Thursday, November 21, 2013

An Explanation Of CMS Pulse Oximeters

By Georgia Diaz


CMS pulse oximeters are the little medical devices that they plug onto your fingertip whenever you go to the Emergency Room or before an operation. Sometimes they put them onto the earlobes. In tiny babies, they use a foot. The purpose of the device is to measure the percentage of hemoglobin that is saturated with oxygen. Generally, this number should always be at 95% or higher.

It really is fascinating that a simple instrument can take a measurement down to the molecular level without being stuck underneath the skin. This isn't the place to go into the smoke and mirrors physics, but it is something to do with absorbing light. Somehow, the machine to which the oximeter is attached can calculate the concentration of oxygen circulating in a patient's arterial blood.

While this is an excellent way of screening sick people from really sick people, a more accurate measurement is obtained by measuring oxygen directly from arterial blood. This is important in places like intensive care units or when a patient is under anesthesia having an operation.

They need a good reason to measure arterial oxygen levels because placing the needle into an artery is very painful to the patient. This is fine if the person is unconscious, as if they were under an anesthetic or unconscious. If they are awake and aware, it feels like someone is plunging a needle directly into bone.

One of the circumstances where pulse oximetry is employed is during sleep studies. These investigations require an overnight stay in the hospital and are done for the purpose of finding out if someone has a condition called sleep apnea. This is when a person periodically stops breathing during the night. At best, they wake up drowsy and fuzzy-headed. At worst, it is a risk factor for life-threatening conditions like heart attack and stroke.

There are two categories of sleep apnea, neurological and obstructive. Obstructive sleep apnea (OSA) is more common than neurological sleep apnea, but no less dangerous. Treatments may include a device that is prescribed by a dentist to keep the mouth partially open at night, continuous positive airway pressure (CPAP) or, in extreme cases, surgery to correct an anatomic deformity that makes the airway unable to open.

The other kind of sleep apnea, neurological or central sleep apnea, is rarer and more serious than OSA. Rather than being unable to breathe, your brain doesn't bother to try. This is usually associated with a serious underlying condition affecting the brain stem, which is the part of the brain that controls breathing. Central sleep apnea may manifest itself alone or alongside OSA.

The biggest risk factors for sleep apnea are being overweight, male gender or being over the age of 40. However, sleep apnea can happen to anybody. Some small babies can stop breathing for as long as 20 seconds, which is very disturbing for already anxious new parents. If a baby is discovered to be at risk for this condition, the parents can obtain an alarm that will alert them if and when this happens. CMS pulse oximeters are also available for use at home.




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