ATS Pulmonary Function Laboratory Manual

chapter  17

Post-test Procedure

Post exercise phase

Monitor the patient for 3–5 minutes for adverse symp- toms: • Patient complains of severe chest angina, tightness or wheezing • Lightheadedness, confusion, nausea, ataxia, pallor, etc. • Inappropriate tachycardia (> 160 bpm) May be appropriate to educate the patient on the gen- eral use of O 2 therapy devices.

Reporting of Test Results The physician’s order and pulse-oximeter results obtained should be documented in the medical record with the date and time of measurement. The patient’s position and activity level should be noted. 1. The supplemental O 2 flow rate and delivery device should be documented (8). 2. The type and duration of exercise, and perceived exertion scale should be noted. 3. The oximeter type (if more than one type is available), probe type, and placement should also be noted. 4. The results of ABG analysis and directly measured saturations of O 2 Hb, COHb, and MetHb should be recorded or referenced, if simultaneously measured. 5. The stability of readings, length of observation, and range of fluctuation of readings should be included (8). 6. The clinical appearance of the patient should be included, if significant, including peripheral perfusion, skin temperature, cyanosis and other signs and symptoms (8). 7. Correlation of the heart rate readout on the oximeter with the actual palpated heart rate should be noted, but good agreement with the heart rate does not guarantee valid Sp O 2 results (8, 9). To assure accuracy and consistency of reported results, it is ideal to standardize oximeter types throughout the testing continuum. If various oximeter brands are available in an institution, the same type of device should be used for serial measurements on a patient, since there are differences in accuracy among devices (7). 2. The pulse-oximeter probe should be compatible with the instrument used and the appropriate site used for the probe type. 3. Comply with all manufacturers’ recommendations for patient safety and device application. 4. Pulse oximetry may be used to check for desaturation during exercise (change in Sp O 2 ). Absolute values are less reliable when compared to CO-oximetry values (10, 11). 5. Situations or outside interference may affect pulse-oximeter readings, limit precision or limit the perfor- mance of a pulse-oximeter instrument (8, 9). 5.1. Motion artifact can interfere with pulse oximeter measurements (8, 9, 12–15). Some pulse oximeters are better than others at rejecting motion artifact. Procedure Notes 1.

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