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Nocturnal Oximetry/Capnography Studies (3.21)

Nocturnal Oximetry/Capnography Studies (3.21) - Policies, Clinical, UWHC Clinical, Department Specific, Respiratory Care Services, Patient Assessment

3.21

3.21 Nocturnal Oximetry/Capnography Studies
Category: UWHC Patient Care
Effective: December 2015
Manual: Respiratory Care
Section: Patient Assessment


NOTE: Complete polysomnographic studies including respiratory monitoring, ECG and EEG data are
performed by Wisconsin Sleep at 6001 Research Park Blvd. in Madison (608-232-3308).

I. PURPOSE

Respiratory Care (RC) provides nocturnal studies to determine a patient’s need for additional oxygen or
ventilation at night. Continuous oximetry is used to monitor the patient. If the patient’s ventilatory
status is in question, continuous capnography is utilized along with oximetry.

II. POLICY

A. Inpatient nocturnal oximetry/capnography monitoring is scheduled through the charge therapist.
B. Outpatient nocturnal oximetry monitoring is scheduled through the RC Clinic staff.
C. Capnography studies will only be offered to Pediatric Pulmonary patients. All other patients
should have polysomnography testing performed for diagnosis of sleep disorders by Wisconsin
Sleep.
D. Inpatient oximetry, to determine a patient’s home oxygen prescription, must be done within 48
hours of discharge to qualify for reimbursement. Outpatient oximetry for prescriptive purposes
must be done within 30 days to qualify for an oxygen prescription.

III. EQUIPMENT

A. The Nocturnal Oximetry monitoring cart with laptop computer and Capnostream 20 is used with
in-patient studies.
B. A portable battery operated oximeter is used for outpatient studies.
C. Computer with data cable and ProFox Oximetry Software.

IV. PROCEDURE

A. The inpatient procedure is as follows:
1. Review and acknowledge provider’s order. If the parameters for titration of the oxygen
or ventilation are not clarified in the order, contact the provider.
2. Review the patient’s chart.
3. Obtain the appropriate equipment.
4. Introduce yourself to the patient and/or family and explain the reason for the procedure.
5. Assess the patient throughout the procedure.
6. Refer to the related link “Noc Oximetry Set-up Instructions” to set up the study.
7. The order for the study must be completed in Health Link at the end of the study. This
modifies the order number.
8. Document that the study was completed in the Progress Note.
9. Exit Profox and notify the charge therapist that the study is complete and ready to be
uploaded to the HIM Oximetry folder.

10. Notify the provider the study may be viewed in the Proc/Dx Tests tab once the study is in
Health Link.

B. Outpatient nocturnal oximetry monitoring
1. When the patient arrives for their appointment, instruct them on the appropriate
use of the Oximeter. Refer to the related link titled “Nonin WristOx Form.”
2. Review the oximeter and sleep study form with the patient. The form should have the
test parameters, ordering provider, and patient sticker on it before the patient leaves the
clinic.
3. Set up an appointment time or provide a postage paid mailer for the patient to return the
oximeter.
4. When the patient returns the study, download it using the Pro Fox software. Refer to
related link “Overnight Oximetry Downloads.”
5. When the study has been uploaded into Health Link, notify the ordering provider via a
Health Link e-mail. If the provider is not with UW Health, contact them via phone.
C. AFCH pediatric inpatient sleep studies are performed by Wisconsin Sleep.

VI. REFERENCES

A. Related Link Noc Oximetry Set-up Instructions
B. Related Link Overnight Oximetry Downloads
C. Related Link Nonin WristOx Form
D. Related Link Sentec TcO2 Instructions
E. Related Link ResMed Respiratory Assist Device (RAD) Qualifying Guidelines
F. Related Link RAD Guidelines Flowchart
G Related Link Capnostream 20 Instructions


Approved by Director and Medical Director of Respiratory Care.
A copy of this Policy & Procedure is available in the Respiratory Care Office [E5/489].