Nail polish affect on pulse-ox

Q: Which of the following nail polish is found to least affect the pulse oximeter readings?

A) black
B) green
C) blue 
D) red 
E) brown


Answer:  D

Nail polishes, particularly older brands can affect the pulse oximeter (pulse-ox) readings. The underlying issue is the ability of the nail polish to absorb the light at 660 nm-940 nm. The blue nail polish tends to give the highest discrepancy, almost by the difference of 6 percent - followed by green, black and brown nail polishes. Red nail polish tends to least affect the pulse-ox readings. Similarly, artificial nails can make pulse-ox readings very unreliable. In such situations, pulse ox probe should be placed either side to side on the finger or at the other locations such as earlobes.

#oxygenation



References:

1. Hinkelbein J, Genzwuerker HV, Sogl R, Fiedler F. Effect of nail polish on oxygen saturation determined by pulse oximetry in critically ill patients. Resuscitation 2007; 72:82. 

2. Chan MM, Chan MM, Chan ED. What is the effect of fingernail polish on pulse oximetry? Chest 2003; 123:2163. 

3. Hinkelbein J, Koehler H, Genzwuerker HV, Fiedler F. Artificial acrylic finger nails may alter pulse oximetry measurement. Resuscitation 2007; 74:75.