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Radical Signal Extraction Pulse Oximeter Operator’s Manual 25

operation

LOW PERFUSION

The Radical displays an indicator (i.e., “Low Perfusion” message) when there are very low

amplitude arterial pulsations.

It has been suggested that at extremely low perfusion levels, pulse oximeters can measure

peripheral saturation, which may differ from central arterial saturation

. This “localized

hypoxemia” may result from the metabolic demands of other tissues extracting oxygen

proximal to the monitoring site under conditions of sustained peripheral hypoperfusion.

(This may occur even with a pulse rate that correlates with the ECG heart rate.)

CAUTION: IF THE LOW PERFUSION MESSAGE IS FREQUENTLY DISPLAYED, FIND A

BETTER-PERFUSED MONITORING SITE. IN THE INTERIM, ASSESS THE PATIENT

AND, IF INDICATED, VERIFY OXYGENATION STATUS THROUGH OTHER MEANS.

Severinghaus JW, Spellman MJ. Pulse Oximeter Failure Thresholds in Hypotension and

Vasoconstriction.

Anesthesiology

1990; 73:532-537

ACTIONS TO BE TAKEN

If the SpO

readings show significant differences, do the following:

■

Make sure the emitter and photodetector are aligned directly opposite each other.

■

Select a site where the distance between the emitter and photodetector is minimized.

■

Wipe the sensor site with a 70% isopropyl alcohol pad or rubefacient cream (10-

30% methyl salicylate and 2-10% menthol) for 20-30 seconds. Strong vasodilator

creams, such as nitroglycerin paste, are not recommended.

■

If possible, remove electrical noise sources such as electrosurgical units or other

electrical/electronic equipment. If these solutions are not possible, operate the

oximeter on battery power, or try plugging the oximeter into a different electrical outlet.

■

If artificial nails or excessive fingernail polish are present, select another site or

remove the polish/artificial nails.

■

If possible, ensure that the sensor is placed in a location with low ambient light.

Although the Radical Pulse Oximeter with integrated Masimo SET technology has

significant immunity to ambient light, excessive ambient light may cause readings to

be incorrect.

CAUTION: IF ANY MEASUREMENT SEEMS QUESTIONABLE, FIRST CHECK THE

PATIENT

’

S VITAL SIGNS BY ALTERNATE MEANS AND THEN CHECK THE PULSE

OXIMETER FOR PROPER FUNCTIONING.

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