How CMS Pulse Oximeters Work

By Georgia Diaz


CMS pulse oximeters are medical gadgets that help medical professionals determine, somewhat indirectly, if a patient is getting enough oxygen. The devices clip onto the finger, the earlobes or, in infants, a foot. What they actually measure is the amount of hemoglobin that is fully loaded up with oxygen. In most people, this figure should be at least 95% or more.

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.

They need a good reason to measure arterial oxygen levels because placing the needle into an artery is very painful to the patient. This is fine if the person is unconscious, as if they were under an anesthetic or unconscious. If they are awake and aware, it feels like someone is plunging a needle directly into bone.

A pulse oximeter may also be used for research purposes, for example, during sleeping studies. These investigations are performed when a patient is suspected to have a condition called sleep apnea. People with this type of disorder are unable to breathe, sometimes for dangerously long periods, while they are sleeping. This can result in stroke, heart attack or even death. At best, it can leave people foggy headed and tired the next day.

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.

Anybody can be diagnosed with either form of sleep apnea. The principal risk factors are age over 40, obesity and being male. This is a particularly heart-breaking condition in young babies, who can sometimes stop breathing for periods as long as 20s. This is frightening for new parents. Fortunately, alarms are available that can sound an alert when the baby has an apnea episode. CMS pulse oximeters may also be purchased for use at home for both adult and child use.




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