#ir #peds
Pulse oximetry is a measurement of arterial oxygen saturation or the SPO2. The device
is attached to the child’s finger or ear and uses the differential absorbance of light by
oxygenated hemoglobin compared to deoxygenated hemoglobin. The SPO2 has widely
been accepted as the 5th vital sign. SPO2 is expressed as a percentage, and has been
shown to be superior to the physical sign of cyanosis at detecting low oxygen levels in
the blood.
Sources of error in pulse oximetry include poor perfusion such as in hypothermia,
excessive ambient light, motion, and nail polish/artificial nails. The SPO2 also fails to
detect problems of poor oxygen delivery such as anemia, decreased cardiac output or
hemoglobinopathies. Interestingly, patients with carbon monoxide poisoning will have
normal SPO2 because their hemoglobin is saturated with carbon monoxide and the
device cannot detect a difference.
Trends with Age: SPO2 is lower in the immediate newborn period. Beyond this period,
normal levels are stable with age.
Normal pediatric pulse oximetry (SPO2) values have not yet been firmly established.
Generally, a SPO2 of <92% should be a cause of concern and may suggest a
respiratory disease or cyanotic heart disease.
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Approach to Pediatric Vital Signscially
preterm babies are prone to hypothermia due to an increased body surface area to
body mass ratio and reduced ability to produce heat. In neonates, hypothermia can be
an early indicator of sepsis.
Pulse Oximetry
<span>Pulse oximetry is a measurement of arterial oxygen saturation or the SPO2. The device
is attached to the child’s finger or ear and uses the differential absorbance of light by
oxygenated hemoglobin compared to deoxygenated hemoglobin. The SPO2 has widely
been accepted as the 5th vital sign. SPO2 is expressed as a percentage, and has been
shown to be superior to the physical sign of cyanosis at detecting low oxygen levels in
the blood.
Sources of error in pulse oximetry include poor perfusion such as in hypothermia,
excessive ambient light, motion, and nail polish/artificial nails. The SPO2 also fails to
detect problems of poor oxygen delivery such as anemia, decreased cardiac output or
hemoglobinopathies. Interestingly, patients with carbon monoxide poisoning will have
normal SPO2 because their hemoglobin is saturated with carbon monoxide and the
device cannot detect a difference.
Trends with Age: SPO2 is lower in the immediate newborn period. Beyond this period,
normal levels are stable with age.
Normal pediatric pulse oximetry (SPO2) values have not yet been firmly established.
Generally, a SPO2 of <92% should be a cause of concern and may suggest a
respiratory disease or cyanotic heart disease.
Conclusion
Now let’s review our clinical case – Your patient is a 12-month old boy admitted with
bronchiolitis. His vitals include HR of 120, RR of 36, BP of 85/37, tympa Summary
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