Carer Skills Passport
Standardised Training for parents and carers
Training in Saturation Monitoring
Jenny Bayliss Specialist Nurse
Aims
The Training session in Saturation Monitoring and this information book aims to help parents and carers
1. understand what a saturation machine is
2. understand why, when and how a saturation machine is used
3. know what to do if you are concerned or unsure
4. know how to look after the saturation machine
What is Saturation Monitoring?
Checking the amount of oxygen in your child's blood by using a sensor
The sensor rests on the surface of the skin and a light shines onto the skin – from this we can tell how much oxygen is in the blood
Saturation monitors are also known as:
Sats monitor
Oxygen saturation monitor Pulse oximeter
And can be written as SAO2 They all mean the same
Different machines
As with all machines there are different makes of saturation machines and the newer and older models differ slightly. They do the same thing which is measure oxygen saturations and the heart rate.
Different cables and sensors
There are also different cables and sensors which will usually have the same connectors to use on various machines. The right one for your child or the young person will be chosen for them and ordered. You will be told where the replacements can be ordered from before you are discharged home from hospital.
What do the numbers mean?
Normal oxygen levels in the blood are around 96-100%.
In those living with a long term condition, these 'usual' oxygen levels can be lower and it's worth remembering that we are all different and will have different saturation levels.
The childs specific oxygen saturations should be written in their care plan as a range and will say what to do if they go lower and have other symptoms. A health care professional should
Care with a Holistic Approach?
Holistic means whole, it is part of the assessment of the child or young person, and it means looking at the child as a 'whole'. For example, if a child is uncomfortable in their position their oxygen saturations might drop because they're becoming unsettled and this can sometimes change their breathing.
If a child can't tell you, you need to be able to think about what it could be. It doesn't always mean they are unwell at that time, they might be unhappy with something which they rely on you to change. If you don't carry out a holistic assessment you might never know why the saturations are dropping and the child could become unwell without your help.
Here are some examples of the questions you could ask yourself in assessing the child holistically: How do they look?
Are they trying to tell you something?
What is their environment like? Too hot or too cold? Too noisy or too quiet? Are they under stimulated and bored?
Are they uncomfortable? Do they need a position change? Are their clothes too tight or rubbing? How do they look?
What's their colour like? Rosy cheeks or pale? Are their lips pink or turning grey/blue?
Do they appear happy or sad? Are they smiling or crying or grimacing (pulling an unsettled face)? Are they becoming unwell? Do they have a temperature? What are their secretions like? Have they had their bowels opened?
Do they need to be assessed by a doctor? This all part of your assessment
Words you may hear
Well perfused means the child has a good amount of oxygen circulating in their blood, their skin and lips are usually pink or their usual colour. Their hands and feet are usually warmer to touch (unless they usually have cool hands and feet). Their saturations will be 'normal' here (normal for them) and within their usual range. Take note of how they usually are when they are well, in their colour, usual saturations and their behaviour so that you can pick up on any changes quickly.
Cyanosis is the opposite of being well perfused, and it means there is not enough oxygen going around the child's body. If the child is having their saturations recorded they will have dropped out of their normal range. The first signs are usually pale skin and they can have a blue tinge to their lips. See the pictures below. In children with a darker complexion it can be harder to see but you will get to know how your child or the child you look after becomes when they need some help. They can be cool to touch but can also feel clammy. You need to respond quickly to these signs without panicking.
You will be trained in what your child needs you to do so will be properly equipped to deal with this so don't worry!
Also, remember to do your holistic assessment!
How to use the Saturation Monitor (please note all models are different)
1. Turn on by pressing the On/standby button
2. All of the lights on the front of the machine should light up. This tests the machine before you start
3. You will hear a beep when the test has finished and the machine is ready to use
4. The correct probe/sensor for the child's size needs to be attached to the lead and positioned on the child securely
Using the Probe/sensor and the saturation machine
1. The sensor will have been chosen for your child by a nurse. This is chosen depending on their size and how sensitive their skin is and sometimes how wriggly they are
2. You will be shown how to place the sensor on your child and will get to know which place and position suits them best. Sensors can be placed on fingers, thumbs and toes, feet and ears depending on which sensor you use. They can be disposable which are an adhesive like a plaster, or the non-disposable sensors are clips. Make sure the sensor is positioned well with the light opposite the sensor. See the pictures below
3. If the sensor is to be worn all of the time it may need to be moved to a different area every 1-4 hours depending on the child. Some people can be sensitive to the sensor and can become sore. You should always check the skin as pressure sores can develop which is a potential area for infection and can lead to other problems
4. Make sure the probe is not too tight
5. You need to allow 5 minutes for the sensor to settle into place to make sure it's working. Check the pulse corresponds with the pulse wave - you will get used to checking this
6. Be mindful that nail varnish, soiling, cold circulation can stop the saturation monitor from working properly
7. Movement and positional changes can effect the saturation machine from working
Maintaining the saturation machine
The saturation machine needs to be calibrated (checked by the manufacturer) every year. The parent needs to arrange this
Clean the machine with a damp cloth weekly
Clean the clip on the sensor with a damp cloth weekly, sooner if becomes dirty. Change the disposable sensor weekly, sooner if needed
Faults should be reported to the manufacturer immediately to make sure it is working accurately
Always remember your holistic assessment and to assess your child without the machine because sometimes equipment can fail so trust your judgement and remember what you've learned. GET HELP IF YOU ARE UNSURE!!
If ever you have questions or feel out of your depth ask a health care professional. Never practice outside your limitations.