Impact of Skin Color on SpO2 Detection of Hypoxemia

Part of AACN Critical Care Webinar Series

Presenter(s): John Gallagher, DNP,RN,CCNS,CCRN-K,TCRN,CHSE,RRT,FCCM

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Webinar Summary

Recent evidence reveals that pulse oximetry devices can overestimate arterial oxygen saturation among racial and ethnic minorities with darker skin pigmentation. This inaccurate data can lead clinicians to miss or delay identification of hypoxemia, which in turn may contribute to delayed implementation of effective treatments. While we expect the healthcare industry is working to improve pulse oximetry devices, that will take some time. In the meantime, how do you ensure appropriate recognition of hypoxemia and provide safe care for your vulnerable patients?

This webinar will help you understand the technology of pulse oximetry and how skin pigmentation can impact the results. You will learn how this inaccurate SpO2 data affects patient care and what you can do to optimize care for darker-skinned patients. Webinar content includes clinical assessments you can use to help gain a realistic understanding of your patient’s condition.


  • Briefly describe how pulse oximetry works and what it can/ can’t tell you about your patient.
  • Identify the patients who are at risk of pulse oximetry overestimating their oxygenation level.
  • List the clinical assessment findings of hypoxemia to help provide a more complete interpretation of a patient’s condition.




John Gallagher works at the University of Pittsburgh School of Nursing as professor, acute and tertiary care, and director of simulation education. He is also a clinical nurse specialist in trauma and critical care at the University of Pittsburgh Medical Center. Gallagher’s career includes positions as staff nurse and CNS in diverse clinical settings, such as: trauma resuscitation and surgical ICU, emergency department and pulmonary step-down unit. Additionally, he is a registered respiratory therapist and former paramedic. Gallagher recently completed his term on the American Association of Critical-Care Nurses board of directors. Currently, he serves as a member of the National Institutes of Health COVID-19 Treatment Guidelines Panel, the Society of Critical Care Medicine (SCCM) nursing section and the SCCM Airway and Mechanical Ventilation Task Force. His areas of clinical interest include ARDS, mechanical ventilation, respiratory monitoring and endpoints of resuscitation.

Continuing Education Disclosure Statement

Successful Completion

Learners must attend/view/read the entire activity and complete the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.


This activity has been reviewed by the Nurse Planner. It has been determined that the material presented here shows no bias. No conflicts of interest have been identified for any individual with the ability to influence the content of this activity. Accreditation refers to recognition of continuing education only and does not imply AACN or ANCC approval or endorsement of any commercial products discussed or displayed in conjunction with this educational activity.


The American Association of Critical-Care Nurses (AACN) is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's (ANCC's) Commission on Accreditation, ANCC Provider Number 0012. AACN has been approved as a provider of continuing education in nursing by the California State Board of Nursing (CBRN), California Provider number CEP 1036. This activity is approved for 1.00 contact hours.

AACN programming meets the standards for most states that require mandatory continuing education contact hours for license and/or certification renewal. AACN recommends consulting with your state board of nursing or credentialing organization before submitting CE to fulfill continuing education requirements.

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