoid cross talk. Oximeter’s data was later downloaded via Profox software, PROFOX Associates, Inc., Escondido, CA. We recorded live data, using PhysioLog software by ProtoLink, Inc., Richardson, TX. Both oximeter’s data were graphically displayed simultaneously in two colors. ABG's were drawn when clinically necessary.

Results: Objective data from 11 patients were analyzed and 32 subjective forms were collected. Five of the eleven patients had SpO2 and SaO2 correlations. RCP, RN, MD and Material Management reviewed data collaboratively. The final decision has yet to be made, as discussions between hospital’s Medical Directors are pending.

Conclusion:
We realized further discussions prior to the trial were vital. Issues like limiting the number of Reps present, whether or not lunches should be provided and, time limits set when in-servicing so one company does not have an advantage over the other. Daily meeting times with both manufacturers are recommended. Cost comparison was not considered during the clinical evaluation process. We believe our attempt at a fair evaluation was successful and provided needed information to make an educated decision for quality service to our patients.

 

The graph below illustrates an observed episode of poor perfusion and was correlated with the SpO2 from each oximeter, red (top wave form) measured 94%, blue measured 87% and the co-oximeter SaO2 was reported as 96.8%:


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