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Pulse Oximeter

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A Pulse Oximeter is a device for checking how much oxygen is in your blood (Blood Oxygen Saturation or [[SpO2|SpO<sub>2</sub>]]). They work by shining two different colored lights through your finger and seeing how much of each color is absorbed. A healthy person at sea level should have a [[SpO2|SpO<sub>2</sub>]] of 96-99%. A pulse oximeter is primarily used in [[Altitude Training]] or when traveling to altitude, but it is also handy for measuring [[Resting Heart Rate]]. I recommend two Pulse Oximeters – the cheap ($30) Octive Tech CEN and the more expensive CMS-60CIf you have any concerns with possible Sleep Apnea, a pulse oximeter than can record your overnight oxygen saturation may be valuable.  
=Getting an Accurate Reading=
Because a Pulse Oximeter is indirectly measuring [[SpO2|SpO<sub>2</sub>]] via the light traveling through your skin, there are a number of factors that can impact the accuracy of the reading.
* '''Fingernail polish'''. Any polish or covering over the fingernail can create problems for the Pulse Oximeter. If you can use a finger that is clear, that is ideal, but you can twist the Pulse Oximeter sideways to get a reading across the finger rather than down through the nail. * '''Skin color'''. Dark skin pigmentation can result in an over-estimated [[SpO2|SpO<sub>2</sub>]] reading when it the levels are below 80%. Try to find an area of lighter skin color if possible. * '''Movement'''. Any movement tends to disrupt the measurement, so stay as still as possible. Most devices will give some indication of your pulse, and this can be used to check how well it's detecting your oxygen saturation level. * '''Bright lights'''. A good Pulse Oximeter will tend to shield out any external light, but try to keep light levels reasonably low and avoid shining a light onto the Pulse Oximeter. * '''Carbon monoxide poisoning'''. The pulse Oximeter will show the overall saturation of the blood, without telling the difference between oxygen and carbon monoxide.* '''Blood insufficiency'''. Low blood volume, anemia or poor circulation can all cause problems with the reading.
=Positioning the Oximeter=
These pulse oximeters can be positioned on the finger or the toe. While the toe is the most accurate location<ref name="AggarwalDas2010"/> there is a delay in the reading<ref name="Hamber-1999"/> that makes it unsuitable for [[Intermittent Hypoxic Exposure]]. For overnight recording, it would be nice to have an ear lobe based pulse oximeter, but I've not been able to locate one at a reasonable price.
=Recommended Pulse Oximeters=
I have four pulse oximeters that I recommend. There are from CMS; the 500DL is cheapest but has no recording capability, the more expensive 50E and 60C can interface with a PC via USB and will record data, and the really expensive Masimo MightySat will record via Bluetooth to a smartphone. * For travelling to altitude, checking [[Resting Heart Rate]] without any recording capability, get the CMS 500DL.* For [[Altitude Training]] or recording data overnight, get the CMS 50E or CMS 60C.* If you want the best quality consumer grade Pulse Oximeter, consider the Masimo MightySat.==Octive Tech CENCMS 500DL==This is one of the cheapest pulse oximeters I found, and provides the basic functions adequately. It will display current [[SpO2|SpO<sub>2</sub>]] and [[Heart Rate]], and is easy to use. It doesn't have the more advanced features of the CMS-60C or CMS-50E, such as values overnight or interfacing to a computer, but I've found them to be reasonably accurate. I use a similar pulse oximeter to record my [[Resting Heart Rate]] each morning. <html><a hrefjfs id=" B00SCPB9KU" noreferb="http:true"//www>.clinicalguard.comThis pulse oximeter is also available as the CMS 500D (no 'L') that has an alarm for heart rate and/r27/93/1/product_info.phpor oxygen saturation <jfs id=" B00TCWFPZW" targetnoreferb="_blanktrue"/><img src.[[File:CMS 500DL.jpg|center|thumb|300px|The CMS 500DL, a cheap and effective pulse oximeter.]]==CMS-50E=="http://wwwThe CMS-50E is similar to other pulse oximeters, being a compact unit the fits on the fingertip. It provides a full color display, but this may not be so easy to read in bright light as a simple red LED.clinicalguardThis pulse oximeter will record data overnight on its internal storage, which can then be uploaded to a PC for analysis.com/r27/p/93/bannerI created my [[Hypoxic Timer]] software to work with this pulse oximeter, and found it to be a good choice for [[Intermittent Hypoxic Exposure]] training.html" border<jfs id="0B00IWOKTC0" altnoreferb="Fingertip Oximeter Entry Level Octive Tech CENtrue" title/>. There is a CMS-50D+ that may also work with the Hypoxic Timer, but I've not tested it <jfs id="Fingertip Oximeter Entry Level Octive Tech CENB00B8L8ZXE" widthnoreferb="250true"></a></html>.[[File:CMS-50E.jpg|center|thumb|300px|The CMS-50E with USB interface and internal recording.]]
==CMS-60C==
This is The CMS-60C has an unusual form factor, with the fingertip sensor connected to the main body of the device via a significantly more expensive and more sophisticated pulse oximetercable. Unlike most pulse oximeters This reduces the main unit weight on your fingertip, and the fingertip sensor are separatecan reduce motion artifacts a little. I find this makes it much easier to use for [[Altitude Training]] as there is little weight on the fingertip. Like cheaper pulse oximeters, the CMS-50E, the 60C will display current [[SpO2|SpO<sub>2</sub>]] can record data to internal storage and [[Heart Rate]], but it will also record the values uploaded for up to 24 hours. However, the biggest advantage of the CMS-60C is that it will interface analysis to a computer. I have written some custom software, the [[Hypoxic Timer]], that helps record and evaluate [[Intermittent Hypoxic Exposure]] trainingPC. The CMS-60C sensor is also easily replaceable, which is nice. <html><a href="httpUnfortunately, this pulse oximeter is not available from Amazon, only [https://www.clinicalguard.com/r27health-monitors/oximeters/palm-size-cms60c-pulse-oximeter-for-sleep-study-p-589/1/product_info.php" target="_blank"><img src="http://www.html clinicalguard.com/r27/p/589/banner].html" border="0" alt="Palm Size [[File:CMS-60C Pulse Oximeter with software and probe for Sleep Study" title="Palm Size .jpg|center|thumb|300px|The CMS-60C Pulse Oximeter with software and probe for Sleep Study" width="250"></a></html>an external fingertip sensor.]]==CMS-50E=Masimo MightySat=Before I got the CMS-60C I used the CMS-50E with my [[Hypoxic Timer]] softwareThe MightySat is a far more expensive pulse oximeter, and will interface to a smart phone via Bluetooth. I upgraded Pulse oximeter itself will record data, but to the CMS-60C smart phone app will. This pulse oximeter also displays a value for convenience and perfusion index, which is a measure of how good the price blood flow is not radically different, so I would not recommend the CMS-50E unless you particularly want to your finger. While the compact form factor. Note that this MightSat is a far nicer device than the only other pulse oximeter other oximeters, its price is rather outrageous and I don't believe it is significantly more accurate than the CMS-60C that I know will work with my [[Hypoxic Timer]] softwareother devices<html><a hrefjfs id="http://www.clinicalguard.com/r27/89/1/product_info.phpB00RT9RQXY" targetnoreferb="_blanktrue"/><img src="http.[[File://wwwMasimo MightySat.clinicalguardjpg|center|thumb|300px|The Masimo MightySat and smartphone app.com/r27/p/89/banner.html" border="0" alt="CMS-50E OLED Fingertip Pulse Oximeter" title="CMS-50E OLED Fingertip Pulse Oximeter" width="250"></a></html>]]
=References=
<references>
<ref name="Hamber-1999"> EA. Hamber, PL. Bailey, SW. James, DT. Wells, JK. Lu, NL. Pace, Delays in the detection of hypoxemia due to site of pulse oximetry probe placement., J Clin Anesth, volume 11, issue 2, pages 113-8, Mar 1999, PMID [http://www.ncbi.nlm.nih.gov/pubmed/10386281 10386281]</ref>
</references>
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