“Do you have a pulse oximeter at home?” “Have you checked your O2 sats (saturation)?” “What does your pulse ox say?” Those are some questions that I used to ask my patients all the time when I was leading a pulmonary rehabilitation class or talking to one of our patients who was in the hospital. It was a quick way to get a snapshot of how the person was doing and if they needed help or not.
The pulse oximeter, or pulse ox, is a handy device that I believe everyone should have in their home medicine cabinet, but it does not tell the whole story by itself. In fact, if that device is the only thing you are using to gauge your lung health, you may be missing a big part of the picture.
What do I mean by that? Say for instance one morning you find your sinuses are a little congested and you are running a low-grade temperature. You might grab your pulse ox and find that your oxygen level is 96% and your heart rate is 80 BPM (beats per minute.) That looks good and doesn’t sound any alarm bells, right?
Then let us imagine the next day you wake up to find the congestion has moved into your chest and lungs. Again, you might reach for your pulse ox. This time you find that you still have a little temperature, your oxygen level is 95%, and your heart rate is 105 BPM. Would that get your attention? Maybe, but probably not for most people. The thing I would take notice of on this particular morning is that the oxygen level is about normal, but the heart rate is higher than it usually is. It looks like the heart might be working harder to keep the oxygen levels up in the normal range.
If you have created a “My COPD Action Plan” with your doctor, then you would look to see what he or she wants you to do if you are experiencing a “Yellow Day.” Do they want you to call the office? Should you start an antibiotic? What do they want you to do to start treating an exacerbation (flare-up)? This is one instance where keeping an eye on your oxygen saturations and heart rate can help you recognize when something is not normal so you can get help.
If it is so helpful, then why did I say you may be missing part of the big picture? Because the pulse ox is a device with limits. It really does only give you a quick snapshot into how someone is doing when it is used correctly. The pulse oximeter can lose some of its accuracy if your fingers are cold, if your blood pressure is low, if you are moving around a bit, or if you have on dark nail polish. Any one of these conditions might create a low oxygen level on your monitor. If you don’t know to warm up your hands, or if you don’t realize your blood pressure is low, you may be worried about low oxygen levels. If your hands are cold, that is an easy fix, but if it is your blood pressure, then that is a real problem that needs to be corrected. In that case, your low oxygen might have led you to discover your low blood pressure and get treatment for it.
Of course, there are times when you may feel like things are not quite normal, but your oxygen level looks like things are in your normal range. In a situation like this, you would go back to your My COPD Action Plan and you would find that you are actually having a Yellow Day. Would that surprise you? Helping you recognize Yellow Days is one of the reasons we talk about the My COPD Action Plan so much. By helping you detect the warning signs, the action plan can show you what you can do to get ahead of the problem and hopefully keep your exacerbation from getting worse.
If you are interested in a little more information on how the pulse oximeter works and how it can tell how much oxygen you have in your blood, here is an article you might enjoy: https://www.copdfoundation.org/COPD360social/Community/Questions-and-Answers/Teaching-with-a-Twist-Oxygenate.aspx
Now, let me hear from you! Do you have questions or comments about pulse oximeters? Your questions might help someone else learn, don’t be shy!