Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Motion artifact and poor perfusion are the most common sources of SpO2 inaccuracies, which occur because the photoplethysmographic pulse signal is very low in these settings compared with the total absorption signal.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The oxyhemoglobin dissociation curve must be taken into account when interpreting the SpO2. If the curve is in a normal position, then high SpO2 values (96%-98%) represent a PaO2 in the range of 80-100 mm Hg.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The accuracy of pulse oximeters has improved over the years. In critically ill patients with an arterial oxygen saturation (SaO2) >90%, it is now estimated that the mean difference between SpO2 and SaO2 is less than 2%.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The standard pulse oximeter emits two wavelengths of red light (660 nanometers and 940 nanometers) from the light-emitting diode on one side of the probe, through the capillary bed, to a light-detecting photodiode on the other side.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Pulse oximetry targets the signal arising from the arterial bed as light absorbance fluctuates with changing blood volume. Arterial blood flow causes signal changes in light absorption that can be distinguished from venous and capillary blood.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Often considered the “fifth vital sign,” pulse oximetry is one of the most important technologic advances for monitoring patients during anesthesia, in intensive care, on the general ward, in the emergency department and during procedures.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Pulse oximetry is a microprocessor-based measurement that incorporates both oximetry and plethysmography to provide continuous noninvasive monitoring of the oxygen saturation of arterial blood (SpO2).

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In cases of shock, a low ScvO2 (less than 70%) is suggestive of insufficient DO2 and should prompt clinicians to increase DO2. Conversely, a high value of ScvO2 (greater than 80%) is suggestive of altered oxygen extraction capabilities.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Insertion of an arterial catheter has been recommended in patients with shock. In addition to providing real-time accurate measurement of arterial blood pressure, it allows monitoring of pulse pressure variation.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Mottling or prolonged capillary refill time (CRT) is suggestive of low cardiac output with great specificity but low sensitivity. A strategy guided by CRT is better than one based on decrease in blood lactate during early resuscitation of septic shock.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Careful clinical examination should be performed in the early phase of shock, as it can provide useful information about the causative mechanism. Particular attention should be paid to markers of skin perfusion.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Because pulmonary arterial blood blends the mix from all venous territories of the body, measuring mixed venous oxygen saturation (SvO2) with the pulmonary artery catheter enables assessment of global tissue oxygenation.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The pulmonary artery catheter provides hemodynamic variables (RAP, PAP, PAOP and CO) and with tissue perfusion variables such as mixed venous oxygen saturation (SvO2) and the mixed venous carbon dioxide pressure (PvCO2).

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The pulmonary artery catheter's use declined due to (1) insufficient knowledge in measuring/interpreting data, (2) a report showing increased mortality with use, (3) no outcome benefit with use and (4) development of other noninvasive options.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In the 1990s, the pulmonary artery catheter was at its apogee, as it was the only method to assess/monitor hemodynamics. It measures cardiac output, pulmonary artery pressure, cardiac filling pressures and mixed venous blood gases.