My mum is 76 and has COPD. She has been become increasing SOB and i know thats to be expected but its so hard to get home o2 in nz because the criteria is so almost unreachable. On my pulse oximeter she has been low to mid 80s and same on the doctors but when the respiratory nurse CNS came to visit her pulse oximeter says 91 meaning shes borderline meeting the criteria(she had started a course of prednisone a couple of days before). has anyone had this issue with different pulse oximeters? its silly that the difference can mean she may not get it. She is in bed all the time because she is so SOB she cant do anything else. The nurse said she doesnt look unwell enough when she probably feeling slightly better on prednisone. Any thoughts?
Do you have an emergency plan for when the reading is below a certain number?
I don't understand this; oxygen supplementation is based on standards determined hopefully by a pulmonologist. Although I don't have a citation for this, Medicare is involved in determining those standards.
DME suppliers provide the oxygen and supplies.
My recollection of a mid 80's Sat Rate is that it's well below acceptable and your mother should be on supplemental oxygen.
I'm not sure the issue is different Pulse Oxes, although it could be. But night respiration is different from daytime, as is actively moving vs. being stationary.
I just did a sleep test and I am positive that I will wind up with some kind of CPAP machine. Not thrilled, but maybe that will help me feel less logy all day.
Not sure--but altitude may have something to do with it? We lives at 5500 miles above sea level, and when I am at sea level, I oxygenate at a high 90. Dunno if that's an issue.
In short, discuss with doctor. Ask what actions to take if Mum falls below a certain number he finds acceptable. More than that, do know that Mum is the best to discuss her own "subjective" symptoms with you. A feeling of "shortness of breath " is of concern and requires assessment.
You should be getting numbers close to what the RN is getting on your home oximeter, so may be time to change that out if you are not. Most who use at home devices such as BP monitors do not understand that they should take this device to MD office in order to ascertain that it is working and is giving numbers close to the professional's devices.
Wishing you good luck.
The rise is more likely to be the benefit of the prednisone than dodgy readings. Having said that, 91 is still not exactly great, and if it was 91 provided your mother sat tight in her chair and wasn't, for example, asked to walk to the bathroom, get into bed, or fetch herself a drink so that the nurse could observe what happened then it really isn't great and you should argue. Ask for another assessment including one or two activities of daily living.
Your best bet might be to take readings over the next few days and keep a journal of what your mother was doing. E.g.
Monday:
on waking
walked [distance] to the bathroom
recovery allowed 3 minutes
seated on perching stool to wash
recovery allowed 3 minutes
walked to the kitchen with rest interval(s)
etc etc etc
You don't have to make it this detailed - the aim is to build up a picture showing what happens during a reasonable standard day.
There are negatives to O2 as well as benefits. I'm not familiar with best practice in NZ, but if they try to avoid hooking people up to concentrators there probably are good arguments for it. Would it be practical for her to use one in her home?
How long have the steroids been prescribed for, has the doctor explained all that?
Sometimes is is the actual oxygen in the blood, or the actual blood pressure of the patient that varies. Other times it is the setting, the machines used and the expertise of the person taking the reading that vary.
It is important to get an accurate reading over time, record this on a medical file you are keeping at home, then show the doctor. The readings plus other observations will be what determine the treatment your mother's doctor orders.
Your concern is that your Mom may not be getting enough oxygen. Put her STATS in writing, present that to the doctor.
"A normal level of oxygen is usually 95% or higher. Some people with chronic lung disease or sleep apnea can have normal levels around 90%. The “SpO2” reading on a pulse oximeter shows the percentage of oxygen in someone's blood. If your home SpO2 reading is lower than 95%, call your health care provider." per online.
Over oxygenation can also be problematic. You can enter: "Can too much oxygenation harm a patient". Then pick the articles that you can best understand what they are teaching. MacinCT confirms what I found:
"CMS criteria for home oxygen or increasing the flow is 88 for 5 minutes".