Patients preparing for surgery are typically required to remove nail polish and artificial nail coverings before the procedure. This requirement is not related to sterility but is a procedural measure linked to monitoring the patient’s physiological status during the operation. Keeping the nail bed clear allows medical staff to accurately track changes in blood oxygen levels, which is a standard safety measure throughout any surgical event.
Understanding Pulse Oximetry
The primary reason for bare nails involves the function of the pulse oximeter, a non-invasive device used to monitor oxygen saturation in the peripheral blood. This small clip-like device is typically placed on a fingertip or earlobe. It works by emitting two specific wavelengths of light: one red and one infrared.
The oximeter measures the amount of light transmitted through the tissue to determine the ratio of oxygenated hemoglobin to deoxygenated hemoglobin. This calculation provides the medical staff with a real-time percentage of arterial oxygen saturation, often displayed as SpO2. Any opaque substance on the nail surface directly interferes with the accurate transmission and detection of these light wavelengths.
A physical or colored barrier absorbs or scatters the light before it reaches the capillary bed. When the light signal is obstructed, the sensor receives insufficient data, leading to a falsely low reading or an inability for the machine to register a measurement. This obstruction compromises the medical team’s ability to quickly identify changes in a patient’s respiratory function during anesthesia.
Which Types of Nail Coverings Cause Interference
Certain colors of polish pose a greater risk of signal distortion due to their high light absorption properties. Darker, opaque shades such as deep blue, black, purple, and dark green are particularly problematic because they block the path of the red and infrared light. Even small areas of dark polish can significantly skew the SpO2 reading.
Beyond color, any material that adds substantial thickness to the nail surface can prevent proper monitoring. This includes artificial coverings like acrylic nails, dip powder manicures, and gel polishes. The added bulk can create distance between the sensor and the skin or prevent the probe from clamping down correctly, weakening the light signal.
While clear nail polish is less likely to absorb light than colored polish, its presence is still generally discouraged by many facilities. The safest approach is to ensure all ten fingernails are completely bare, as hospital policies vary on what clear substances are acceptable. The primary focus for monitoring is the fingers. Removal from toenails is generally not a concern unless a medical condition requires alternative placement of the monitoring device.
Final Pre-Operation Guidance
Before removing all polish, patients should confirm the specific requirements with their surgical facility or pre-operative nurse. While the general rule is bare nails, hospital policies can differ regarding the necessity of removing clear polish or polish from the toes. This communication step ensures compliance with the specific protocols of the operating room.
If a patient has difficulty removing a thick or permanent covering, medical staff often only require removal from a single finger. The index finger or thumb is commonly used for the oximeter, and having just one clear nail is sufficient for continuous monitoring. Removing the polish or artificial material at home simplifies the process and avoids potential delays on the day of surgery. Any remaining residue should be completely wiped away to ensure the underlying nail bed is fully exposed for immediate monitoring upon arrival.