SPM 100 Clinical Skills Lab 5 Pulse Oximetry and Cardiac Monitoring Daryl P. Lofaso, M.Ed, RRT

Arterial Blood Gas (ABG) Normal Ranges pH 7.35-7.45 PaCO2 35-45 mmHg PaO2 80-100 mmHg

Oxyhemoglobin Dissociation Curve

Oxygen Transport Dissolved in plasma: Bond to Hemoglobin: (vol % = 0.0031 (ml O2 /100cm3/mmHg) x PaO2 Bond to Hemoglobin: 1.34 ml of O2/g of Hb x g of Hb x g of Hb/100 cm3 x % Saturated

Cyanosis Approximately 5 g/dl of unoxygenated hemoglobin in the capillaries (> 5 gHb / 100ml of blood)

Hypoxemia: Signs and Symptoms Tachycardia Tachypnea Mental Status Changes

Changes in Oxygenation Altitude Hyperbaric Therapy Carbon Monoxide

ECG Monitor Lead Placement

Anatomy of Hearts Electrical System

Basic ECG

Confirmation of Asystole Check lead and cable Monitor power Monitor gain Change leads

Cardiac Assessment Ref: Bates 8ed

Heart Sounds S1: “ lub” occurs at the beginning of systole (mitral and tricuspid close) S2: “dub” marks the start of diastole, (aortic and pulmonic close) S3: (ventricular gallop) early signs of CHF S4: (atrial gallop) pulmonic stenosis, aortic stenosis, hypertension, MI & cardiomyopathy

Professional Conduct Introduce yourself Explain the procedure / examination to the patient Ask the patient if they have any questions Cover the patient with a sheet. Only expose area examining while performing a procedure/examination