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Pulse Oximetry in Delivery Room
O'Donnell CPF, Kamlin COF, Davis PG, et al. Feasibility of and Delay in Obtaining Pulse Oximetry during Neonatal Resuscitation. J Pediatrics (November 2005) 147: 698-99. [Full Text]
Application of the sensor to newly born infants before connection to a pulse oximeter increases the reliability and speed with which data are displayed. Data are available in most infants within 90 seconds of birth. Oximetry may be useful in guiding interventions during resuscitation.
Comments: Like many of you, we are in the process of
equipping our delivery rooms with neonatal monitors for heart rate and oxygen
saturation to aid in newborn resuscitation. This paper provides a great tip
that I did not know: If you attach the pulse oximeter probe to the monitor
first, it will take an average of 41 seconds before you get a reliable
reading. If you attach the probe to the baby first (and then plug it in to
the monitor), you get a reliable reading in only 15 seconds! The reason for
this difference is that the monitor is averaging the signal from before the
baby was connected with the true signal. ABK.
topic: Pulse Oximetry - beware
Date: 13 Mar 2006
Time: 09:01:02
ABK suggests fitting the probe to the baby, and then connecting to the monitor
to obtain a faster reading. I must strongly caution against this approach. A
baby under my care sustained full thickness burns on the foot when a pin bent as
the lead, already on the baby, was connected to the monitor and the probe
shorted out. A freak accident yes, but entirely avoidable by application of the
sound principle of ensuring that equipment is functioning correctly before it is
applied to a patient. I can live with the extra 30 seconds or so.....
UserName: Dr. Peter Reynolds
Institution: Consultant Neonatologist, UK
Date: 26 Apr 2006
Time: 19:28:32
What is the hurry to get a pulse Ox reading to do intervention in the DR. The
fetus lives with a PaO2 of 20 (corresponds to a SaO2 of 70 or so in the
Hemoglobin dissociation curve of Fetal Hemoglobin)the entire 40 weeks and brain
grows fine. PPV for apnea is fine or Chest Compression for HR </= 60 I forsee as
the initial interventions.
UserName: Ravi Agarwal, MD
email: neodoc1@yahoo.com
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