What CMS Pulse Oximeters Are Used For

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 isn't obvious how a non-invasive instrument can measure with any degree of accuracy something down to the molecular level. Without getting too technical, oximetry works on the principle that different substances absorb light differently. Two different wavelengths of light are passed through the patient and the instrument is able to determine the absorbance, and therefore the concentration, of oxygen in pulsating arterial blood.

While this technology can reveal the oxygen saturation of a person's hemoglobin, it is at best an indirect means of finding out how much actual oxygen is circulating in the bloodstream. To measure this directly, it is necessary to sample the blood passing through the arteries in real time. This involves placing a needle into an artery.

This is a painful and invasive procedure and there needs to be a good reason for collecting this information. Patients who have their arterial blood sampled while they are awake describe the sensation as akin to having a needle stuck directly into their bone. Unfortunately, because one of the circumstances in which this information is important is while a patient is under an anesthetic, so the poor patient has to have the needle inserted while they are still awake.

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 basic forms of sleep apnea; neurological (or central) and obstructive sleep apnea (OSA). Of these, OSA is the more common and the easiest to treat. Some people need surgery to correct an anatomical abnormality, while others are easier to treat with continuous positive airway pressure (CPAP) or wearing an oral device, prescribed by an oral surgeon, while thy sleep.

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.

Although anyone can have any type of sleep apnea, the major risk factors are male gender over the age of 40 and being overweight. Sleep apnea is particularly dangerous in infants, who can stop breathing for as long as twenty seconds. This is a very daunting prospect for new parents. Fortunately, there are apnea alarms available that will alert the parents when a baby stops breathing for a set number of seconds. It is also possible to obtain CMS pulse oximeters for home use.

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