blood oxygen saturation

And here we can look at the SF or saturation to FiO2 ratio, and the number we're looking at is three hundred and fifteen or less.

And that's typically when your SpO2 is ninety-seven percent or lower.

And we can also incorporate some ultrasound or lung ultrasound as an imaging modality versus just chest X-ray or CT.

For an intubated patient, Berlin remains really familiar.

That is not why patients die.

Sepsis, shock, multiple organ dysfunction, those are the major reasons that these patients pass away.

And that's why source control, optimization of hemodynamics, and avoidance of VILI really belong in the same conversation, even more so than the SpO2.

All right.

And then for the assessment part, you know, basically that's what have you assessed, and what does that tell you? So again, this is-- I definitely wanna know about the abnormals, but I also wanna know about the normals if they're clinically relevant.

For example, with our pneumonia patient, if their SpO2 is 97% on room air, I wanna know that because that tells me, "Hey, Bob's doing A-okay." I don't just wanna know what is abnormal because sometimes it's really, really clinically relevant to know that something's normal based on their disease condition and whatever is going on with them.

And then the R is for recommendation or, you know, what do you think needs to happen next? What's your plan for the day? At first, probably gonna stumble through this.

Hey, it's okay.

So here's a quick example so you can picture it.

Let's say one of your nursing diagnoses is related to ineffective gas exchange.

In plain English, their SpO2 is low.

So a SMART goal for this might read something like, "By discharge, SpO2 will be greater than 95% on room air." So this is a specific, measurable, attainable Realistic and time-oriented goal tied directly to something you can actually track.

They're 14.

His cardiac index has fallen to below 2 at 1.9, and his SpO2 is down to 51.

So what does this clinical syndrome, what are-- how are you putting these pieces together, and how would you approach this patient, Sami?

So that's a, a, a common story in a patient who had previous, uh, tetralogy repair before and now coming for what we call in cardiac surgery spectrum a simple pulmonary valve replacement, you know?

His, uh, CVP is up.

His PA pressures are up.

Uh, CVP's 19, PA is 24, and SpO2 has dropped to 51 and his sat is 93.

A lot going on there, but if you could kinda comment on what you think this might indicate and how you would work through this situation in this patient.

By 2014, Michael's lung disease developed to the point that he had difficulty catching his breath, and his program had to be modified so that he was working at a lower intensity with much bigger rest periods between efforts.

At around this time, his medical team had concerns that his blood oxygen saturation was dropping too low while he was exercising, and in order to monitor it, he started wearing a finger pulse oximeter on his finger during rest periods.

The guideline was provided that his SpO2 blood oxygen saturation was not allowed to drop below 90 and needed to return to 95 before Michael could be allowed to continue training.

This guideline was proving hard to meet as he was regularly dipping below as low as 80%, which put him at risk for ectopic heartbeats and arrhythmias.

Managing the SpO2 levels became the highest priority, and for the next 12 months, the program was continually modified to scale back to keep his levels above 90%.

work to rest ratios were adjusted and various exercises and workouts styles had to be dropped altogether because of the oxygen cost it was determined that he needed a work rest ratio of no higher than one to five to stay above ninety percent He was also unable to cope with any exercises in combination, so he could do push-ups, rest, and then do pull-ups, but he could not cope with push-ups and pull-ups mixed together.

The majority of his program became strength-based.

He remained strong and during this period actually increased his capacity at bodyweight movements.

And it's important, you know, that the patient is under some kind of monitoring.

I mean, I would always say ECG, SpO2, capnograph and blood pressure, if you can.

And quite often, people haven't thought about this.

So they're either having to take equipment from other rooms to then, you know, to support that patient.

A crucial skill for a CCMA is measuring oxygen saturation using a pulse oximeter.

A normal SpO2 reading is 95% or higher.

The exam loves to test on factors that cause inaccurate readings.

A classic exam trap is a question about a patient with dark nail polish, your cold hands, who has a low reading.

And, uh, got her out of the car, laid her out, got her stable, and I went to my car because I had my entire medical kit right there.

So I had a litter, I had oxygen, I had a heart monitor, I had, uh, the SpO2 system.

So I had her rigged up, covered with a, a blanket, a space blanket, active war- warming to keep her stable.

And, uh, then the ambulance showed up, and they had no clue what was going on.