What finger should i use for pulse oximeter

The oxygen level may be lower in some people with lung conditions, even when they are feeling well. If you have an existing lung condition, please check with your doctor about what your readings should be. 

To view guidance in a language that isn't English, please click here. 

Ideally, it is best to place the probe on a warm finger on the patient’s non-dominant hand so that the patient can still use their dominant hand without hindrance. For patients with decreased levels of consciousness (e.g. emerging from sedation), the middle finger is a good finger to place the probe because patients are less likely to scratch their face or eyes with this finger.  However, if you are unable to get a good reading on this finger, try the other fingers or the other hand until a good waveform is obtained.

References: Lifebox Pulse Oximetry Learning Module

Keywords: finger, placement, location

A pulse oximeter is a small device that fits on your finger and quickly and easily checks your oxygen levels and heart rate.

On this page, you can find the following information:

• What is a pulse oximeter?
• When should I use a pulse oximeter?
• How do I use a pulse oximeter?
• What do pulse oximeter numbers mean?
• Other signs or symptoms of low oxygen levels
• Limitations in using pulse oximeters
  
  

What is a pulse oximeter?

A pulse oximeter is a small, painless device that clips onto your finger and uses light beams in a sensor to estimate the amount of oxygen in your blood without taking a blood sample. This helps to track and assess how well your lungs are working.

Note: Be aware that the quality and accuracy of different pulse oximeters can vary. 

A pulse oximeter measures 2 things:

• Pulse – this is a measure of how fast your heart is beating. Your pulse is measured in beats per minute (bpm). On your device this number may show as bpm or PRbpm (pulse rate/beats per minute).
• Oxygen saturation level – this is a measure of how much oxygen is in your blood. Your oxygen saturation is measured as a percentage (scored out of 100). On your device this number may show as SpO2% (saturation percentage of oxygen).

When should I use a pulse oximeter?

A pulse oximeter can be used to help monitor a range of conditions in hospital or at home, including COVID-19 infection. COVID-19 is a viral infection. For most people, the symptoms are relatively mild, and they usually get better over 2–3 weeks. However, for some people, the symptoms can be very serious and can get worse quickly.

• Your healthcare team will let you know if you need a pulse oximeter at home
• If you are advised to monitor your symptoms and breathing, then the use of a health and symptom diary can help you and your healthcare team track any changes.

This page will explain how to use a pulse oximeter, what the numbers mean and what actions you should take.

How do I use a pulse oximeter?

There are different brands of these devices – please read the manufacturer's instructions. The following video and table provides a general guide. Ask your healthcare team if you have any questions.

Click the image below to play the video:

View transcript

You can also watch this video directly on Youtube.

Preparing

• Wash your hands and remove any nail polish or false nails. This allows the light beams in the sensor to measure through your fingernail.
• Make sure you have been resting for at least 5 minutes before taking the reading.
• If your hands are cold, warm them by rubbing them together.
• Rest your arm and hand and keep them still while taking your reading.
• Your hand should be at waist level, such as resting your hand on a table or the arm of your chair.

Taking your reading

• Switch the pulse oximeter ON and the display will light up.
• Squeeze to open and insert your finger until your fingertip touches the end.
• It works best on the middle or index finger of either hand.
• Keep your hand still and wait for 1 to 2 minutes until your pulse (bpm/PRbpm) is steady and your oxygen saturation (SpO2%) number has not changed for 5 seconds or more.
• If your numbers are not steady, try a different finger.

Recording your numbers

• You should record the oxygen saturation number ‘SpO2%’ and the pulse rate number ‘PRbpm’ to track any changes. Here is a diary you can print and fill in.
• Your heart rate and oxygen level numbers are easy to mix up. Be careful to record these correctly.
• Measure and record your pulse (heart rate) and oxygen level 3 times a day at about the same time every day. See the table below on what the pulse oximeter numbers mean and when to seek advice from your healthcare team. 
• Your symptom diary is crucial to track any changes so your healthcare team can monitor you safely at home.
• You should take extra measurements if you feel a change in your health.
• To clean your device, check the manufacturer’s instructions.

What do pulse oximeter numbers mean?

Your healthcare team will give you details on appropriate oxygen saturation levels for your specific medical condition. The following is a guide for adults with no previous lung conditions. 

Other signs or symptoms of low oxygen levels

Do not rely only on a pulse oximeter to assess your health condition or oxygen level. It is only a measurement device.

Other signs or symptoms of low oxygen levels are:

• bluish colouring in your face, lips or nails
• shortness of breath, difficulty breathing or a cough that gets worse
• restlessness and discomfort
• chest pain or tightness
• fast or racing pulse rate.

If you have any concerns or questions, contact your healthcare team directly.

If at any time you experience any of the symptoms above, or your symptoms become suddenly worse, call 111 for an ambulance.

Limitations in using pulse oximeters

Pulse oximeters are very useful devices but it is important to remember that there are limitations to their use.

• Be aware that lots of different factors can affect the accuracy of a pulse oximeter reading. These include poor circulation, skin pigmentation/colouring, skin thickness, skin temperature, current tobacco use, use of fingernail polish or artificial nails, tattoos and dyes, and maintenance and cleaning of devices.
• Also be aware not all pulse oximeters are of the same quality and accuracy. 

If you have any breathing problems or concerns, phone your healthcare team or HealthLine 0800 611 116 for advice. Do not rely on a pulse oximeter alone to assess your health condition or oxygen level, it is only a measurement device.