Children's fingers and toes are often too small to properly attach oximeter sensors; therefore, the sensors are often placed
on the sole or the palm. However, no study has determined the precision and accuracy of the pulse oximeter readings at these
different locations. The study was conducted with 50 critically ill children, newborn to 2 years of age, in a tertiary-care
pediatric intensive care unit.
As a control, co-oximeter-measured arterial oxygen saturation (SaO2) was compared with simultaneously obtained pulse oximetry saturations (SpO2). Measurements in the upper extremities (finger and palm) and lower extremities (toe and sole). The median SaO2 was 92% (66% to 100%).
There was a significant difference when the sole and toe were compared and the toe was more accurate. But no significant difference
in bias and precision between the palm and the finger.
However, there was a significant difference in bias precision when the SaO2 was less than 90%, compared with when SaO2 was greater than or equal to 90%, in the sole and palm; but no significant difference in the finger or toe. Pulse oximeter
and sensors were less accurate and precise when used on the sole of the foot or palm of the hand of a child with an SaO2 less than 90%.Sedaghat-Yazdi, F., Torres, A., et al. (2008). Pulse oximeter accuracy and precision affected by sensor location in cyanotic
children. Pediatric Critical Care Medicine, 9(4), 393-397.
Staff Editor: MARTHA K. RAYMOND, RN, BSN, BS
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