The Clinical and Laboratory Standards Institute (CLSI) recently published 'Pulse oximetry; approved guideline-second edition' (POCT11-A2).
Pulse oximetry is a widely used device for the clinical assessment of arterial oxygenation and pulse rate, and its clinical applications, quality assessment and limitations are discussed in this guideline.
The ease of use, noninvasive nature and low cost associated with pulse oximeters have resulted in their widespread use in diverse clinical settings by a variety of medical personnel, including physicians, nurses, respiratory care practitioners and therapists, paramedics and other allied health personnel.
These groups, as well as clinical equipment services managers and technicians, comprise the intended audience for POCT11, the primary focus of which is to provide guidance on the medical use of pulse-oximetry devices.
POCT11 is a revision of the original document, 'HS03-A-Pulse oximetry; approved guideline', which was published in 2005.
Its revision was prompted by expressions of concern regarding the general lack of basic understanding by caregivers of the related physiology, technical operation and limitations of pulse oximetry.
In an effort to limit this shortcoming, the guideline now addresses standard precautions, pulse CO-oximetry, data trending, device interfaces, and patent ductus arteriosus and intercardiac shunt detection.
New additions to the guideline also include illustrations of a revised depiction of the schematic representation of light transmission through tissue, transmittance and reflectance sensors, and a pulse-oximetry plethysmograph tracing.
The elements in the guideline are organised according to the path of workflow - decisions that need to be made before initiating monitoring; concerns during monitoring; interpretation of the data; and information management.
Considerations that should accompany use of these instruments, including a thorough summary of the limitations of existing technology, have also been outlined.
The inclusion of such details reflects the importance of pulse oximetry as a tool for monitoring patient oxygen status and pulse rate, and POCT11 will assist healthcare professionals in the comprehension of its maximum clinical value.
