Oxygen Therapy and Patient Safety
- Inaccurate pulse oximeter sensors can result in patients getting the wrong treatment.
- These sensors can be identified by The Lightman.
- Quality Improvement - Removing inaccurate sensors from use improves patient safety.
- Accurate sensors reduce costs.
High reading pulse oximetry sensors

These can result in insufficient oxygen therapy and inappropriate management e.g.
- delay in giving oxygen,
- delay in more active management (e.g. intubation, admission to ITU),
- hypoxic tissue damage,
- post operation confusion,
- brain damage (e.g. cerebral palsy, strokes),
- death.
Low reading pulse oximetry sensors
These can result in excessive oxygen therapy and inappropriate management e.g.
- unnecessary clinical tests,
- unnecessary and possibly harmful interventions (e.g. intubation),
- unnecessary admission to ICU,
- retinopathy of prematurity (eye damage/blindness),
- lung tissue damage,
- metabolic disturbances (especially in Chronic Chest Patients leading to
admission to ICU),
- Increased morbidity after strokes and heart attacks.
Conclusions
- The accuracy of a pulse oximeter system is very dependant on the match
between the spectral properties of the sensor and the reference data in the
monitor.
- Spectral errors in the sensor can lead to incorrect high and low SATs
readings.
- High readings can lead to oxygen therapy being deferred or not being
given at all.
- Low readings can lead to excessive oxygen therapy being given.
- Sensors should be tested for accuracy.
- Sensors with local bias greater than +/- 3% should not be used.
- Sensor accuracy can not be determined by
- testing on a human finger,
- testing with a circuit tester or functional tester.
- testing with a simulator.
- Sensor accuracy can only be checked with test equipment with sufficient
optical resolution to determine the accuracy of the sensor - ISO 9919.
- Inaccurate sensors should be identified and removed from use.