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Sendoa Ballesteros. RN, Ph.D
Irrintzi Fernández. RN, Ph.D
Artzai Picón. EngD, Ph.D
Sergio Lorrio. RN, MD
Authors declare no conflict of interest.
INTRODUCTION
We always must removenail polish before
checking pulse oximetry!
Always?
Pulse oximetry is an essential parameter in the clinical assessment of the patient
INTRODUCTIONEmergency
Patient says “NOOO”
Nail polishremover no available
Can we use pulse oximetryon polished nails?
Vade retro! Don’t touchmy nails!
THE AIM OF OUR STUDY
Does nail polish affect oxygen saturation readings
in patients undergoing pulse oximetry?
The PICO question…
METHODS
A PRISMA* based sistematic review. 6 data bases: Medline, WOS, Scopus, IBECS, CINAHL, Embase.
Clinical trials and observational studies. Limits: from 01/1999 to 02/2014. No language limits.
2 independent reviewers. Quality evaluation: AATMC.
* BMJ 2009;339:b2700
Search strategy:oximetry AND nails AND polish
RESULTS
12 non randomised trials. Mild quality.
Volunteers vs patients. Normoxia vs hipoxia. Several models of oxymeters.
RESULTS
Accuracy error <2,0%. Statistically significant differences. Clinically non relevant.
Differences between oxymetermodels: oldest vs newest devices. Clinically non relevant.
DISCUSSION
What physics shows us…
Stationary tissues
Capillary and vonous blood
Arterial blood
Time
DC
AC
LED(R) LED(IR)
Sensor(R) Sensor(IR)
AC component: 5% of signal. A high absorption coefficientdecreases AC component.
CONCLUSIONS
Although nail polish can generate a statisticallysignificant variation on
oxygen saturation readings, this disturb hasn’t got a
clinical relevance.
To use pulse oximeters onpolished fingernails can offera clinically valid reading of
oxygen saturation.
PARTNERSHIPS:
Eskerrik askoThank you
ACKNOWLEDGMENT :
Free full text research will be available at EMERGENCIAS®