Oxygen saturation monitoring

Since infection may cause RDS, a sepsis work-up is needed, i.e., WBC with differential, and blood culture. Arterial blood gases and oxygen saturation monitors can be used to evaluate for adequate oxygenation. 

Woodman T, Robertson CS. Jugular venous oxygen saturation monitoring. In Narayan RK, Wilberger JE, Povlishock JT, eds. Neurotrauma. New York, McGraw-Hill, 1996. 

Latronico N, Beindorf AE, Rasulo FA, et al. Limits of intermittent jugular bulb oxygen saturation monitoring in the management of severe head trauma patients. Neurosurgery 2000 46 1131—1138. 

The placement of 12-lead electrocardiographic monitoring is often useful in determining left ventricular capture. In addition, patient monitoring equipment should include an automated blood pressure cuff, the presence of continuous oxygen saturation monitoring, as well as intravascular pressure monitoring, both arterial and venous. 

H. Vohra, A. Modi, and S. Ohri, Does Use of Intra-Operative Cerebral Regional Oxygen Saturation Monitoring during Cardiac Surgery Lead to Improved Clinical Outcomes Interact. Cardiovasc. Thorac. Surg., 9,318 (2009). 

General treatment measures for all STE ACS and high- and intermediate-risk NSTE patients include admission to hospital, oxygen administration (if oxygen saturation is low, less than 90%), continuous multi-lead ST-segment monitoring for arrhythmias and ischemia, frequent measurement of vital signs, bed rest for 12 hours in hemodynamically stable patients, avoidance of Valsalva maneuver (prescribe stool softeners routinely), and pain relief (Fig. 5-3). 

Patients with incomplete responses should contact their health care provider immediately for instructions, while those with a poor response should proceed directly to the emergency department.1 In the emergency department, baseline PEF measurements and oxygen saturation should be monitored. PEF should be monitored before and 15 to 20 minutes after bronchodilator administration. Treatment should be initiated as soon as lung function is assessed (Fig. 11-3). Dosages for emergency department and hospital use of quick relief medications are shown in Table 11-5. 

Monitor patients for hypoxemia. Oxygen saturation should be greater than 90% in adults and greater than 95% in children, pregnant women, and patients with co-existing cardiovascular disease. 

Monitor for changes in pulmonary symptoms such as cough, sputum production, respiratory rate, and oxygen saturation. Symptoms of an acute exacerbation should improve with antibiotics and aggressive airway clearance therapy. Pulmonary function tests should be markedly increased after 1 week and trend back to pre-exacerbation levels after 2 weeks of therapy, ft improvement lags, 3 weeks of therapy may be needed. 

Evlauation Close monitoring of pulmonary status, blood gases (if indicated), oxygen saturation, chest x-ray, blood and sputum cultures, CBC, bronchoscopy with lavage (if needed)... 

Evaluation Close monitoring of vital signs, spleen size, and oxygen saturation, CBC, reticulocyte, and cultures... 

Patients should be educated to recognize the signs and symptoms of complications that would require urgent evaluation. Patients and parents of children with SCD should be educated to read a thermometer properly and to seek immediate medical care when a fever develops or signs of infection occur. With acute illnesses, prompt evaluation is important because deterioration may occur rapidly. Fluid status should be monitored to avoid dehydration or overhydration, both of which may worsen complications of SCD. Patients in acute distress should maintain oxygen saturation at 92% or at their baseline. Any supplemental oxygen requirements should be evaluated.6,27... 

Oxygen saturations can be easily monitored continuously with pulse oximetry. For young children and adults, pulse oximetry, lung auscultation, and observation for supraclavicular retractions is useful. 

In acute exacerbations of COPD, white blood cell count, vital signs, chest x-ray, and changes in frequency of dyspnea, sputum volume, and sputum purulence should be assessed at the onset and throughout the exacerbation. In more severe exacerbations, arterial blood gases and oxygen saturation should also be monitored. 

Invasive continuous hepatic function monitoring by the fluorescence procedure was also evaluated in rabbits [148]. In this study, a commercial catheter equipped with fiber optic technology for mixed venous oxygen saturation measurements (SVO2) was modified to emit light at 780 nm and detect fluorescence at 840 nm. The catheter was placed into the right jugular vein and advanced... 

Monitor the patient s respiratory rate and oxygen saturation continuously during parenteral administration to detect apnea and respiratory depression... 

Docetaxel should be administered the day after trastuzumab for the first cycle because of the potential for infusion-related reactions to trastuzumab, particularly during or after the first administration. Serious adverse reactions to trastuzumab infusion that have been reported infrequently include dyspnoea (shortness of breath), hypotension, wheezing, hypertension, bronchospasm, supraventricular tachyarrhythmia, reduced oxygen saturation, anaphylaxis, respiratory distress and urticaria (itching). The majority of these events occur during or within 2.5 hours of the start of the first infusion. Should an infusion reaction occur, the infusion should be discontinued and the patient monitored until resolution of any observed symptoms - the infusion may be resumed when symptoms abate. If the first cycle is well tolerated then dosing of the drugs in future cycles may occur on the same day. 

Eor inhalation exposures, move the patient to an uncontaminated atmosphere and administer oxygen as indicated. Insure a patent airway. Treat broncho-spasm with inhaled pi agonists and oral or parenteral corticosteroids. Again monitor the level of consciousness, EKG, oxygen saturation, liver, and renal functions carefully. Cardiac sensitization has occurred with other compounds in this class so EKG monitoring should be carried out carefully. Epinephrine or other S-adrenergic agents should be immediately available should arrhythmias occur. 

Monitoring for impending respiratory failure should include continued assessment of the adequacy of gag and cough reflexes, oxygen saturation, vital capacity and inspiratory force. Control of oropharyngeal secretions is essential. Patients at risk for hypoventilation usually develop airway obstruction or aspiration. In patients with botulism, deterioration of respiratory function is an indication for controlled, anticipatory ventilation. The proportion of patients requiring mechanical ventilation has varied from 20% in a food-borne outbreak to 60% in infant botulism. 

Every patient must be properly monitored with pulse oximetry and electrocardiography (EGG). Even if the peel is done by the book and even when the simplest and least aggressive techniques are used, stress can cause vagal reactions, low blood pressure and tachycardia. Pulse oximeter monitoring can pick up on any drop in oxygen saturation that could accentuate myocardial irritability and cause arrhythmias. 

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