The Sat is 87%. Oh shit! What do I do?

My phone dinged. The message flashed urgently: "CCU2's sat is 87. Can he get a breathing treatment?" 

I swiftly replied to the nurse, my fingers flying across the screen: "He just had a breathing treatment."

Her response came back quickly, tinged with concern: "But his sat is still low."

I felt a surge of alarm. This patient's directive was clear-cut: maintain an SpO2 of 88-92. A saturation level of 87 was not just below par—it was critically low. Without hesitation, I dashed from the RT Cave. Up flights of stairs, down long, echoing halls, through bustling corridors that seemed to stretch for miles, I raced towards the critical care unit—way on the other side of the hospital, out in BFE. Determined to intervene before his sat plummeted to the even more perilous 86%, I pushed myself to reach him in time.

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He lay there covered in blankets, his head slightly raised. Glancing at the monitor, I noted his saturation was at 92%, a perfectly acceptable value in my book — just as acceptable as the 87%, which was within our margin of tolerance (give or take 2%). He looked at me with a wry grin peeking out from under his mustache and said, "Hi John. How are you doing today?" A sparkle in his eyes gleamed as if to say he wasn’t in a critical care room.

"I'm doing well," I replied. Then, noticing the elderly lady by the window -- his wife, I greeted her, "Hi there. How are you doing?"

"I'm doing fine. What's going on?" she asked. 

"Just came to check in," I said casually, glancing over at the TV tuned to Fox News. "You guys going to watch the debate tonight?"

To this, the wife smiled and said, "Yeah, I'll probably watch it for a while. What about you?"

"Yeah, I'll watch it like most Americans," I replied, "just to see how doped up Biden is, and if he can get through the debate without freezing or falling."

"Same with us," the patient chuckled again, his belly shaking like Santa's 

Turning back to my patient, I asked, "So, how are you feeling?"

"Just came to check in," I said casually, glancing over at the TV tuned to Fox News. "You guys going to watch the debate tonight?"

To this, the wife smiled and said, "Yeah, I'll probably watch it for a while. What about you?"

"Yeah, I'll watch it like most Americans," I replied, "just to see how doped up Biden is, and if he can get through the debate without freezing or falling."

"Same with us," the patient chuckled. His belly shook like a bowl full of jelly, reminiscent of Santa's hearty laugh.

Turning back to my patient, I asked, "So, how are you feeling?"

"I'm hanging in there," he chuckled again, his belly dancing once more. It always impressed me how someone at this stage, confined to a hospital bed for over a month, could maintain such a cheerful disposition.

"Would you like to go back on your BiPAP?" I asked.

"If you think it would help," he replied.

"Are you short of breath?"

"No, but it can't hurt to go back on. I'm fine with that."

Taking his response as affirmative, I swiftly activated the BiPAP machine and carefully adjusted the straps of the mask over his head, ensuring it fit snugly under his nose and over his mouth. With that, my concern was alleviated. The BiPAP machine should assist in maintaining his saturation above the critical 86% mark. Whew.

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After leaving the room, I waved to my favorite nurse. "The day is saved," I announced with a satisfied grin.

She returned my smile warmly. "You are the best," she replied.

With that praise echoing in my ears, I sauntered back down to the RT Cave