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What is a pulse oximeter?
Before the advent of the pulse oximeter, assessing arterial oxyhemoglobin saturation required the use of expensive blood-gas analyzers and invasive sampling of arterial blood [1,5]. Although blood-gas analyzers still can be used nowadays, the standard method of measuring oxygen saturation has been greatly changed and improved by pulse oximeter.
Generally speaking, a pulse oximeter such as OctiveTech 300C is a medical device that is used for non-invasively measuring oxygen saturation in a patient's blood, as one of the indices of the patient's medical condition, either continuously or intermittently. The invention of the pulse oximeter made the oxygen saturation measurement much more efficient and convenient.
How does a pulse oximeter work?
A typical pulse oximeter shines a pair of small light-emitting diodes(LED) facing a photodiode through a translucent part of the patient's body, usually a fingertip or an earlobe. One LED is red, with wavelength of 660 nm, and the other is infrared, 905, 910, or 940 nm. Absorption at these wavelengths is significantly different between oxyhemoglobin and deoxyhemoglobin, therefore the oxyhemoglobin/deoxyhemoglobin ratio can be calculated from the ratio of the absorption of the red and infrared lights. [2]
The monitored signal bounces in time with the heart beat because the arterial blood vessels expand and contract with each heartbeat. By assessing only the varying part of the absorption spectrum (basically, subtracting minimum absorption from peak absorption), a monitor ignores factors caused by other tissues, such as venous blood, skin, bone, muscle, fat, etc. and even (in most cases) fingernail polish and discerns only the absorption caused by arterial blood. Thus, detecting a pulse is necessary to the operation of a pulse oximeter or the oximeter will not function. [2, 3, 4]
Due to the simplicity and the speed of measurement (they clip onto a finger and display results within a few seconds), a pulse oximeter is very important in the settings where the patient's oxygenation is unstable, including emergency, intensive care and recovery settings. They are also very useful for patients with respiratory or cardiac problems and pilots operating in a non-pressurized aircraft above 10,000 feet (12,500 feet in the US), where supplemental oxygen is required. Pulse oximeters are also used in sports industry to provide references for athletes' training and healthcare. Prior to the oximeter's invention, many complicated blood tests were needed to be performed. [2,3,4]
What is normal level of oxygen saturation?
Normally, oxygen saturation level should be between 97% and 99% in a healthy person. An oxygen level over 95% is clinically acceptable. Using the oxyhemoglobin dissociation curve, an oxygen saturation value of 90% is generally equivalent to a PaO2 (arterial partial pressure of oxygen) of 58 mm Hg. [6]
What models can I purchase from www.clinicalguard.com?
ClinicalGuard.com provides various models of fingertip pulse oximeters and hand held pulse oximeters in affordable prices for your selection to satisfy your requirements either in medical condition monitoring or for your personal healthcare. The portable size allows you to monitor your spO2 (percent hemoglobin saturated with oxygen) wherever you want, either in a clinic or at home, whenever you want, either daily use or after sports.
Please check out our website ClinicalGuard.com for detail pulse oximeter specifications for each model.
References:
[1] Grosenbaugh, G.A. and Miur, W.W., 1998, Pulse Oximetry: A practical, efficient monitoring method, Veterinary Medicine, 60-66
[2] Wikipedia, viewed Mar. 2007
[3] Wikipedia, viewed Mar. 2007
[4] Oxford University, Nuffield department of anaesthetics, viewed Mar. 2007
[5] Wikipedia, viewed Mar. 2007
[6] American Association of Criticalcare Nurses, viewed Mar. 2007
Disclaimer:
The information on this website aims to provide customers with relevant knowledge regarding our products. Under no circumstances should the information be used for therapeutic purposes. Customers must consult their doctors for the correct use of these information and products. ClinicalGuard.com is not responsible for any losses or accidents caused by the use of information on this website.
| Hemoglobin / Haemoglobin(Hb) | The iron-containing oxygen-transport metalloprotein in the red blood cells of the blood in vertebrates, consisting of about 6 percent heme and 94 percent globin. |
| Oximeter | A device for measuring the oxygen saturation of arterial blood. |
| Oxyhemoglobin / Oxyhaemoglobin | Oxyhemoglobin is formed during respiration when oxygen binds to the heme component of the protein hemoglobin in red blood cells. |
| PaCO2 | Arterial partial pressure of carbon dioxide |
| PaO2 | Arterial partial pressure of oxygen |
| Pulse Oximeter | A medical device that non-invasively measures the oxygen saturation in a patient's blood and changes in blood volume in the skin by employing a pair of small light-emitting diodes facing a photodiode through a translucent part of the patient's body, usually fingertip or earlobe. See Working principles for fingertip pulse oximeter for details. |
| SpO2 | Blood oxygen saturation |
1. Overview
This document contains an overview of suggested operating parameters for the OctiveTech series of Finger Pulse Oximeters. This document is intended to be a guide only, and should not be used as a substitute for clinical diagnosis performed by a licensed practitioner.
2. Extended Specifications
| Spo2 Measurements | Pulse Rate |
|
Range: 0% - 100% Resolution: 1% |
30-254 BPM Resolution: ±1bpm |
| Accuracy: 80% - 99%, ±2% | Accuracy: ±2bpm or ±2% |
| Accuracy: 70% - 79%, ±3% | Accuracy: 0% - 69%, unspecified |
3. Measurement Interpretation
This section contains a guideline on various levels of blood oxygen and heart rate that are within tolerable ranges.
3.1 Oxygen Saturation
| Measurement | Critical | Notes |
| Spo2 > 95% | N | Normal healthy individual |
| Spo2 91% - 95% | N | Clinically acceptable, but low. Patient may be a smoker, or be unhealthy. |
| Spo2 70% - 90% | Y | Hypoxemia. Unhealthy and unsafe level. |
| Spo2 < 70% | Y | Extreme lack of oxygen, ischemic diseases may occur. The OctiveTech 300-series of Oximeters is not calibrated to detect readings lower than 70%. |
3.2 Resting Pulse Rate
| Measurement | Critical | Notes |
| PR <40 BMP | Y | Below healthy resting heart rates. OctiveTech 300-series does not detect pulse rates lower than 30BMP. |
| PR 40-60 BPM | Y/N | Resting heart rate for sleeping. |
| PR 60-100 BPM | N | Healthy adult resting heartrate. |
| PR 100 BPM 220 BPM | Y | Acceptable if measured during exercise. Not acceptable if resting heartrate. |
| PR > 220 BPM | Y | Abnormally high heart rate. The OctiveTech 300-series does not detect heart rates > 254 BPM. |
Disclaimer:
The information on this website aims to provide customers with relevant knowledge regarding our products. Under no circumstances should the information be used for therapeutic purposes. Customers must consult their doctors for the correct use of these information and products. ClinicalGuard.com is not responsible for any losses or accidents caused by the use of information on this website.
People use nail polish or nail varnish on the nails of fingers and/or toes for cosmetic purposes, or sometimes for the protection of their nails. Artificial nails, such as acrylic nails, serve the same purpose, and occasionally help people kick the bad habit of biting nails. Do these cosmetic products affect pulse oximeter readings? This question is often asked by people who are well manicured and are in need of a pulse oximeter.
Generally speaking, nail polish and acrylic nails do not affect the readings of modern state-of-the-art pulse oximeters. This has been proved by many recent researches. Many published papers can be found on the website National Center for Biotechnology Information which is operated by the National Library of Medicine and the National Institutes of Health in the U.S.A. There are also numerous other resources, either on the Internet or found in published professional magazines, discussing effects of nail polish and acrylic nails to pulse oximeters.
In the early days of pulse oximetry, researchers conducted some trial to verify the effects of nail polish on pulse oximetry. In the tests, a number of adult volunteers had various colors of name brand nail polish applied to their finger nails. Measured data from some commercialized pulse oximeters are analyzed. Cote et al. reported that the reading of SpO2 is significantly lowered by 3% to 6% for those who use blue, green and black nail polish, and then suggested nail polish should be routinely removed before pulse oximetry monitoring. [1] White and Boyle tested several colored nail polishes and agreed with Cote et al.[2] Meanwhile, Rubin [3] also found that a blue color fingernail polish decreased SpO2 from 97% to 87%.
However, with the advance of technology, most pulse oximeters can ignore other tissues or nail polish[4] and discern only the absorption caused by arterial blood by examining only the varying part of the absorption spectrum. [5] Brand et al. tested the effects of colors of enamel nail polish to pulse oximeter readings on 12 healthy nonsmoking normoxic volunteers. The results showed that blue, green and black enamel nail polish which had the most significant impact on pulse oximetry, reported by Cote et al. earlier, does not interfere with pulse oximetry. [4] The test results of Rodden et al. in 2007 also drew a conclusion that fingernail polish did not cause a clinically significant change in pulse oximeter readings in healthy people. This test involved in 27 healthy volunteers with SpO(2)> or =95%. [6]
In reference [7], Hinkelbein et al tested the effect of nail polish on pulse oximeter readings in critically ill patients. Their conclusion is: "Nail polish does not alter pulse oximetry readings in mechanically ventilated patients to a clinically relevant extent. The mean error of measurement for all colours was within the manufacturers' specified range of 2%.", although black, purple and dark blue nail polish had greatest effect on the readings.
With respect to acrylic nail, Hinkelbein et al showed that acrylic finger nails may affect the measurement of oxygen saturation results depending on the pulse oximeter used and may cause significant inaccuracy.[8] On the other hand, a research conducted by Peters [9] demonstrated that unpolished acrylic nails do not affect pulse oximetry measurements of oxygen saturation. Patients may not need to remove unpolished acrylic nails before surgery.
To sum up, most commercialized pulse oximeters are not influenced by enamel nail polish while arguments still exist on the impacts of acrylic nails. However, it is necessary to mention that, while it is not possible to test all illness conditions in the researches, it usually depends on doctors' experience and knowledge to determine the situation of using a pulse oximeter.
References:
[1] Cote CJ, Goldstein EA, Fuchsman NH, Hoaglin DC. The effect of nail polish on pulse oximetry. Anesth Anal 1988; 67:683-686
[2] White PF, Boyle AW. Nail polish and oximetry. Anesth Anal 1989; 68:545-547
[3] Rubin AS. Nail polish color can affect pulse oximeter saturation. Anesthesiology 1988;68(5):825
[4] Brand TM, Brand ME, Jay GD. Enamel nail polish does not interfere with pulse oximetry among normoxic volunteers., J Clin Monit Comput. 2002 Feb;17(2):93-6
[5] Wikipedia, viewed Mar. 2007
[6] Rodden AM, Spicer L, Diaz VA, Steyer TE. Does fingernail polish affect pulse oximeter readings? Intensive Crit Care Nurs. 2007 Feb;23(1):51-5. Epub 2006 Oct 24 [7] Hinkelbein J, Genzwuerker HV, Sogl R, Fiedler F. Effect of nail polish on oxygen saturation determined by pulse oximetry in critically ill patients. Resuscitation. 2007 Jan;72(1):82-91. Epub 2006 Nov 13
[8] Hinkelbein J, Koehler H, Genzwuerker HV, Fiedler F. Artificial acrylic finger nails may alter pulse oximetry measurement. Resuscitation. 2007 Mar 10
[9] Peters SM. The effect of acrylic nails on the measurement of oxygen saturation as determined by pulse oximetry. AANAJ 1997; 65(4):361-363
Non-medical oximeters are sport-versions of pulse oximeters designed to meet the needs of the high altitude performance sports and aviator markets. They often come in the form of the fingertip pulse oximeter used in high-altitude situations and can be relied upon by pilots or anyone working under such environments (i.e. extreme sports and mountain climbing). They are designed to provide correct blood oximetry and pulse rate measurement while in motion. This makes it perfect for pilots, who can receive inaccurate readings from some other oximeters under conditions of high-altitude and motion artifact.
By measuring your saturated blood oxygen content and heart rate you will be able to accurately assess how you are adapting to high altitude. A fingertip pulse oximeter tells you what percent of your hemoglobin molecules are carrying oxygen, commonly referred to as blood oxygen saturation (%SpO2).
At higher altitudes, blood oxygen saturation decreases because of the reduced amount of oxygen in the air.
Digital pulse oximeters measure blood oxygen saturation in a non-invasive fashion by shining red and infrared light through the fingertip and reading the fluctuating signals that are received as a result of fluctuations caused by blood flow.
This fluctuation in red and infrared signals is used to calculate the blood oxygen saturation of hemoglobin.
As a medical guideline, one should never allow one’s saturation level to fall below 10 percentage points under his’ stable home level. For example, if the saturation level at home is normally 97%, adjust the oxygen flow rate so that the level doesn't fall below 87%. A fingertip pulse oximeter can be used to help one determines when to start using supplemental oxygen.
Economical and convenient, a fingertip pulse oximeter is compact and may come either in the clamshell design or the rubber boot design. The user can just insert his finger and to turn it on and the results come in a few seconds. Finger digit pulse oximeters come in various sizes for portability and convenience, depending on the use. Finger digit pulse oximeters, not just promise instant and accurate results, but also carry add-on features.
Digital pulse oximeters are often times the most advanced among the nonmedical oximeters and have the capacity to store up to 99 readings. There are even digital pulse oximeters that are powered to enable up to 1,500 spot checks, can indicate the real signal strength, and are printer-interfaced.
1850's Russian physiologist I.M. Sechenov developed a vacuum blood pump which was laterly used for research purpose. [8]
1864 Sir George Gabriel Stokes, 1st Baronet, an Irish physicist and mathematician, discovered the respiratory function of haemoglobin. [1,2]
1876 Karl von Vierordt, a German physician who developed techniques and tools for the monitoring of blood circulation, used a light source to distinguish fully saturated blood from that which is not. [1,3]
1898 English physiologist Halden brought forward the principle of chemical expulsion of oxygen from its complexes with haemoglobin. J.Barcoft used this principle for the examination of gas composition of blood. [8]
1900 R. Vierordt demonstrated that application of Hufner tourniquet caused a decrease in the intensity of red light passed through a human hand.1922 American biochemist D. van Slyke combined the vacuum and chemical principles of gas expulsion from blood and used them in his manometric appratus.[8]
1932 German physiologist L. Nicolai optically recorded the in vivo oxygen consumption of a hand after circulatory occlusion in Gottingen, Germany. [5]
1935 The first device developed by Carl Matthes to noninvasively measure oxygen saturation in human blood by transilluminating it with coloured light,which employed an ear probe. [1,2,5]
1939 K.Matthews and F. Gross used photometry in examination of the ear auricle. Two-wavelength spectrophotometry was used to avoid the absorption of light by surrounding tissues.
1940's The development of pulese oximeter intensified due to the need of pilots flying at high altitudes in lack pressurized cabins during WW II. This technique saved pilots in the war.[3,5]
1941 Oximetry testing is first used to identify the process of obtaining saturation readings with an pulse oximeter. [1]
1942 E.Goldie used compression of earlobe to obtain "bloodless" reference. [7,8]
1942 G. Millikan and H. Sarre used local heating to arterialize capillary blood.[1,8]
1942 Light reflection oximetry was developed.
1970 Oximetry becomes clinically feasible, after scientists at Hewlett-Packard developed commercial ear oximeter that preferentially measured arterial saturation by heating the tissue to 41 Celcius degree to increase local cutaneous blood flow. [1,4]
1974 Takuo Aoyagi found that arterial oxygen saturation could be measured by quantifying pulsations in the light signals coming through tissue, which made heating the tissue unnecessary. This device was the ancester of most modern pulse oximeters. [4]
1978 William New, MD, PhD invented the prototype for modern pulse oximetry.[6]
1980s Oximeters became smaller in size, easier to apply, and less expensive. [1]
1995 Fingertip oximeters, which are small enough to put a finger in, first appeared on the market. [1]
2000 U.S.A. Medicare accepts physicians' billing for in-office oximeter readings. [1]
References:
[1] Portable Oxygen: A User's Perspective, Viewed May 2007
[2] George Gabriel Strokes, Viewed May 2007
[3] Karl von Vierordt, Viewed May 2007
[4] Pulse oximetry, C Crawford Mechem, MD, FACEP, Viewed May 2007
[5] History of blood gas analysis. VI. Oximetry, Severinghaus JW; Astrup PB, J Clin Monit 1986 Oct;2(4):270-88.
[6] Saving Lives One Breath At A Time, Viewed May 2007
[7] Medical Electronics Lecture, Neil Townsend, Viewed May 2007
[8] The history of oximetry, B.D.Zislin and A.V.Chistyakov, Biomedical Engineering, Vol. 40, No. 1, 2006, pp. 53-56. Translated from Meditsinskaya Tekhnika, Vol. 40, No. 1, 2006, pp. 44-47.
Both OctiveTech 300BH and 300IH hand held pulse oximeter have the capability to download pulse rate and SpO2 data stored in the unit to a computer for detail analysis.
The data transfer procedure is pretty straightforward. The following 5-minute installation guide is provided to walk user through the installation procedure.
























Finger pulse oximeter uses light-emitting diodes (LED) to emit red light and infrared light whose wavelengths are 660nm and 940nm respectively. By calculating the difference of the absorption of the lights in these two wavelengths between oxyhaemoglobin and deoxyhaemoglobin, oxygen saturation of blood can be obtained through a certain algorithm by means of built-in integrated circuits (IC). Hence, it is important to keep the probe clean so that the lights are not blocked by dirt or dusts.
Oil and/or dirt may accumulate over months no matter that the oximeter is used or not. It happens even for a new oximeter, although rarely. If your oximeter is not working accurately or shows error information, you may need to consider a cleaning. You need to use a soft dry clean cloth to clean the inside of the clip, especially near the LED (the light emitters, you can see a beam of red light from one, but no visible light comes from the other). Please note NEVER use water or other liquid to clean the probe because of the concern of corrosion or accumulation of mud.
In this way, you can keep your oximeter long life and have accurate readings. If you unfortunately have your oximeter damaged or dysfunctional, please check out our website http://www.clinicalguard.com to choose a reliable oximeter.
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