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Pulse Oximetry in Children:
Understanding and Interpreting
Oxygen Saturations.
My name is Hannah
Bellsham-Revell, and
I'm a pediatric cardiologist at
Evelina London
Children's Hospital.
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Normal oxygen saturation
levels by age.
Normal oxygen
saturations are 100%.
But on most monitors, we
will accept over 95%.
Immediately after birth,
there is a period
of adaptation over the
first few minutes of
life with fetal saturations of
50-60% rising to the
90s within minutes.
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Factors that can affect
pulse oximeter
readings in children.
The pulse oximeter works
by sending a beam of
light to a sensor, which
is on the other side,
for example, of a finger.
Anything that interferes with
the passage of light can
affect the readings.
For example, measuring
in a place with
too much subcutaneous tissue
or things like nail varnish.
If the sensor is not directly
opposite the light beam,
this can cause errors.
The current monitors can
cause inaccurate readings in
darker skin tones and may
overestimate the saturations.
Movement can produce
an inaccurate trace,
and the measurement
should be observed
once there is a steady trace.
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Interpretation of desaturation.
Some children with
congenital heart disease
may have lower saturations,
which are normal for them.
If a patient is known to have
congenital heart disease,
read the notes and see what
their normal saturations are.
It's important to
look at whether
the number on the monitor
correlates with a patient.
Clinical assessment of cyanosis
is limited until
they are severe.
If a number is low on a monitor,
it's very important to
corroborate that, and it may be
real even if you don't feel
the child looks cyanotic.
