Thread Closed 
Comparing Oximeters - I should have known better...
Author Message
DocWils Offline

Members-b

Posts: 1,271
Joined: Jul 2012

Machine: Philips Remstar series 60
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10
Humidifier: same as machine
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Switzerland

Post: #11
RE: Comparing Oximeters - I should have known better...
Tim, if your bp varies more than 10% between arms, it could indicate circulatory problems and is an early indicator of heart problems, if you are consistently reading a more than 10% variance between arms. However a single reading is not enough for that - you need to read each arm several times in succession, alternating, to determine that, since your bp rises and falls quit a a lot a quickly, so the average on each side is what counts. Also sit up straight, let your legs relax outward in front of you, and don't talk or move during the reading. If you have a wrist cuff, it is essential not to move the arm at all, as the wrist cuff picks up stray vibrations and can be less accurate than an arm cuff, giving false indications of cardiac disturbances and the like.

PulseOxymeters are less sensitive to that variance, but the sensor is designed to penetrate only so much skin, so callouses, scars and the like can throw it off, as can finger thickness, which is a reason to try on various fingers, starting with the third finger, which is generally slightly less thick than the index, due to less use (unless you are a guitarist or a piano player).
02-03-2013 09:38 PM
Find all posts by this user

Donate to Apnea Board
2Tim215 Offline

Preferred Members-2

Posts: 283
Joined: Oct 2012

Machine: S9 ResMed AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Swift FX Nasal Pillow - Medium
Humidifier: ResMed H5i w/Climate Hose
CPAP Pressure: 6cm-12cm
CPAP Software: ResScan SleepyHead

Other Comments: OSA, Fibromyalgia, Rheumatoid Arthritis, Osteoarthritis, Gout, PTSD, & Meralgia paresthetica.

Sex: Male
Location: Finger Lakes Region, NY

Post: #12
RE: Comparing Oximeters - I should have known better...
(02-03-2013 09:38 PM)wilorg Wrote:  Tim, if your bp varies more than 10% between arms, it could indicate circulatory problems and is an early indicator of heart problems, if you are consistently reading a more than 10% variance between arms. However a single reading is not enough for that - you need to read each arm several times in succession, alternating, to determine that, since your bp rises and falls quit a a lot a quickly, so the average on each side is what counts. Also sit up straight, let your legs relax outward in front of you, and don't talk or move during the reading. If you have a wrist cuff, it is essential not to move the arm at all, as the wrist cuff picks up stray vibrations and can be less accurate than an arm cuff, giving false indications of cardiac disturbances and the like.

PulseOxymeters are less sensitive to that variance, but the sensor is designed to penetrate only so much skin, so callouses, scars and the like can throw it off, as can finger thickness, which is a reason to try on various fingers, starting with the third finger, which is generally slightly less thick than the index, due to less use (unless you are a guitarist or a piano player).
Thank you, I appreciate the information. I haven't done repeated testing of each arm so could be as you suggested a single reading wouldn't be enough. I will check more in the future and see what I get. Thanks again!

Tim
Finger Lakes Region, NY
02-04-2013 09:38 PM
Find all posts by this user
DocWils Offline

Members-b

Posts: 1,271
Joined: Jul 2012

Machine: Philips Remstar series 60
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10
Humidifier: same as machine
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Switzerland

Post: #13
RE: Comparing Oximeters - I should have known better...
Yeah, there are all sorts of tips for bp readings - if it seems high at first, take a deep breath in through your nose and let it out slowly from your mouth, that will bring it down by relaxing you and removing some of the stressers that may have raised it temporarily. If you take it with your legs crossed or tucked under, it will raise the bp. If you see some unusual readings, take it three time alternating arms over a five minute period and check the averages. Sometimes you may need to take them even more until the readings make sense, since you could have been stressed, just sitting down (or up) or other factors that throw it off. So your heart needs to calm down, etc. If you laugh or sneeze or suppress a cough (or cough) you can pump up your systolic. If you just ate something salty, your diastolic goes up fast. That is why we prefer to take readings when the patient is sitting calmly for a bit and not just when they sit down.

Getting back to PulsOxs, your sO2 sats will vary over the period of a minute or two as well, affected by many factors, and most of the display type PulsOxs need to be taped on if you want to record at night, as they can easily slip and lose their ideal position. It is not uncommon to see sudden drops to 0 over a five second period, nothing to be alarmed about - any movement or noise will return a null reading, tapping the finger, bending it, sliding it along the bed sheet, banging it against the other fingers, so don't worry about those sudden down spikes. Worry only if if the overall trend is downwards. 0 readings are only possible if you are dead, so when they return them, it is just noise and nothing else. A lot of recordings will show that repeating all over the course of the night - just ignore it, so long as you can see the general trend between safe and unsafe levels.

How to tape on a PulseOx -tape some elastic tape (Fixomul is good type, and preferred here, but Johsnon&Johnson make some nice tapes for this purpose) And attach one end to the underside of the device - get the device comfortably seated on the finger and ensure good clear readings, then affix the remaining side of the tape to the underside of the finger it should cover a good half of the finger and the complete width of the device. Some do a complete taping around the finger and device, I have never found it necessary - the idea is to keep it anchored in one place, and the underside tape is enough normally to do that. Don't tape on the top side, you'll leave a messy tape residue on the display. If you don't anchor the device, it will slide off in the night or move sufficiently to return distorted readings. This isn't a problem for sleeve type PulseOxs....
(This post was last modified: 02-04-2013 10:30 PM by DocWils.)
02-04-2013 10:26 PM
Find all posts by this user

Donate to Apnea Board
Moriarty Offline

Advisory Members

Posts: 270
Joined: Jul 2012

Machine: Respironics REMStar 50 Series Auto
Mask Type: Nasal pillows
Mask Make & Model: Fisher & Pakel Pilairo Q
Humidifier: Respironics System One
CPAP Pressure: 8.5-20 (average 9.4)
CPAP Software: SleepyHead

Other Comments: Image above is my CPAP machine...

Sex: Male
Location: Toowoomba - Qld - Australia

Post: #14
RE: Comparing Oximeters - I should have known better...
Good stuff wilorg...

I have difficulty getting consistent BP readings from my automatic BP gauge because I have occasional Ventricular Ectopics (whatever that is) The effect is to miss a pulse occasionally then cop a big one for the next beat. The BP gauge sees the missed beat as the loss of the flow and registers that giving me occasionally ridiculous readings like 105/75. My actual BP is more like 135/75. The machine is 100% consistent for Mrs Moriarty but has wild fluctuations for me.

Obviously the machine doesn't have the intuition of a living breathing Doctor when deciding the points although it does have the decency to flash up a broken heart symbol to tell me that my pulse is too irregular for it to read reliably.
02-05-2013 10:39 PM
Find all posts by this user
DocWils Offline

Members-b

Posts: 1,271
Joined: Jul 2012

Machine: Philips Remstar series 60
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10
Humidifier: same as machine
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Switzerland

Post: #15
RE: Comparing Oximeters - I should have known better...
Thanks Moriarty.

Are you using an arm cuff or a wrist cuff?

I had a discussion the other day with some fellow medi-types, about the loss of a necessary skill when using these modern cuffs. In the older days, listening to the pulse helped in a lot of ways in diagnosis - alas, these machines can't judge if a pulse is thready, strong, skipping a beat for a specific reason, etc. If you have good ears and a good "nose", using a traditional sphygmomanometer and stethoscope is far better a diagnostic tool, because you get way more information. One colleague sighed that although he has this skill still, his daughter, who is now joining him in private practice, has never learned it. He is sitting in on some sessions with her and teaching her, as he also believes it is a necessary diagnostic skill that is being eroded by modern machinery. I agree - we are all to happy to embrace every modern tool, but we lose some very special skill sets in the process...

Wrist cuffs tend be less accurate than arm cuffs, because they are more sensitive to any movement of the arm or body, and the microphones are less protected from outside noise. So some conditions won't read right at all, but if you are consistently 135/75, you are in good nick, nothing to worry about there. VEBs can be benign, so unless your doc says otherwise, don't worry about it - avoid cold medicines and cigarettes, or too much caffeine, they can exacerbate it, and you will live a long time. If there is evidence of coronary disease, however, your doc will take appropriate action. Usually an Electrocardiogram will tell the doc if he needs to look further or not, and if you are very worried despite that, ask for a stress echo, which will rule out any disease and pinpoint the cause for the VEB if there is one (usually either a wring fault or a thickening of a valve or something else innocuous).
02-06-2013 06:33 AM
Find all posts by this user

Donate to Apnea Board
Moriarty Offline

Advisory Members

Posts: 270
Joined: Jul 2012

Machine: Respironics REMStar 50 Series Auto
Mask Type: Nasal pillows
Mask Make & Model: Fisher & Pakel Pilairo Q
Humidifier: Respironics System One
CPAP Pressure: 8.5-20 (average 9.4)
CPAP Software: SleepyHead

Other Comments: Image above is my CPAP machine...

Sex: Male
Location: Toowoomba - Qld - Australia

Post: #16
RE: Comparing Oximeters - I should have known better...
I'm using an arm cuff of the appropriate size - the unit came with two sizes.

I will be having a Holter Test shortly so more will be clear after that.
02-06-2013 06:41 AM
Find all posts by this user
DocWils Offline

Members-b

Posts: 1,271
Joined: Jul 2012

Machine: Philips Remstar series 60
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10
Humidifier: same as machine
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Switzerland

Post: #17
RE: Comparing Oximeters - I should have known better...
Good luck Moriarty. In most cases what you have is innocuous (and we're not 100% certain why it shows up), but it is worth testing to be sure....
02-06-2013 01:09 PM
Find all posts by this user

Donate to Apnea Board
TorontoCPAPguy Offline

Preferred Members-2

Posts: 143
Joined: May 2012

Machine: S9 Autoset II
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro FFM
Humidifier: H5i; Control III Germicide
CPAP Pressure: 12-20
CPAP Software: ResScan SleepyHead

Other Comments: CMS50EW Oximeter; Everflo Q O2 Concentrator; O2 Analyzer; Climate Control Hose (winter)

Sex: Male
Location: Toronto; Southern USA; etc.

Post: #18
RE: Comparing Oximeters - I should have known better...
As far as I am concerned, the CMS50EW is the best bet - it may cost a bit more, but is USB chargeable with a standard USB cable off your laptop or the included charger and date may be transferred using BlueTooth or USB. It has a rechargeable lithion Polymer battery and it will give you days of nightime recording. It is accurate (when compared to a clinic pulse oximeter) but keep in mind that all of these inexpensive pulse oximeters are prone to variance with vibration. For an accurate stable reading one needs to keep their finger still. I use mine (I have three pulse oximeters, all CMS50E's: the first uses a proprietary USB type cable, the second a standard USB cable and the third BlueTooth). They cost about $125. The Bluetooth Model is the CMS50EW and it works great. In fact, when I am exercising at home I will have one of my laptops (an old one) with Bluetooth sitting on the table in front of my stationary cycle and reading out my pulse and blood oxygen. My Rx is 115 BPM and SpO2 no less than 90%. Clinically, anything less than 89% is respiratory distress. I also have an Accutor III BP meter picked up on eBay for $125 and it is automatic once the cuff is on (I will use blue masking tape to hold it up and together while cycling). It records my BP every 5 minutes and prints out and reads out on the screen, albeit a bit small (That's why I go with the readout printout so that I can see where I have been).

CMS50EW = your best bet

----------------------------------------------------------------------------
Educate, Advocate, Contemplate.
Herein lies personal opinion, no professional advice, which ALL are well advised to seek.
02-11-2013 12:31 AM
Find all posts by this user
Moriarty Offline

Advisory Members

Posts: 270
Joined: Jul 2012

Machine: Respironics REMStar 50 Series Auto
Mask Type: Nasal pillows
Mask Make & Model: Fisher & Pakel Pilairo Q
Humidifier: Respironics System One
CPAP Pressure: 8.5-20 (average 9.4)
CPAP Software: SleepyHead

Other Comments: Image above is my CPAP machine...

Sex: Male
Location: Toowoomba - Qld - Australia

Post: #19
RE: Comparing Oximeters - I should have known better...
(02-11-2013 12:31 AM)TorontoCPAPguy Wrote:  As far as I am concerned, the CMS50EW is the best bet - it may cost a bit more, but is USB chargeable with a standard USB cable off your laptop or the included charger and date may be transferred using BlueTooth or USB. It has a rechargeable lithion Polymer battery and it will give you days of nightime recording.


The CMS50EW looks like my old CMS50D fingertip clamp on oximeter with more bells and whistles.

The CMS50F is a wrist worn device with a slide on fingertip sensor pouch that is, for me anyway, more convenient to use.
(This post was last modified: 02-12-2013 05:54 PM by Moriarty.)
02-11-2013 06:13 PM
Find all posts by this user

Donate to Apnea Board
JJJ Offline

Advisory Members

Posts: 751
Joined: Apr 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Most recent: Wisp, Pilairo, Mirage Vista
Humidifier: ResMed S9 Autoset
CPAP Pressure: 17-20
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: USA 97217

Post: #20
RE: Comparing Oximeters - I should have known better...
(02-11-2013 06:13 PM)Moriarty Wrote:  [quote='TorontoCPAPguy' pid='29198' dateline='1360560671']
As far as I am concerned, the CMS50EW is the best bet - it may cost a bit more, but is USB chargeable with a standard USB cable off your laptop or the included charger and date may be transferred using BlueTooth or USB. It has a rechargeable lithion Polymer battery and it will give you days of nightime recording. /quote]

The CMS50EW looks like my old CMS50D fingertip clamp on oximeter with more bells and whistles.
[link removed] is the manufacturer's web site for all the CMS50xx devices.

JJJ - you must have been posting as I was editing. - Moderator

The link works, but Contec's web site has never heard of a CMS50EW. There's a phone number, but I didn't call. I was only curious if the Bluetooth capability might mean I don't need a Windows computer to get the data into SleepyHead.
02-11-2013 06:35 PM
Find all posts by this user
Thread Closed 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  2015 peer reviewed article comparing a bench test of 11 APAPs robysue 4 328 12-06-2016 07:06 AM
Last Post: cands
  Comparing AHI between CPAP and For Her Beej 11 484 12-04-2016 11:27 AM
Last Post: OpalRose
  Research Article comparing CPAP machines stephennic 0 237 09-10-2016 07:27 AM
Last Post: stephennic
Question What Pulse Oximeters work with SleepyHead? jerod 20 7,599 09-05-2016 05:47 PM
Last Post: Marthajoy7
Gross Pulse Oximeters and Arrhythmias srlevine1 1 387 07-24-2016 09:47 AM
Last Post: Jimsp1
  Trending Oximeters? Brewskie 13 2,144 10-03-2014 12:45 PM
Last Post: PaulaO2
  question about oximeters for detection of apnea john4131 13 2,256 08-12-2014 03:03 PM
Last Post: archangle

Forum Jump:

Who's Online (Complete List)