Oximeter: I have been a bit hors de... - Asthma Community ...

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Oximeter

Homely2 profile image
Homely2Administrator
30 Replies

I have been a bit hors de combat recently, so bought myself a little oximeter, 16 pounds from amazon.

I have always found the variation in my peak flows irritating, also I do not like using the peak flow when badly out of breath. So I wondered how for me personally an oximeter worked as a measure of asthma.

So far I have found my basic resting pulse is 70 to 75, and oxygen level is 99.

As my asthma deteriorates, my pulse goes up into my low 100s, oxygen stays at 99. Then as asthma gets worse, very quickly pulse falls to 50 something and oxygen goes into the 80s. Ventolin then quickly restores the situation.

Has anybody else played with an oximeter.

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Homely2
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Lysistrata profile image
LysistrataAdministratorCommunity Ambassador

I'm sure you probably know this and aren't planning to rely on it to decide when to get help, but just need to add a general warning for anyone reading this about not relying on oximeters for asthma unless you've explicitly discussed this with your asthma team and it works for you. A word from the nurses here on this: healthunlocked.com/asthmalu...

Basically, for anyone reading: don't rely on your sats to tell you when to get help for asthma, and don't rely on ranges that are 'ok' for COPD and COVID. Your sats shouldn't be in the low to mid-90s or lower with asthma, and 80s really isn't good - even if you're told it's ok by a healthcare professional, as they can get mixed up with COPD. Likewise, sats of 99 do not mean you are ok and can't be having a severe attack, whatever you may be told.

Homely, have you discussed this pattern with your consultant/asthma team? The 80s especially isn't good!

I've also found that my sats stay more or less ok but heart rate will increase as I get worse (from asthma, not from Ventolin - Ventolin often lowers it). Sometimes during an attack they like to go up and down and up and down - ok numbers but I remember them not being happy at the dropping even though the numbers were ok by themselves. I've also had arterial blood gasses that were not good even when my sats were 98 and my peak flow was above 50%, so I'm wary of sats. I also think there's too many people in the UK being told their asthma is ok because their sats and/or peak flow aren't bad!

CANINE12 profile image
CANINE12 in reply to Lysistrata

You are so right, I've been told numerous times that my sats and peak flow are fine therefore I'm ok. Only to end up in resus in a bad way. Fortunately I know my asthma and now ignore these comments. I think healthcare professionals say this to reassure patients. However as I understand the risk of high carbon dioxide levels etc it worries me that the professional caring for me doesn't understand asthma and the risks especially as I can I deteriorate rapidly.

Lysistrata profile image
LysistrataAdministratorCommunity Ambassador in reply to CANINE12

Yes, I don't find it remotely reassuring when people say things that I know aren't actually correct, and which make me think they don't understand asthma, or are dismissing me, and so won't treat me correctly (or at all). It's also really frustrating when they do this because if you argue (assuming you're even physically capable, which I often am not), or appear frustrated or agitated because they're not listening or understanding, they put it down to anxiety and ramp up their idea of 'reassurance', which then becomes a vicious cycle.

It's much scarier for me than the physical sensations, that feeling that no one gets it or will actually do what is needed. Reassurance for me would be 'ok, we see that isn't a good marker for you, we understand what's going on and will treat it', and some understanding that I'm not just an anxious hysterical child who needs meaningless soothing.

Ugh that was unpleasant to type and remember!

Itswonderful profile image
Itswonderful in reply to Lysistrata

spot on!

Pipsqueak77 profile image
Pipsqueak77

Thanks Homely2 for raising this topic..👍

I am interested in hearing others ideas on oximeters too as I had a GP appt recently (😱) where he pretty much insisted that I buy myself one to the exclusion of any other topic!

I have to say that I’ve never even considered buying one and am quite sceptical about both their accuracy and their place in the self management of asthma. In fact I actually thought that they were not advised for asthmatics??🤔

I have had asthma for many years and have never needed to monitor my oxygen levels. Indeed if my levels drop off that badly then I am generally quite poorly and am already in hospital.

So I am feeling quite confused really and wonder whether all of the hype around oximeters is just a knee jerk reaction post Covid? Or even worse an easy excuse for asthmatics not to be seen for a f2f GP appointment because their sats are ‘oximeter ok’!

Sorry Homely…! Bit of a hijack there….. I guess I’m trying to say that personally I am a bit worried about being pressurised into using an oximeter which I feel would be of little benefit to me.

I am glad it seems to be helping you though and await hearing others thoughts.

😊

Homely2 profile image
Homely2Administrator in reply to Pipsqueak77

I think I got it partly because I was confused that when I had a nasty asthma attack my oxygen Sat's taken by the medics are always OK.

So far I have shown for myself that if I take enough ventolin generally my oxygen Sat's will be fine. However if I do not take the ventolin my oxygen Sat's can be lousy during an attack.

So I think I understand a little bit more about my own asthma. I do not know if that is useful, but more knowledge is normally better.

Lysistrata profile image
LysistrataAdministratorCommunity Ambassador in reply to Pipsqueak77

I feel the same - and feel like at times in hospital I've been triaged as 'ok' purely on the basis that my sats were eg 96%, and everything else is then ignored. My local ambulance service, and no doubt others, are officially told not to give nebs to asthmatics if their sats are ok and they're not wheezing! I'm glad to say they've often ignored that rule.

I'm sure sats have their place, but I feel at times there's too much temptation to push asthma into easy, binary measurements (sats ok Y/N? Wheeze Y/N etc?) I feel a lot happier when I have attacks/admissions if I can see they understand it's not that simple.

CANINE12 profile image
CANINE12

I was given a oxymeter by the GP surgery (apparently it was left over after they handed them out to covid patients and they it might be helpful for me to have one).Apart from checking that it worked when I got it, I haven't used it as by experience of numerous times in A&E my pf can be fine, my sats can be 98 but my arterial blood gas can show oxygen can be 90 and carbon dioxide can be higher than they should be.

Lysistrata profile image
LysistrataAdministratorCommunity Ambassador

A good O2 sat is not helpful or better though if it makes it look like everything is fine when it isn't, and puts people off getting help because they think they are ok, when they're not. That's why it's not recommended here (see this link to a post by the asthma nurses and ALUK's GP on the UK approach: healthunlocked.com/asthmalu...

I've also had differences of a similar size to Canine12 at times between pulse ox and arterial blood gas saturation value - with continuous pulse oximeter and other monitoring. Perhaps more to the point, I've had arterial blood gas values which showed things being less than ideal in multiple different ways beyond just oxygen saturation, and all the while the continuous pulse oximetry monitoring looked fine, and my peak flow wasn't too bad. So I wouldn't say the pulse oximetry was particularly helpful in that case.

I also have a friend who like Canine12 tends to maintain sats for ages while she builds up carbon dioxide, then everything takes a nosedive. It's happened multiple times for her, and is often accompanied by someone thinking her sats look fine so they don't need to do anything, until everything goes wrong. Again, not massively helpful to rely just on the pulse oximetry. Sure if you have a *bad* value on the oximeter (within what that means ie don't apply COPD 'normal' to asthma) and you know your monitor is accurate, then you need to do something. But if you have a supposedly 'good' value, it can be dangerous to assume everything is fine.

It may be helpful for specific people to monitor their sats at home as directed, it's just not generally recommended for asthmatics here and may not be particularly helpful (I note you have pulmonary issues in addition to asthma).

Pipsqueak77 profile image
Pipsqueak77 in reply to Lysistrata

Hi Karenjaninaz

Interesting to hear your thoughts and the US take on oximeters….

Can I just ask how you know that your oximeter is accurate? Are you able to calibrate it?

Thanks 😊

Patk1 profile image
Patk1 in reply to Pipsqueak77

I've compared mine to health professionals for accuracy.ive found 02 to be as accurate as theirs but iv checked pulse myself many times and its incorrect on oxometer.i only v occasionally use it,as a guideline.the actual blood gas readings are different.

Lysistrata profile image
LysistrataAdministratorCommunity Ambassador in reply to Pipsqueak77

Just as an FYI, this reply is to me, not to Karenjaninaz's post reply, so she may not see it - I'm not a fan of how this feature works!

Pipsqueak77 profile image
Pipsqueak77 in reply to Lysistrata

Yep… sorry! Didn’t want to push in above your reply.. but not tech savvy enough to work out how best to do it!!😂😂

Lysistrata profile image
LysistrataAdministratorCommunity Ambassador in reply to Pipsqueak77

No worries - I do it accidentally a lot, and also sometimes can't decide who to reply to on a thread, when there's a whole conversation with different users contributing who may want to see replies. I wish the forum were set up in a different way sometimes re threads etc.

Karenjaninaz profile image
Karenjaninaz in reply to Pipsqueak77

Only the blood gas machine gets calibrated but my pulmonologist compares my oximeter with his and they match. That being said oximeters have a a deviation of 1-2% higher or lower than true reading. With lower readings it becomes less accurate. Quality counts as well.

I wear an O2 ring at night with continuous monitoring that I download to my phone. One night, while sleeping, my nasal cannula fell off and the ring alarmed me when my O2 sat dropped. It dropped to 87%😱

Karenjaninaz profile image
Karenjaninaz in reply to Lysistrata

A good o2 sat rules out hypoxemia but not hypercarbia, acidosis, alkalosis. Those are measured by a blood gas measurement.

Some people can become hypoxic and not notice it until too late.

Asthmatics can have other pulmonary issues.

Other symptoms like wheezing, chest tightness, cough- despite good O2sat need attention.

Discouraging using an oximeter is foolish. Education in proper use is better.

(Retired anesthetist here)

Lysistrata profile image
LysistrataAdministratorCommunity Ambassador in reply to Karenjaninaz

The ALUK professional team have addressed the use of routine home O2 sats monitoring in asthma in their reply below.

As I also mentioned, they acknowledge that it may be useful for some individuals, in consultation with their medical team. That might include people who have difficulty detecting hypoxia, or those with other pulmonary issues alongside asthma.

Claire_ALUK profile image
Claire_ALUKPartnerALUKAsthma Nurse

Hi all,

I hope everyone is well?

Interesting post and replies..

According to UK and US Asthma guidelines there is NO PLACE for routine oxygen monitoring in people with asthma. In the rare cases where it is useful, it will be on the advice of a hospital consultant who is specialist in asthma.

When someone is having an increase in asthma symptoms or starting an asthma attack there are lots of things that change in the body before oxygen levels drop. In fact, your body breathes faster and your heart pumps faster to help keep your oxygen levels within normal limits.

Symptoms, the response to medication and peak flow are more reliable signs that you need to take action (contact your GP surgery or 111, or follow your action plan). Once your oxygen levels have dropped you are in a life-threatening phase - any action should have been taken long before this.

Many people were given oxygen monitors (oximeters) when they had COVID19. This is because the pattern of that disease, which is very different from asthma, did cause drops in oxygen levels in some cases. Having a monitor at home allowed people with covid19 to keep an eye on how covid was affecting their lungs and oxygen levels without having to leave the house and risk infecting other people.

So for asthma, follow your personal plan and act on increase of symptoms, drops in peak flow and/or need for extra reliever medication. asthmaandlung.org.uk/condit...

I hope this helps ☺️

Pipsqueak77 profile image
Pipsqueak77 in reply to Claire_ALUK

Hi Claire

Thanks for this info… very helpful!

So really my GP should not be insisting that I get an oximeter?

Thanks..😊

CANINE12 profile image
CANINE12 in reply to Pipsqueak77

I should have clarified, I was having an appointment with a paramedic (short staffed no nurse available), he was the one who gave me the oximiter. My GP who knows how my asthma can be I don't think would have given me one.

Karenjaninaz profile image
Karenjaninaz in reply to Claire_ALUK

I stand corrected, folks.

CANINE12 profile image
CANINE12

Unfortunately they were widely out in all visits to A&E. Lysistrata has explained the ins and outs of what tends to happen much better than I could.

ellamental profile image
ellamental

Recently went to A&E after phoning 111.. Saw the triage nurse who took oxygen level and then said.. you can either wait for 5 hours or go home. She did not ask anything... did not know that I had been on the nebuliser at hone several times and also taken prednisolone. When we saw the Dr she listened to my chest and said oh dear and gave me nebs and different neb steroids. I asked if I had done the right thing in coming and she said absolutely ... you don't need this getting worse and asthma is life threatening, chest infection makes asthma worse etc

Gwalltarian profile image
Gwalltarian

you say that after checking all the different deteriorating data that Ventolin then helos. Why don’t you take the reliever - Ventolin when you start having breathing difficulties? That’s what it’s for.

Homely2 profile image
Homely2Administrator in reply to Gwalltarian

I have quite a lot of asthma attacks in a day. I keep the ventolin for when it gets nasty.

Lysistrata profile image
LysistrataAdministratorCommunity Ambassador in reply to Homely2

People do have different strategies but if it helps, I've found from experience that not waiting too long to take it can cut down on how much I need in the end, and stop it from getting worse sometimes. I'm also inclined to wait and see, but often that means more puffs later vs fewer if I get it earlier.

It is a balance though, as I also don't want to immediately take Ventolin every time I feel any whiff of a symptom. But you may want to experiment with taking it a little earlier, when it's noticeable but not impossible to ignore/nasty, and see if that helps stop it getting to the 'non-ignorable'/nasty point so often. I would definitely say that Ventolin is designed to be used before things get too bad, though it doesn't always work that way in practice I know.

Naturesvalley profile image
Naturesvalley

I have both sats and peak flow meter. I use these when I get short off breath as they are an indicator that something is up. I do a diary an give it to my gp who then decides on the appropriate action. I started this when I had covid and it helped especially when I was very poorly

PPxwoods profile image
PPxwoods

Same results almost

Pulse at resting is 60 to 80

During acute asthma with steroid and additional ventolin pulse goes to 95 to 105

Oximetry ranges from 95 to 99

Birthday60 profile image
Birthday60

yes - I now have an IWatch which does it automatically which is helpful - my asthma clinic recommends having one - good to add to your portfolio - fix you get a blood pressure monitor as well - even more fun!!

Lysistrata profile image
LysistrataAdministratorCommunity Ambassador in reply to Birthday60

They (as in sats monitors, not the iWatch) can be useful for specific people with asthma if recommended by their medical team, as it seems yours has. But as per the post above, they're not generally recommended for asthma monitoring.

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