Problem and potential errors | Solution |
Inadequate waveform | |
Malposition of probe | Reposition probe, alternate site |
Motion artifact | Reposition probe, alternate site |
Hypoperfusion | Reposition probe, alternate site, warming |
Hypothermia | Use ear or forehead probe, warming |
Skin pigment | Measure ABG |
Falsely normal or elevated oximetry reading | |
Carboxyhemoglobin (eg, carbon monoxide poisoning) | Co-oximetry |
High levels of glycohemoglobin A1c | Measure ABG |
metHb, sulfHb* | Multiwavelength co-oximetry (metHb), biochemical analysis (sulfHb) |
Ambient light | Remove ambient light source |
Skin pigment | Measure ABG |
Falsely low oximetry reading | |
Inadequate waveform | Reposition probe, alternate site |
metHb* | Multiwavelength co-oximetry |
sulfHb* | Biochemical analysis |
HbS and inherited forms of abnormal Hb | Measure HbS and abnormal Hb levels |
Severe anemia | Measure ABG |
Venous pulsations or congestion | Loosen probe, reposition patient or probe, measure ABG |
Ambient light | Remove ambient light source |
Nail polish | Remove polish or change site |
Vital dyes | Usually transient, measure ABG |
ABG: arterial blood gas; metHb: methemoglobin; sulfHb: sulfhemoglobin; HbS: sickle hemoglobin; Hb: hemoglobin; SpO2: peripheral arterial oxygen saturation; SaO2: true arterial oxygen saturation.
* In these conditions, SpO2 is low; when levels of metHb or sulfHb are mildly elevated, SpO2 underestimates the SaO2, but when levels are high, the SpO2 automatically trends towards 85% such that pulse oximetry can overestimate SaO2.Do you want to add Medilib to your home screen?