Measuring Oxygen Saturation with Pulse Oximetry

Key Points

  • Pulse oximetry provides a noninvasive estimate of arterial oxygen saturation.
  • Cold extremities, poor perfusion, nail products, and probe misplacement can create falsely low values.
  • Abnormal readings should be validated with repositioning, site change, and clinical correlation.

Equipment

  • Pulse oximeter with appropriate sensor/probe
  • Optional alternate-site sensor (earlobe or forehead)
  • Hand hygiene supplies

Procedure Steps

  1. Complete routine pre-procedure actions: knock, identify resident, explain procedure, provide privacy, and perform hand hygiene.
  2. Select a warm, well-perfused site; remove nail polish/artificial nail barrier when finger sensor is used.
  3. Apply probe correctly and ensure patient minimizes motion.
  4. Wait for stable waveform/reading according to device guidance before recording value.
  5. If value is unexpectedly low, reassess for artifact causes (cold limb, poor placement, motion, low perfusion) and repeat.
  6. If needed, switch to alternate site (earlobe or forehead) and compare trend.
  7. Correlate reading with respiratory effort, pulse, and overall clinical appearance.
  8. Restore comfort/safety, perform hand hygiene, and document SpO2 with site and any validation steps used.

Common Errors

  • Recording before signal stabilizes unreliable SpO2 value.
  • Ignoring nail product/perfusion artifacts false low interpretation.
  • Treating isolated number without clinical context inappropriate escalation or delay.