Tuesday, December 8, 2009

What are normal oxygen sats for asthmatics?

Every day at MyAsthmaCentral.com we get lots of asthma related questions. Below are some questions I thought my readers at the RT Cave would enjoy.

Question: What are normal oxygen levels for my daughter who has asthma. My daughter's oxygen level was 88 and she was sent home from the doctor's office. Should I be concerned.

My humble answer: I'm going to assume that by "oxygen level" you are referring to a pulse oximetry reading, otherwise known as an SpO2 or a pulse ox or sat (some people incorrectly call it a stat). You can see a picture of one here. This is where they take a little gadget and place it over your daughters finger and it checks her oxygen level.

First let me explain what a pulse ox is.

What is a pulse ox? It is a device that allows medical people like me, your nurse or doctor, to determine how much of the oxygen that you breath in is actually getting to your tissues. Thus, the # 88 means that 88% of the air your daughter was breathing in was getting to her tissues.

What is a normal pulse ox? Perfectly normal is 98%, although for most people anything greater than 88-92% is acceptable, although the actual range can fluctuate with some hospitals, doctors, or patients.

If you have concerns about your daughters pulse ox, you should probably talk to the doctor and ask him why he thinks 88% is okay. In my opinion, so long as a patient is relatively stable, I wouldn't worry about a sat of 88. For one thing it's just a number generated by a machine and can fluctuate +/- 2%. It's best not to treat a number but the patient.

A reading of 88% is worth noting, but is not critical. Perhaps this is what your daughter's doctor was thinking. I have seen asthma patients go home with similar readings and they did just fine. In fact, my daughter had an asthma attack a few years ago and her sat was 84% and she was sent home with me and ended up just fine.

If your daughter continues to have trouble breathing, or her breathing gets worse, call your doctor or return to the emergency room. And it's always a good idea to continue to monitor your daughter for these signs of asthma, which I'm sure you already do.

I don't know if this was the case with your situation because I wasn't there, but I know from my own personal experience taking care of children in the emergency room that it sometimes is very hard to get an accurate saturation reading. That's another thing to consider anyway. My wife took my asthmatic daughter to see the pediatrician a few years ago and her oxygen level was 83%. However, since I wasn't there I wonder if that was truly accurate. The doctor sent my daughter home anyway and she was fine after a few days of breathing treatments and antibiotics.

Question: What is a good o2 sat level? For a child having an asthma attack is there an O2 SAT level that is a red flag that you should call an ambulance?

My humble answer: A normal O2 Sat is 98%. For most asthmatics, the O2 Sat does not drop except for during severe exacerbations. Some severe asthmatics may have a lower O2 Sat.

Where I work an acceptable O2 Sat is anything above 92 (+/- 2). If you notice your O2 sat drops significantly and stays there, then you should call your physician or go to the ER. You should also discuss with your doctor what your normal O2 sat is what to do if it drops.

That said, a pulse oximeter is not normally used as a monitor to help asthmatics decide what to do. Ideally, you should be acting before your O2 sat drops. However, I'm saying this not knowing how severe your asthma is.

You may already know this (but I have to say it), the asthma guidelines recommend every asthmatic work with his or her physician to create an asthma action plan to help you decide what to do when an attack is impending or ongoing. Some plans will have you utilize a peak flow meter, some will have you simply monitoring your symptoms, and some will have you using both methods. I describe this more fully in this post. Some asthmatics may incorporate other methods into the plan, such as the use of a pulse oximeter to monitor O2 Sats.

I provide more information on this topic here.

If you have any further questions email me, or Visit MyAsthmaCentral.com's" Q&A section.

1 comment:

Anonymous said...

Very interesting and stopped me. Worrying. For now.