Using a Pulse Oximeter

Goal: The patient exhibits arterial blood oxygen saturation within acceptable parameters, or greater than 95%.

1. Review chart for any health problems that would affect the patient’s oxygenation status.

2. Bring necessary equipment to the bedside stand or overbed table.

3. Perform hand hygiene and put on PPE, if indicated.

4. Identify the patient.

5. Close curtains around bed and close the door to the room, if possible. Explain what you are going to do and why you are going to do it to the patient.

6. Select an adequate site for application of the sensor.
a. Use the patient’s index, middle, or ring finger.
b. Check the proximal pulse and capillary refill at the pulse closest to the site.
c. If circulation at the site is inadequate, consider using the earlobe, forehead, or bridge of nose.
d. Use a toe only if lower extremity circulation is not compromised.

7. Select proper equipment:
a. If one finger is too large for the probe, use a smaller one. A pediatric probe may be used for a small adult.
b. Use probes appropriate for patient’s age and size.
c. Check if patient is allergic to adhesive. A nonadhesive finger clip or reflectance sensor is available.
8. Prepare the monitoring site. Cleanse the selected area with the alcohol wipe or disposable cleansing cloth. Allow the area to dry. If necessary, remove nail polish
and artificial nails after checking pulse oximeter’s manufacturer instructions.

9. Apply probe securely to skin. Make sure that the lightemitting sensor and the light-receiving sensor are aligned opposite each other (not necessary to check if placed on forehead or bridge of nose).

10. Connect the sensor probe to the pulse oximeter, turn the oximeter on, and check operation of the equipment (audible beep, fluctuation of bar of light or waveform on face of oximeter).

11. Set alarms on pulse oximeter. Check manufacturer’s alarm limits for high and low pulse rate settings.

12. Check oxygen saturation at regular intervals, as ordered by primary care provider, nursing assessment, and signaled by alarms. Monitor hemoglobin level.

13. Remove sensor on a regular basis and check for skin irritation or signs of pressure (every 2 hours for spring-tension sensor or every 4 hours for adhesive finger or toe sensor).

14. Clean nondisposable sensors according to the manufacturer’s directions. Remove PPE, if used. Perform hand hygiene.