Delton Fingertip Oximeter Uživatelský manuál

© World Health Organization, 2011. All rights reserved.Tutorial 2 – AdvancedUsing the Pulse Oximeter1© World Health Organization, 2011. All rights r

© WHO, 2011. What can prevent a pulse oximeter reading accurately?10Write down 5 factors that might stop a pulse oximeter reading accurately.

© WHO, 2011.Answers• Nail varnish or pigment on finger• Bright light on the probe• Patient movement• Poor perfusion• Carbon monoxide poisoning11

© WHO, 2011. Nail varnish12This is picture of nail varnish – why does it interfere with pulse oximetry?The colour can absorb light emitted by the oxi

© WHO, 2011. Here are two patients with henna pigmentation on their fingers13What do you think will happen to the oximeter reading?

© WHO, 2011. 14The oximeter may detect a pulse but is unable to measure SpO2 due to the pigment blocking the signal. Select a toe or ear lobe inste

© WHO, 2011. Bright light15Bright light such as sun light or the operating light on the probe may interfere with the light detector and cause inaccu

© WHO, 2011. Movement16Here is an oximeter attached to a patient. The SpO2is 98% and pulse 72bpm.The trace shows a waveform with a regular pulse.Wha

© WHO, 2011. Movement17Notice the pulse waveform is erratic and not being well detected.This is the same patient but has now started shivering which

© WHO, 2011. How can you check if an oximeter is working?18If you are concerned whether an oximeter is working correctly - how could you check it?

© WHO, 2011. Is the probe working?19Put the probe on your own finger and check it is working!

© WHO, 2011.Pulse oximetry – advancedIn this lesson you will learn about:• Using an oximeter correctly• What can interfere with an oximeter• Maintaini

© WHO, 2011. Perfusion20Oximeters need a flow of blood through the finger to function.Some oximeters give an indication of the blood flow detected.In

© WHO, 2011. Perfusion21Why might this scale be important during anaesthesia?If the blood flow to the finger changes - usually due to peripheral vaso

© WHO, 2011. Carbon monoxide poisoning22Patients involved in fires, or who have inhaled smoke may have significant amounts of Hb combined with carbon

© WHO, 2011. Caring for your oximeter23• Keep the battery fully charged!!

© WHO, 2011. Caring for your oximeter24When the probe gets dirty clean it gently with a damp cloth or alcohol swab

© WHO, 2011. Caring for your oximeter25Position safely to avoid dropping or damage from spillages. Consider connecting to a pole or trolley using th

© WHO, 2011. Caring for your oximeter26When connecting your probe, or the lead, always insert the plug correctly. Check carefully to avoid damage.No

© WHO, 2011. Caring for your oximeter27When disconnecting and connecting probe, grip the plug firmly and not the cable.If the cable is pulled, small

© WHO, 2011. Caring for your oximeter28When disconnecting and connecting probe, grip the plug firmly and not the cable.If the cable is pulled, small

© WHO, 2011. Caring for your oximeter29When not in use, always coil the lead and position the probe where it cannot be damaged.Too tight a coil will

© WHO, 2011.Putting on the probe• The probe should be put on the patient correctly to ensure the oximeter works correctly• The oximeter is supplied wi

© WHO, 2011.What should we do if the patient becomes hypoxic?The next slide describes an action plan to deal with hypoxiaBy using the plan, a logical

© WHO, 2011. Action plan for SpO2< 94%31

© WHO, 2011. What is the normal level of SpO2during anaesthesia?321. 85 - 89%2. 90 - 94%3. 95 - 99%4. 100%Select one answer

© WHO, 2011. What is the normal level of SpO2during anaesthesia?331. 85 - 89%2. 90 - 94%3. 95 - 99%4. 100%Select one answerNormal SpO2is 95% or above

© WHO, 2011. 34All anaesthetists should start to investigate why the SpO2is 94% or below during or after anaesthesia.When the SpO2 falls below 90%, t

© WHO, 2011. When a patient becomes hypoxic during anaesthesia what should we consider?35

© WHO, 2011. When a patient becomes hypoxic during anaesthesia what should we consider?A = AirwayB = BreathingC = CirculationD = DrugsE = EquipmentTh

© WHO, 2011. 37The next few slides will look at each part of the plan in turn and describe how to use itAction plan for SpO2< 94%

© WHO, 2011. Immediate checks38Immediately the SpO2 falls below 95% start to check the patient. ACTION:• Increase the oxygen flow• Ventilate the p

© WHO, 2011. Immediate checks39Always call for help early. Hypoxia worsens rapidly and needs emergency treatment. It is better to call someone unne

© WHO, 2011. What do you think of these two probes?4

© WHO, 2011. 40The next set of actions check ABCDE rapidly. Using the plan will remind you to check everything and manage the patient logically.The t

© WHO, 2011. 41

© WHO, 2011. Airway42The most common cause of hypoxia in theatre is airway obstruction or inadequate breathing!

© WHO, 2011. Breathing43The most common cause of hypoxia in theatre is airway obstruction or inadequate breathing!

© WHO, 2011. Circulation44An inadequate circulation may be caused by a number of factors -Can you write some causes down?

© WHO, 2011. Circulation45An inadequate circulation may be caused by a number of factors - can you write some causes down? Hypovolaemia, cardiac

© WHO, 2011. Circulation46Normally circulation failure presents as a deteriorating pulse signal which the oximeter finds difficult to pick up periphe

© WHO, 2011. Circulation47If no pulse is present –start CPR and diagnose the problem

© WHO, 2011. Drugs48Anaesthesia drugs may cause respiratory depression, muscle weakness or paralysis. A high spinal may cause respiratory failure.

© WHO, 2011. What sort of problems with the anaesthesia equipment might cause hypoxia?49

© WHO, 2011. 5This probe is well positioned on the finger. The finger fits well and the probe is not too tight (which would constrict the circulatio

© WHO, 2011. Equipment 50Check the equipment carefully for leaks and blockages. If a fault is discovered, disconnect the patient and ventilate by ha

© WHO, 2011. Now try to draw the whole plan for treating hypoxia from memory!51

© WHO, 2011. Did you get it correct?If you did – give yourself a round of applause!!52

© WHO, 2011.Summary• Oximeters are essential during anaesthesia• Oximeters and probes need looking after carefully • Certain factors can interfere wit

© WHO, 2011. 6This probe has been put on the large toe and is incorrectly positioned as the toe is too big for the probe. Forcing the probe on to a

© WHO, 2011. Paediatric probes7Paediatric probes are made for small children (less than a year old). Alternatively an adult probe can be tried on th

© WHO, 2011. Ear probes8

© WHO, 2011. Ear probes9Ear probes are made to be used on the ear lobe. In small babies ear probes can be used on the cheek from inside to outside t