Four factors that can interfere w/ accurate pulse oximetry measurement:

🅾️ Methemoglobinemia (falsely ⬇️)
🅾️ Carbon monoxide poisoning (falsely ⬇️)
🅾️ Venous congestion eg severe tricuspid regurg or cardiomyopathy (falsely ⬇️)
🅾️ Dark skin (falsely ⬆️)

#MedTwitter
Correction as someone pointed out: Carbon monoxide poisoning will falsely ⬆️ SpO2.

Two other factors to remember:
🅾️ Nail polish (falsely ⬇️)
🅾️ Raynaud’s (falsely ⬇️)
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