Oxygen saturation monitoring

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Oxygen saturation monitoring

• Teaching pack 11
• Liz Herd

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Introduction
What do you know
about oxygen saturation
3
Ground rules

• We value the young people we care for we would
  never put them or you at risk
• Always ask any questions when they occur to you,
  weve all asked questions that may seem
  silly-there is no such thing as a silly question!
• Stop me if you dont understand- the chances are
  others dont either
• Tell me if you need a break

4
Parent Experts

• All parents know their child/young person best
  They care for them daily
• Listen to them-act on what they say!!
• As a resource they are second to none Use
  Them-get to know the child as the parent does

5
Hand hygiene

• As with all care hand hygiene is extremely
  important
• Please follow the 8 point plan and repeat steps 5
  times
• Wash hands as required through out the procedure

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Why do we need oxygen saturation?

• Oxygen is the fuel of the body and is essential
  to life, growth and development
• Oxygen saturation monitoring shows the level of
  oxygen attached to haemoglobin in the blood
• This helps us measure oxygen levels in the blood
  to ensure optimum health for our children and
  young people

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Who needs oxygen saturation monitoring?

• Anyone on oxygen therapy
• Ventilated patients, as a secondary alarm
• Patients recently off oxygen therapy
• Patients who are respiratory compromised for any
  reason

8
Pulse oximeters

• These are the machines that give us the readings
• They can be spot check machines or give
  continuous readings like this one
• This one runs on mains but most will have a short
  life internal battery-check guidelines

9
Spot check machines

• Useful for intermittent checks
• Do not need to be attached all the time
• Are easily portable
• Use batteries as a power source-very useful in a
  power cut

10
Mains monitors

• They have 2 functions
• Heart rate and oxygen saturation monitoring
• Both functions have upper and lower alarm
  settings
• These should always be set according to the care
  plan

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Alarm parameters

• These will be set according to the childs need
• The parameters may revert to factory settings
  when the machine is switched off
• You must be able to check the alarm settings as
  part of this competency

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Important probe information

• Correct size for child/young person
• Compatible with machine in use
• Secured properly
• Ensure it is not near neck as there is an
  accidental strangulation risk

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How it works

• Red and infra-red light pass through a vascular
  bed
• The monitor counts the O2 attached to the
  haemoglobin
• This is shown as a percentage
• It also counts the pulse

14
Attaching the probe

• Light sources must be in direct line
• Although the probe must be secure ensure it is
  not too tight as this can cause-
• pressure sores
• And restrict circulation
• Sight should be changed frequently as childs
  care plan states

15
Tissue damage from probe

• This is not a burn
• This is a pressure sore
• The younger the child the more need for vigilance
  in checking the probe site

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Sites for attaching probes

• Fingers
• Toes
• Feet in very small children
• All sites need to be warm and well perfused if
  not the probe will be unable to accurately
  measure the readings

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Saturation monitoring as a secondary alarm

• All children must have a saturation monitor in
  place whilst being ventilated. If the vent
  alarms fail then the drop in oxygen saturations
  will set the sats alarm off and alert us to the
  problem

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Saturation monitoring during and after oxygen
therapy

• Spot checks will be done regularly
• It is the trends that are most important in the
  care of these children

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Overnight monitoring

• Overnight readings will also be done to see how
  child is coping when asleep
• This also gives a longer and more detailed
  picture of how the child/young person is coping

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Problem solving

• If the probe is letting in light it will give
  false readings, replace the probe
• Probe failure - replace probe
• If taking blood pressures ensure it is on the
  other arm if using the finger as a site
• Nail varnish may affect the readings

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machine maintenance

• Annual PAK testing
• Regular check of the internal battery if
  appropriate
• Spare batteries available for spot check machines
• Individual child to have own probe

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Playtime!!

• Spend some time looking and playing with the
  equipment
• Know how to set the alarm settings
• Know the battery life
• Be familiar with the equipment it is much easier
  doing it now than looking with parents
  watching!!!!!!

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References

• C Simpson 2006An Introduction to Pulse Oximetery
  Tyco Healthcare
• Sidey A, Widdas D 2nd Edition 2005 Textbook of
  Community Childrens Nursing Elsevier Edinburgh .
• Coventry Teaching PCT hand hygiene Policy March
  2006
• 
  Consent to Treatment April 2004
• Essence of Care 2001- Factors 10 record keeping
• 
  11 privacy and dignity
  
• DOH National Service Framework for Children and
  Young People and Maternity Services 2004
  Standard 6,8
• Boosfield B, OToole M (2000) Technology
  Dependent Children Transition From Hospital to
  Home. Paediatric Nursing 12 6.