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Chapter 10 Pulse CO-Oximetry (SpO2)
Inaccurate SpHb and SpOC readings may be caused by:
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Improper sensor application
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Intravascular dyes such as indocyanine green or methylene blue
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Externally applied coloring and texture such as nail polish, acrylic nails, glitter, etc.
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Elevated PaO2 levels
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Elevated levels of bilirubin
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Low arterial perfusion
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Motion artifact
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Low arterial oxygen saturation levels
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Elevated carboxyhemoglobin levels
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Elevated methemoglobin levels
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Hemoglobinopathies and synthesis disorders such as thalassemias, Hb s, Hb c, sickle
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cell, etcetera
Vasospastic disease such as Raynaud's
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Elevated altitude
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Peripheral vascular disease
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Liver disease
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EMI radiation interference
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Inaccurate SpO2 readings may be caused by:
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Improper sensor application.
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Elevated levels of COHb or MetHb: High levels of COHb or MetHb may occur with a
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seemingly normal SpO2. When elevated levels of COHb or MetHb are suspected,
laboratory analysis (co-Oximetry) of a blood sample should be performed.
Intravascular dyes, such as indocyanine green or methylene blue.
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Externally applied coloring and texture, such as nail polish, acrylic nails, glitter, etc.
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Elevated levels of bilirubin
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Severe anemia
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Low arterial perfusion
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Motion artifact
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Interfering Substances: Dyes or any substance containing dyes that change usual blood
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pigmentation may cause erroneous readings.
The pulse co-oximeter is intended only as an adjunct device in patient assessment. It should
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not be used as the sole basis for diagnosis or therapy decisions. It must be used in
conjunction with clinical signs and symptoms.
The pulse co-oximeter is not an apnea monitor.
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The pulse co-oximeter may be used during defibrillation, but this may affect the accuracy or
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availability of the parameters and measurements.
The pulse co-oximeter may be used during electrocautery, but this may affect the accuracy
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or availability of the parameters and measurements.
The pulse co-oximeter should not be used for arrhythmia analysis
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10-4
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