I remember when we were caring for my dad, we were coached to take his blood O2 level when he seemed lethargic. If his O2 saturation was below 90%, then we gave him a nebulizer treatment with albuterol which was prescribed by his personal care physician.
Belladonna (an RN) chimed in that any O2 saturation measurement below 89% was an issue and warranted a trip to the doctor (or doc-in-a-box). It isn't necessarily an emergency but that it needed looking into.
My personal belief is that one of these O2 Pulse Oximeter monitors is a basic home-medical device right up there with a thermometer. Objective measurements takes the guesswork out of knowing when to escalate an issue.
I sent our Fingertip Pulse Oximeter to the person who was not able to attend and ordered a replacement unit. I don't expect the device to come back.
Comments from my readers who have medical training will be appreciated. It is not my intention to spread misinformation.
I have no medical training but I will say that we have two of those in the house and it will tell you if you Do have a problem, but more important to me is it tells me if I Don't have a problem So Calm Down. ---ken
ReplyDeleteThe pulse-ox devices are certainly in reach price-wise, and a great front-line rough diagnostic tool, like the thermometer ERJ mentioned. I can tell when my blood pressure is out of sight, but having the BP cuff is handy for a rough measure, as is the pulse-ox device, when either of us (of a certain age) is out of sorts. Saves the panic mode.... Definitely good to have around, and the batteries seem to last years (at least in ours).
ReplyDeleteERJ - My only concern in getting a device (thinking BP Cuff in this case) is that given my problem with fixation, it would become a thing that would come to dominate my thinking. It did so for my father.
ReplyDeleteAs a frontline tool? Quite likely. But that is where it would make the most sense.
Let's flip this around. The tool can be used to provide objective biofeedback
DeleteThe pulsometer reports out your pulse-rate. You can use that as a way to fine-tune your meditation. What brings your pulse-rate down? Visualizing lily-pads? Visualizing soaking up sun at the beach? Slow, deep breaths?
Once you are dialed in, you can leave the measuring tool in the drawer. You will have internalized what you need to do and how you feel as you get there.
The idea is exactly the same as using a precise thermometer to train your mind to shunt blood-flow to your hands to relieve headaches and nasal congestion.
These are inexpensive and more than accurate enough for home use. O2 saturation is an important indicator of pulmonary function and a marker for when to seek professional help. Well worth having and using. They aren't complicated or difficult to use and most use common batteries. The only proviso is to store them without batteries installed to keep them from being damaged if not used regularly.
ReplyDeleteI use the BP cuff and the Pulse Oximeter on my MIL. Has helped us know when low BP is causing lethargy. Believe it or not usually we find she is not getting enough salt due to enteral feeding. A liquid IV packet perks her right up.
ReplyDeleteA fingertip pulse ox unit is fairly cheap and in my experience the batteries in it last for years. Looking at my unit, I'd need a really small screwdriver to open it up to remove the batteries for replacement.
ReplyDeleteBelladonna is correct an O2 sat of 90 plus is acceptable but again people are different as if my sats are around 92 I feel poorly.
My wife checks both of our O2 sats every morning as both of us have had blood clots and an embolus in the lungs is often first noted by lethargy and LOW O2 sats. Early detection is easier to resolve with various clot dissolving drugs like Heparin.
I have a pretty serious medical kit at home being EMS but I've not used my Blood Pressure cuff in years. Thermometer and pulse ox often as needed.
The Pulse Oximeter is non-invasive and as such is very safe. It makes an excellent tool in monitoring ones health, especially for those of us with significant health issues. Peace of mind at a minimal cost.
ReplyDeleteAnd get a few data points- the reading seems to vary some with which finger is checked- some have much thicker skin than others. Blood pressure can vary a lot depending on anxiety level, exertion etc.
ReplyDeleteUsed one for years flying a small plane at high altitudes while snorting O2 via canula. The individual baseline is important to know for your device. Apparently I have odd skin or something because numbers were always low, even experimenting with straight O2 at near sea level - low 90s or below. So I watched trends to identify issues, seems to have worked, and confirmed need for higher flow rates a few times. Recommended.
ReplyDeleteThe pulse oximeter emits light that passes through your skin and blood. A sensor on the other side detects the amount of light that passes through without being absorbed. This information is used to calculate the oxygen saturation level, usually displayed as a percentage (SpO2) along with your pulse rate.
ReplyDeleteSeveral factors can influence the accuracy of pulse oximeter readings:
Skin Tone: Some studies suggest that darker skin tones may lead to less accurate readings, particularly at lower saturation levels.
Circulation: Poor blood flow can affect the readings.
Nail Polish: Nail polish or artificial nails can interfere with the light absorption needed for accurate measurements.
duck duck go - search assist - wikipedia.
sam
Things That Can Affect Your Pulse Ox Accuracy, Part II: tremors: a shaking finger (or actively moving infant) can give you a sat reading upon which you cannot rely: make sure your pulse (measured by Mark I, Mod Zero Finger-and-second-hand), correspond.
DeleteCold patient. If one is very cold (just came in from shoveling snow) then peripheral vasoconstriction can hinder oxygenation reading accuracy. This is an offshoot of Sam's "poor circulation" observation.
Shock: mismatch between circulating blood volume and capacity of the vascular system can lead to, among other things, false oxygenation readings by pulse oximetry. This, also, is an offshoot of Sam's circulation observation.
Carboxyhemoglobin. I have read that CO exposure, in clinically significant amounts, can give an encouraging oxygen reading, even in the setting of inadequate oxygen transport and uptake/release. In an urgent care, I have only clinical suspicion to guide me in this, but you should be aware of this failure mode.
That leads me to my chestnut of patient care advice: TREAT THE PATIENT NOT THE MONITOR. If you pulse oximeter reading is OK, but your patient is NOT Ok, go with what you see, not what the oximeter is telling you. Like Da Media, monitors and meters can mislead you.
And, good on Belladonna on achieving Nursing licensure. Quite a lot of high stress schoolwork. Congratulations, and keep on learning.
DeleteWhen I first started nursing in an ICU (as an RN), my preceptor was an LPN. She certainly knew her stuff!
I take the blood-thinner Warfarin and so I need my INR checked every two or three weeks. This involves giving a large blood sample and then waiting for up to a day to get the results from the lab. But last week in hospital it was measured by a gadget reminiscent of the kit used to measure blood sugar: a quick snip at your skin yields a drop of blood, this is coaxed on to a measuring strip, and the hand-held machine gives the reading. Magic! Can you buy these things and do the tests yourself at home?
ReplyDeleteThe pulse function is a great training tool. Establish your baseline resting pulse rate and then as you train (run, cycle, etc.), your resting rate should slowly decrease. If it spikes by 4 or 5 BPM, take a day off. Highly conditioned athletes like elite cyclists will often have resting rates in the forties. If mine goes above 60 that tells me I need to get up off the couch and do some cardio.
ReplyDeleteI have them stashed around in my cars and home. A few last thoughts:
ReplyDeleteThe O2 % is accurate only if the pulse is accurate per my pulmo doc. My heart was racing during a test and the pulse showed 44 bpm. My resting rate is higher than that. Entire test was thrown out due to inacurrate readings.
As long as O2 comes back up over 90%, you should be good. Mine goes into the 70's with exertion, but will recover with rest and supplemental O2 if needed. It's not fun, but it is familiar now. It's the steady state below 90% that becomes an issue. Sleep apnea patients routinely survive low O2 levels, again per my pulmo doc.
Thermometer, pulse-ox, and bp cuff are handy first aid tools. As are those EKG watches and devices. Especially for those of us out in the boonies.
Greetings all
ReplyDeleteNot a medical person but here’s a sidebar regarding respiratory infections…
A highly regarded physician from, MI, who was my doctor when I lived there, is David Brownstein, MD, of The Center for Holistic Medicine, in West Bloomfield. During the beginning of covid he wrote extensively about nebulizing food grade hydrogen peroxide as a way to heal. When the FDA threatened him, and he had to backdown on his writing and posting of all things holistic, the well known holistic physician, Joe Mercola, took up the cause.
As part of our home health kit we have two nebulizers, food grade hydrogen peroxide, and containers of normal saline (or the ingredients to make it). If interested, one can still find articles and videos on this type of treatment on Dr. Mercola’s website. My family did this treatment when we got covid and it worked immediately for my husband (a former smoker). Me, who is always prone to at least 4 weeks of bronchitis after any kind of respiratory infection, didn’t have the stellar response that husband had, but going by past illnesses it probably kept me out of the hospital.