Open Sim Lab
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A number wrong in one direction

Educational use only. Not clinically reviewed

57-year-old woman for calm reading recording, paired-value recording, escalation, and handoff practice. About 8 simulated minutes.

What you will practise

  • Record an oximeter reading as an oximeter reading.
  • Recognize an error that runs one way.
  • State what the gap is and is not.
  • Escalate on the arterial value, with the reading alongside it.
  • Review the boundaries and their certainty.
  • Hand off a chart that reads reassuringly.

Review and sources

Not clinically reviewed. No clinician has signed this scenario.

  • Parr B, Beech A, Young M, Valley TS. Racial and ethnic disparities in occult hypoxemia prevalence and clinical outcomes among hospitalized patients: a systematic review and meta-analysis. J Gen Intern Med. 2024;39(13):2543-2553. doi:10.1007/s11606-024-08852-1. Moderate certainty. Across 732,505 paired measurements, the prevalence ratio for occult hypoxaemia was 1.67 (95% CI 1.47-1.90) in Black compared with white patients, and 1.39 (95% CI 1.19-1.64) for other groups.
  • Sjoding MW, Dickson RP, Iwashyna TJ, Gay SE, Valley TS. Racial bias in pulse oximetry measurement. N Engl J Med. 2020;383:2477-2478. doi:10.1056/NEJMc2029240. Where oxygen saturation by pulse oximetry read 92 to 96 percent, arterial saturation was below 88 percent in 12 percent of Black patients compared with 4 percent of white patients in one cohort, and 17 percent compared with 6 percent in another.
  • United States Food and Drug Administration. Draft guidance on pulse oximeters for medical purposes, January 2025. Applies to devices submitted for premarket review after issuance; it does not recall, recalibrate, or replace devices already in clinical service.

Every scenario in this module

Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.