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Pulse Oximetry
• A noninvasive, pain-free way of measuring
the oxygen in a person's blood
• Pulse oximeters are used routinely, from
during regular physicals to surgery
• Pulse ox is often called the 5th vital sign
• Involves Pulmonary, Critical Care & Sleep
Medicine, Internal Medicine Photo by Getty Images

Related Specialists Overview

Pulse oximetry is a term that frequently appears online and in news
reports in connection with COVID-19. But what, exactly, is it?

Basically, pulse oximetry is a painless, noninvasive method of

measuring the saturation of oxygen in a person’s blood.

Oxygen saturation is a crucial measure of how well the lungs are

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Jane ha e blood vessels called capillaries. In turn, these capillaries send oxygen-
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rest of the body. Our organs need a constant supply of oxygen to
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work properly. When the capacity of the lungs to transport oxygen
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potentially putting our organs in danger. A pulse oximeter can quickly
detect this drop in oxygen saturation, alerting people of the need for
medical intervention.

If you have ever had a physical or visited a doctor for a medical

procedure, you’ve had your blood oxygen saturation measured by a
pulse oximeter. More recently, the spread of COVID-19, which can
cause significant drops in blood oxygen saturation, has spurred a
surge in the popularity of at-home pulse oximeters. (Some people
who are worried they may have—or fear contracting—COVID-19, have
purchased pulse oximeters with the aim of monitoring their blood
oxygen levels.)

“It’s important to remember that not all changes in pulse oximetry are
related to COVID-19,” says Denyse Lutchmansingh, MD, a Yale
Medicine pulmonologist. “Other lung-related issues, such as
pneumonia and blood clots, can also result in low readings on pulse
oximetry. Thus, persistently low readings should be discussed with a
doctor.”

How does pulse oximetry work?

A small, electronic device called a pulse oximeter is clipped onto a
part of the body, usually a fingertip. The device emits light that passes
through the fingernail, skin, tissue, and blood. On the other side of the
finger, a sensor detects and measures the amount of light that passes
through the finger without getting absorbed by the tissue and blood.
Using that measurement, the device calculates the oxygen saturation
of the blood.

What are the pros and cons of

pulse oximeters?
Pulse oximetry offers many advantages over traditional methods of
measuring blood oxygen levels. Whereas traditional methods usually
involve drawing a sample of arterial blood—a potentially painful
experience for patients that requires around 15 minutes, at minimum,
to analyze blood samples—pulse oximetry is noninvasive and provides
near-immediate readings. What’s more, pulse oximeters can be used
continuously and, therefore, can provide long-term monitoring of a
person’s blood oxygen levels.

At the same time, pulse oximetry is less precise than conventional

methods, such as arterial blood gas testing. Also, it does not provide
as much information on other blood gases (e.g., carbon dioxide) as do
tests that directly measure the blood.

When should pulse oximeters be

used?
Today, pulse oximeters are used across a broad range of health care
settings. In general practice, they are frequently used to quickly assess
someone's general health, for instance, during a routine physical
examination. In fact, pulse oximeters have become so widespread that
blood oxygen saturation is often referred to as the “fifth vital sign,” a
piece of data collected alongside four other measurements—
temperature, blood pressure, pulse, and respiration rate—to gain
insight into a person’s health status.

Outside of general practice, pulse oximetry is most frequently used to

monitor patients with lung and heart disorders, who are at risk of low
levels of blood oxygen. In clinical settings, they are routinely used in
the following situations:

• To monitor patients before, during, and after surgery, including

during anesthesia

• To monitor patients on certain medications that may reduce

respiration and lung function

• To assess the lung function of people with conditions that can

cause reduction of blood oxygen levels, including COPD, asthma,
acute respiratory distress syndrome (ARDS), anemia, pneumonia,
lung cancer, cardiac arrest, and heart failure, among others

• To assess individuals with sleep disorders such as sleep apnea

When pulse oximeters are used at home, it has usually been by people
with known lung conditions, who may regularly monitor their blood
oxygen saturation levels with guidance from their doctors.

What do certain pulse oximeter

readings mean?
A resting oxygen saturation level between 95% and 100% is regarded
as normal for a healthy person at sea level. At higher elevations,
oxygen saturation levels may be slightly lower. People should contact
a health care provider if their oxygen saturation readings drop below
92%, as it may be a sign of hypoxia, a condition in which not enough
oxygen reaches the body’s tissues. If blood oxygen saturation levels
fall to 88% or lower, seek immediate medical attention, says Dr.
Lutchmansingh.

Note that for people with known lung disorders such as COPD, resting
oxygen saturation levels below the normal range are usually
considered acceptable. A physician can provide details on appropriate
oxygen saturation levels for specific medical conditions.

How accurate are pulse oximeter

readings?
Most pulse oximeters are accurate to within 2% to 4% of the actual
blood oxygen saturation level. This means that a pulse oximeter
reading may be anywhere from 2% to 4% higher or lower than the
actual oxygen level in arterial blood.

A number of factors can impair the functioning or accuracy of a pulse

oximeter. Nail polish and artificial nails may block the red and infrared
light emitted by the device. Certain dyes used for diagnostic tests or
medical procedures can also hinder light transmission. Excessive
motion—shivering, shaking, or other movement—can also cause
erroneous readings.

Skin temparture and thickness can also reduce the accuracy of pulse
pulse oximeters, and whether a person smokes tobacco can affect the
device’s accuracy. Pulse oximetry can be less accurate for people who
have dark skin pigmentation. Recent evidence suggests that pulse
oximetry more frequently fails to detect hypoxemia—low blood
oxygen levels—in Black patients as compared to white patients.
Related Fact Sheets

Condition Condition

Long COVID (Post-Acute Sequelae of SARS
CoV-2 infection, PASC)
Long COVID occurs when symptoms—new, continuing,
or recurrent—arise four or more weeks after the initial
coronavirus infection.
Acute Respiratory Distress Syndrome (ARDS)
ARDS is a potentially fatal form of respiratory failure
characterized by low blood oxygen levels. Learn about
symptoms and treatment.

Condition Condition

Chronic Obstructive Pulmonary Disease (COPD) Pediatric Respiratory Failure

Chronic obstructive pulmonary disease (COPD) is a Pediatric acute respiratory failure is an emergency. It can
disorder characterized by persistent obstruction to be serious, even life-threatening, but most children
airflow through the lungs. recover without chronic illness.

Related Clinical Trials

Diseases of the Respiratory Systems

A Study to Evaluate the Efficacy and Safety of Recombinant Human Pentraxin-2 (rhPTX-2; PRM-151) in
Participants With Idiopathic Pulmonary Fibrosis (STARSCAPE)

Ages 40 years - 85 years

Gender Both
Date 06/14/2022

COVID-19 Inpatient, COVID-19 Outpatient

A Study of LAM-002A for the Prevention of Progression of COVID-19

Ages 18 years and older

Gender Both
Date 07/20/2020

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