Table 1.

The challenges facing using pulse oximetry in children and how to overcome them

Problem	Suggested solution
Children have smaller fingers and earlobes	Use specialized sensors designed for pediatric use. These are smaller in size and may include adhesive attachments to secure them properly on the child’s finger, toe, or other appropriate site
Increased risk of movement during monitoring	Ensure careful positioning of the sensor and minimize patient movement during measurement to prevent motion artifacts that could affect the accuracy of pulse oximetry readings
Variation in skin pigmentation	Be aware that darker skin tones can absorb more light, potentially leading to lower readings. If necessary, consider appropriate adjustments or alternative monitoring sites to account for skin pigmentation differences
Lower peripheral perfusion in pediatric patients	Choose a monitoring site with better perfusion or use pulse oximetry in conjunction with clinical assessment to ensure accurate monitoring, especially in neonates and infants
Specific calibration settings for pediatric oximeters	Ensure that pulse oximeters used in pediatric settings are appropriately calibrated to obtain accurate readings, with calibration settings tailored to the age and size of the patient population
Consideration of clinical factors in interpretation	Contextualize SpO2 readings within the overall clinical picture, considering the child’s age, clinical condition, and baseline oxygen saturation levels for accurate assessment and appropriate intervention

SpO₂: Oxygen saturation.