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Pulse Oximeter Signal Acquisition in Newborns

April 4, 2014

Pulse Oximeter Signal Acquisition in Newborns

  1. Katherine Bakes, MD

Attaching the pulse oximeter first to the extension cable and then to the infant shortened time to reliable readings.

  1. Katherine Bakes, MD

To achieve pulse oximeter signal acquisition in newborn resuscitations, current guidelines recommend attaching the pulse oximeter sensor first to the newborn and then to the extension cable. In a prospective, randomized trial of newborns ≥28 weeks' gestation born at a neonatal unit in India, investigators compared this method to one wherein the sensor was attached to the extension cable before delivery and was placed onto the newborn's palm or wrist after birth.

Of 149 infants (mean age, 33 weeks' gestation), median time from sensor application to reliable oxygen saturation and heart rate displays was significantly shorter in the oximeter-first group than the infant-first group (10 vs. 16 seconds). A similar time difference was found among the 48 infants who required additional resuscitative efforts (9 vs. 16 seconds). Time from cord clamping to appearance of a reliable signal was similar between groups (approximately 60 seconds). A greater percentage of infants in the infant-first group than in the oximeter-first group required reapplication of the sensor (11% vs. 1%).

Comment

Although it is not clear whether 6 seconds is a clinically significant difference, having equipment set up (including the pulse oximeter attached to the extension cable) in anticipation of delivery results in more-rapid vital sign displays and helps streamline care for an often high-stress emergency department clinical scenario.

  • Disclosures for Katherine Bakes, MD at time of publication Editorial boards Emergency Medicine Secrets

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