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Medical Fashion Victims? Do Nail Polishes and Acrylic Nails affect digital pulse oximetry and patient management in the clinical setting?

Equipment,pulse oximeters, Safety, Monitoring,oxygen

J. Purcell1, S. Mannion2
1University College Cork - Cork (Ireland), 2South Infirmary Victoria University Hospital - Cork (Ireland)


Background and Goal of Study:

Digital Pulse Oximetry (DPO) is ubiquitous in monitoring patients’ oxygen saturation (SpO2) levels. Concerns prevail that nail treatments such as acrylic nails or nail polishes affect these readings, but published data is inconsistent. As changes in SpO2 levels affect the levels of interventions and impact patient monitoring in critical care and anaesthesia, discerning if nail treatments adversely affect DPO is crucial.

1: Survey healthcare staff attitudes and approaches to this issue

2: Experimentally assess effects of specific nail treatments on SpO2 readings under different physiological conditions

Materials and Methods:

1:Questionnaire based survey was issued to clinical staff at four university hospitals to assess current knowledge and opinions regarding how nail treatments impact on clinical decisions pertaining to DPO.

2:An interventional experiment on 12 volunteers analysing effects of nail polish of different colours and acrylic nails from popular brands, on SpO2 measurements under varying physiological conditions (healthy, venous congestion, venous constriction). Congestion modelled using venous stasis on non-invasive blood pressure cuffs and constriction modelled using water immersion for 10min at 10°C.

Results and Discussion:

Survey: 86 Respondents (55 doctors, 21 nurses). Nail treatments affect 45% of respondents’ clinical practice, and >30% of respondents intervene to remove treatments.

Experiment (n=12): Δ<1%(±SEM) in SpO2 readings across all nail treatments and models analysed, none of which resulted in a SpO2 reading <95%, at which O2 intervention is recommended.

Figure1

Conclusions:Knowledge of, and approach to, potential complications of nail treatments on DPO varies amongst healthcare staff, with poor knowledge or understanding of effects. Our survey data suggest it would be reasonable to establish hospital policies that do not require prior removal of nail treatments examined in this study. Experimental data indicate the nail treatments specified do not contribute significantly to a difference in SpO2 readings, therefore have no clinical impact on patient care.

01 / Medical Fashion Victims? Do Nail Polishes and Acrylic Nails affect digital pulse oximetry and patient management in the clinical setting?