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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.

The physical principles of how a pulse oximeter works are beyond the scope of this article. It is based on the absorbance of light. By shining light of two different wavelengths into the skin, the instrument can calculate the light absorbance, and hence the concentration of O2 in blood that is circulating in the arteries.

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.

Jamming a needle into an artery, which are by design very thick, is very painful for the patient. Because of this, it is not routinely done unless it is really necessary. The feeling of having a needle pierce into an artery has been compared to having a sharp implement poking directly into a bone.

Pulse oximeters are used a lot in research. Oxygen saturation is one of the parameters that is measured as part of sleeping studies that are investigating whether an individual suffers from sleep apnea, a condition where they stop breathing for brief periods during the night. This is a potentially fatal condition because it can lead to heart attack or stroke. At the very least, it makes people sleepy and unproductive the next morning.

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.

Central, or neurological sleep apnea, is less common and harder to treat than OSA. Instead of stopping the breathing process, the brain doesn't attempt it. There is often a serious condition underlying neurological OSA that affects the brain stem. This is the brain area that is responsible for breathing and heart rate. Neurological sleep apnea can happen by itself or in combination with 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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