Pulse and Pulse Oximetry.pptx

Pulse and Pulse Oximetry Vocabulary and Abbreviations Vocabulary Abbreviations  Arrhythmia-deviations from the normal pattern or rhythm of the heart beat  BPM-Beats Per Minute  Bradycardia-slow but regular heart beat  HR-Heart Rate  Tachycardia-a heart rate over 100 beats a minute...

Pulse and Pulse Oximetry Vocabulary and Abbreviations Vocabulary Abbreviations  Arrhythmia-deviations from the normal pattern or rhythm of the heart beat  BPM-Beats Per Minute  Bradycardia-slow but regular heart beat  HR-Heart Rate  Tachycardia-a heart rate over 100 beats a minute  Cyanotic-marked by or causing a bluish or purplish discoloration (as of the skin and mucous membranes) due to deficient oxygenation of the blood  PMI- point of maximal impulse  SpO2-oxygen saturation reading usually written as a percentage ex. 97%  Auscultation-the action of listening to sounds from the heart, lungs, or other organs, typically with a stethoscope  Palpate-examine (a part of the body) by touch, especially for medical purposes.  Neonate- a newborn child/ infant less than four weeks old  Perfusion-the passage of bodily fluids, such as blood, through the circulatory or lymphatic system to an organ or tissue. Introduction  “Blood pumped into an already full aorta during ventricular contraction creates a fluid wave that travels from the patient's heart to the peripheral arteries. This recurring wave, called a pulse, is palpable at locations on the body where an artery crosses bone or firm tissue. The number of pulsations counted in 1 minute is called the pulse rate.” Lippincott-Pulse assessment, ambulatory care  “Performed intermittently or continuously, oximetry is a relatively simple procedure used to monitor arterial oxygen saturation noninvasively.” Lippincott-Pulse Oximetry Pulse: Adults  Normal pulse rate in adults is 60-100bpm  Radial artery is most common site for palpation of pulse   For Radial pulse Press your index, middle, and ring fingers gently on the patient's radial artery using moderate pressure  excessive pressure may obstruct blood flow distal to the pulse site  Do not use your thumb because you might confuse your own thumb's strong pulse with the patient's pulse Apical pulse requires auscultation   Above: Anatomic locations of pulse points in adult Done using stethoscope at apex of heart Assessing a patient's pulse involves determining the rate (number of beats per minute), rhythm (pattern or regularity of the beats), and amplitude (strength of the pulse) Pulse: Pediatrics  Several sites allow pulse palpation, but optimal location for palpation varies by age  Younger than 2 yrs.-apical pulse  Apical pulse requires auscultation  Identify the site for auscultation by palpating the child's chest wall to locate the PMI of the apical pulse.  In a child younger than age 7, the PMI is located just left of the midclavicular line at the fourth intercostal space.3  In a child age 7 or older, the PMI is located at the left midclavicular line at the fifth intercostal space.3  If the child's pulse is irregular, count pulsations for 1 full minute.  If the child's pulse is regular, count pulsations for 30 seconds and multiply by 2. Pulse: Pediatrics Cont. Normal Heart Rates for Pediatric Age Ranges:  Premature infants: 110 to 170 beats/minute  Infants ages 0 to 6 months: 100 to 160 beats/minute  Infants ages 6 to 12 months: 90 to 160 beats/minute  Children ages 1 to 3 years: 80 to 150 beats/minute  Children ages 3 to 6 years: 70 to 120 beats/minute  Children ages 6 to 12 years: 60 to 110 beats/minute  Children older than age 12: 60 to 100 beats/minute2 Pulse Patterns and Quality Pulse Oximetry: How it Works  Two diodes send red and infrared light through a pulsating arterial vascular bed, like the one in the fingertip. A photodetector slipped over the finger measures the transmitted light as it passes through the vascular bed, detects the relative amount of color absorbed by arterial blood, and calculates the SpO2 level without interference from surrounding venous blood, skin, connective tissue, and bone Pulse Oximetry: Adult  normal SpO2 level for an adult generally ranges from 95% to 100%  Site most commonly used is fingers  Need to note if they are on portable oxygen and what the oxygen flow rate is during documentation  Consider conditions that may affect reading results:  Acute respiratory distress syndrome (ARDS).  Anemia.  Asthma.  Bronchitis.  Chronic obstructive pulmonary disease (COPD).  Congenital heart defects.  Congestive heart failure.  Emphysema.  Raynaud’s Syndrome Pulse Oximetry: Pediatrics  Acceptable oxygen saturation levels vary with the child's gestational age and underlying health condition, but levels greater than 93% are considered acceptable.  The level should be greater than 96% in a healthy child  Preferred sites for probe attachment  for a neonate are foot, hand, or forehead;  for an infant, the great toe, ball of the foot below the toes, forehead, palm of the hand, earlobe, or wrist  for an older child, the index finger, forehead, or earlobe. Things to Consider  Certain factors can interfere with accuracy, including:  Incorrect positioning of the sensor, such as elevation above the heart, which reduces the incidence of venous pulsations  Nail polish  Artificial nails  Recent use of IV dyes  Phototherapy lights  Shivering  Peripheral vasoconstriction  Diaphoresis  Severe anemia  Under-perfusion and cardiac arrest, which can cause hypovolemia, hypotension, and hypothermia Resources   Lippincott  Pulse oximetry  Pulse oximetry, pediatric  Pulse assessment, ambulatory care  Pulse assessment, pediatric, ambulatory care Comprehensive Medical Assisting: Administrative and Clinical Competencies 6th Edition | Copyright 2018  by Wilburta (Billie) Q. Lindh, Marilyn Pooler, Carol D. Tamparo, Barbara M. Dahl, Julie Morris