A.
When it is found that the oxygen saturation of the patient directly connected to the ECG cable is reduced, the following aspects should be considered one by one to find the problem.
1. Is the partial pressure of inhaled oxygen too low? When the oxygen content in the inhaled gas is insufficient, the oxygen saturation in the blood may decrease. Patients should be asked whether they have ever been to plateaus above 3000m above sea level, flying at high altitudes, ascent after diving, and poorly ventilated areas based on medical history.
1.Is there airflow obstruction? It is necessary to consider whether there is obstructive hypoventilation caused by diseases such as asthma and COPD, tongue drop, and respiratory secretions.
2.Does the SpO2 sensor have ventilatory dysfunction due to low oxygen saturation? Consider whether the patient has severe pneumonia, severe tuberculosis, diffuse pulmonary fibrosis, pulmonary edema, pulmonary embolism and other diseases that affect ventilation.
3.What is the quality and quantity of Hb that transports oxygen in the blood? The occurrence of abnormal substances such as carbon monoxide poisoning, nitrite poisoning and abnormal hemoglobin increase not only seriously affects the transport of oxygen in the blood, but also seriously affects the release of oxygen.
B.
1.Whether the patient has proper colloid osmotic pressure and blood volume. Proper colloidal osmotic pressure and sufficient blood volume are the key factors to maintain the normal oxygen saturation displayed by the adult finger clip SpO2 sensor.
2.What is the patient’s cardiac output? The amount of oxygen delivered to maintain normal organs should be supported by sufficient cardiac output.
3.Microcirculation of tissues and organs. Whether to maintain proper oxygen is also related to the body’s metabolism. When the body’s metabolism is too high, the oxygen content in venous blood will be significantly reduced, and venous blood will cause more severe hypoxia after shunting the pulmonary circulation.
4.Use the oxygen in the surrounding tissues. Tissue cells can only use free oxygen, and the oxygen combined with Hb can only be released to the tissue for use. Changes in pH, 2,3-DPG, etc. will affect the dissociation of oxygen in Hb.
5. After eliminating all the above factors, please don’t forget that this may be caused by the drop in oxygen saturation caused by the malfunction of the adult finger clamp sensor.
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Post time: Oct-28-2020