Pulse oximeter probes attached to the finger may fail to estimate blood oxygen saturation (SpO 2 ) in patients with compromised peripheral perfusion (e.g. hypothermic cardiopulmonary bypass surgery). The measurement of SpO 2 from a central organ such as the oesophagus is suggested as an alternative to overcome this problem. A reflectance oesophageal pulse oximeter probe and a processing system implemented in LabVIEW were developed. The system was evaluated in clinical measurements on 50 cardiothoracic surgery patients. Oesophageal photoplethysmographic (PPG) signals with large amplitudes and high signal-to-noise ratios were measured from various depths within the oesophagus from all the cardiothoracic patients. The oesophageal PPG amplitudes from these patients were in good agreement with previous oesophageal PPG amplitude measurements from healthy anaesthetized patients. The oesophageal pulse oximeter SpO 2 results agreed well with the estimated arterial oxygen saturation (SaO 2 ) values inferred from the oxygen tension obtained by blood gas analysis. The mean (± SD) of the differences between the oesophageal pulse oximeter SpO 2 readings and those from blood gas analysis was 0.02 ± 0.88%. Also, the oesophageal pulse oximeter was found to be reliable and accurate in five cases of poor peripheral perfusion when a commercial finger pulse oximeter probe failed to estimate oxygen saturation values for at least 10 min. These results suggest that the arterial blood circulation to the oesophagus is less subject to vasoconstriction and decreased PPG amplitudes than are the peripheral sites used for pulse oximetry such as the finger. It is concluded that oesophageal SpO 2 monitoring may be of clinical value.

Decision-makers in school psychology are presently engaged in the process of determining how to, if possible, move forward with conducting mandated psychoeducational evaluations of students in schools during the pandemic. Whereas prominent organizations within the profession (e.g., American Psychological Association, National Association of School Psychologists) have issued guidance and encouraged practitioners to delay testing, it is not clear whether that is a viable option in every jurisdiction. Accordingly, professionals are now considering the potential use of telehealth platforms to conduct assessments, in some form, as we move forward and deal with this crisis. The goal of this brief commentary is to raise some provisional limitations associated with the use of telehealth to conduct psychological assessments that we believe will have to be considered as use of these platforms is debated. Recommendations for professional practice are also provided.

Abstract-Peripheral perfusion is often poor and barely pulsatile in patients undergoing prolonged major surgery. Hence, the arterial blood oxygen saturation (SpO 2 ) readings from commercial finger pulse oximeters can become unreliable or cease when they are most needed. To overcome this limitation, the esophagus has been investigated as an alternative measurement site, as perfusion may be preferentially preserved centrally. A reflectance esophageal pulse oximeter probe, and a processing system implemented in LabVIEW were developed. The system was evaluated in clinical measurements on 49 cardiothoracic surgery patients. The SpO 2 values from the esophagus were in good agreement with arterial blood oxygen saturation (SaO 2 ) values obtained from blood gas analysis and CO-oximetry. The means ( SD) of the differences between the esophageal SpO 2 and SaO 2 results from blood gas analysis and CO-oximetry were 0.02 0.88% and 0.73 0.72%, respectively. In five (10.2%) of the patients, the finger pulse oximeter failed for at least 10 min while the esophageal SpO 2 readings remained reliable. The results confirm that the esophagus may be used as an alternative monitoring site for pulse oximetry even in patients with compromised peripheral perfusion.

No abstract

Due to physical distancing guidelines, the closure of nonessential businesses, and the closure of public schools, the role of telehealth for the delivery of psychological services for children has never been more debated. However, the transition to teleassessment is more complicated for some types of assessment than others. For instance, the remote administration of achievement and intelligence tests is a relatively recent adaptation of telehealth, and despite recommendations for rapid adoption by some policymakers and publishing companies, caution and careful consideration of individual and contextual variables and the existing research literature, as well as measurement, cultural and linguistic, and legal and ethical issues, is warranted. The decision to use remotely administered achievement and intelligence tests is best made on a case-by-case basis after consideration of these factors. We discuss each of these issues as well as implications for practice and policy, as well as issue provisional guidance for consideration for publishing companies interested in these endeavors moving forward.