By Georgia Diaz


CMS pulse oximeters are the little medical devices that they plug onto your fingertip whenever you go to the Emergency Room or before an operation. Sometimes they put them onto the earlobes. In tiny babies, they use a foot. The purpose of the device is to measure the percentage of hemoglobin that is saturated with oxygen. Generally, this number should always be at 95% or higher.

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 main types of sleep apnea, obstructive and neurological. Obstructive sleep apnea (OSA) is the more common of the two and is also the easiest to treat. Therapies include surgery, continuous positive airway pressure (CPAP) or prescribing a device that the patient puts in their mouth when they go to bed that helps them to keep their airway open.

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.

The biggest risk factors for sleep apnea are being overweight, male gender or being over the age of 40. However, sleep apnea can happen to anybody. Some small babies can stop breathing for as long as 20 seconds, which is very disturbing for already anxious new parents. If a baby is discovered to be at risk for this condition, the parents can obtain an alarm that will alert them if and when this happens. CMS pulse oximeters are also available for use at home.




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