Oxygen saturation level - what's OK?

[1starwars2]

I am a middle aged asthmatic.
I recently got a finger pulse and oxygen level meter.
I saw Dr today (and got antibiotics and steroids) for a wheeze I can't shake.
I meant to ask the Dr what is a reasonable/concerning oxygen saturation level. It was 91% on Dr's meter.
Anyone know at what point I should be concerned as my asthma has been pretty rubbish this year and trying to monitor it.

Normal o2 sats in healthy people with no respiratory issues are 95%+ on room air

In people with moderate asthma it isn’t unusual to see 92% and severe asthmatics you see sats of below 92%.

Have you got a diagnosis of severe asthma? I would not be happy with sats of 91%. Did your GP perform a peak flow test? Have you got a follow up appointment?

I would be recommending a&e for that, your Doctor is bonkers!

Did your GP do the pulse ox? As in are they aware it is that low? Any changes in your inhalers as well as the steroids and abx?

No follow up, apart from me to phone if no improvement tomorrow.
I am feeling OK now, although mornings are usually worse.
So I should be aiming for/happy with 95 or above?
I have a peak flow meter and going to start monitoring that myself, as I think I have got too used to being a bit wheezy.
No diagnosis of severe asthma. I also take montelukast and sirdupla.
I do feel like my asthma has got worse in the last 9 months.

Above 94 is deemed normal.

DH has an 'interesting' medical history when it comes to lungs, so we've asked a range of medics over the years.

95+ is good
90-94: needs help
below 90: A&E.

Based on that, your doctor was behaving reasonably, especially if you're asthmatic.

We have a pulse oximiter that we use at home - really helpful when DH is unwell; his cost £5 from Amazon.

Pulse oximeters aren’t 100% reliable though, the main plus is that they non-invasive and give a quick result. Blood gases give a much more accurate result but are more invasive and the results aren’t instant.

How are you functioning day to day? I’d expect to see or hear reports of some symptoms from someone with a consistent 91% sats level.

91 was Dr's meter, but 95 on mine now.
I think it is easy to get used to being breathless over time, and really I don't want that to be the norm.

If you have been given treatment then given the current situation ie Covid it’s safer to stay at home and let the medicines kick in. If it goes lower than 89 I’d ring 111 and ask for advice.

I have asthma. That’s what I would do anyway.

Thanks bathorshower that's useful.

I think I have slightly lost a sense of what is normal and accepting being wheezy and taking rescue inhaler a lot. Yes I have symptoms and that's why I called Dr.

I ran a marathon less than 5 years ago so would like to get back to that level of lung function.

@1starwars2

No follow up, apart from me to phone if no improvement tomorrow. I am feeling OK now, although mornings are usually worse. So I should be aiming for/happy with 95 or above? I have a peak flow meter and going to start monitoring that myself, as I think I have got too used to being a bit wheezy. No diagnosis of severe asthma. I also take montelukast and sirdupla. I do feel like my asthma has got worse in the last 9 months.

As you have an asthma diagnosis you may not be able to attain a 95%+ saturation level (it may only be attainable for mild asthmatics) but I would expect to see something over 92% in those if you are infection free and your asthma is controlled.

If you’ve had a wheeze for a long time and feel that your asthma is worsening, I’d be requesting a referral to the asthma clinic/specialist nurse for a review.

Thanks Bagels.
I am not concerned I need any urgent intervention, but just trying to be a bit more on the ball.

Definitely call them tomoro to clarify

Thanks JonHamm.
I haven't had a review for a while, I will see if they are happening - do you think they are?

91% is a bit low but as a single number out of context it’s not very helpful. If your sats are normally only 93% (for example) then it’s barely changed, but if it’s normally 100% then that’s more interesting. It’s also important to remember though that the sats probes aren’t terribly reliable and low sats may reflect cold hands/bad circulation/a knackered probe/nail varnish as much as low oxygen levels. As an individual marker of unwellness it’s a pretty blunt tool and not that reliable - what’s probably as important is how you look and feel generally/respiratory rate/pulse etc. and whether things are getting better/worse. Hope you’re feeling better soon.

@1starwars2

Thanks JonHamm. I haven't had a review for a while, I will see if they are happening - do you think they are?

I couldn’t say. It will depend on your local NHS Trust’s policy.

Greybeardy good point re what is normal.
I haven't used it very often, but definitely never 100%, possibly 94-97, but I intend to start keeping a record along with my peak flow.
No nail varnish and the meter is new. I think my circulation is good - warm hands.

I don’t know about your Gp practice but just last week in London I was accidentally booked with an asthma nurse instead of diabetes nurse for my yearly check up and medication review.

Asthma clinic reviews are still being held. I have been summoned for mine today.

As an aside - asthmatics can be ‘super oxygenators’. Especially those who are normally sporty. Have you looked at the asthma uk website? Lots of help and advice and they have nurses you can contact if worried about anything regarding asthma.

OK I will give that a go. I haven't found recent asthma reviews terribly useful, but if I keep a note of my paek flow that will help.

Dunno about adults but my DS was in hospital on oxygen on 88/89

91 is low, and it will go lower when you sleep. Both of my kids had oxygen in the mid-80’s so they have stay in hospital on oxygen and get treatments until they improved. Staying in the 80’s could cause brain damages
They told me anything under 90’s is a warrant to see a doctor.

But before you test, make sure you have no finger nail paint/polish, it can affect the reading.

How many breathe you take per minute matter as well but someone has count it without your knowledge that they are counting for it to be accurate.

I am asthmatic, I wasn’t well last week I spoke to the asthma nurse, and was told to seek emergency help if sats went below 90 as I would need oxygen. I did hit 88 briefly but it picked up to 91 very quickly, I have had an oximeter for a while and find that if you monitor for a couple of minutes it often gives a better picture as it can fluctuate, it is reassuring if you see it isn’t consistently low.

The nurse did say that at the moment if possible ring 111 before going to A & E so they can direct you to a safe zone.

Has your heart function been checked OP? Does your inhaler provide relief? Just asking as DH's heart issues were misdiagnosed as worsening asthma for a long time. Probably irrelevent in your case but just wanted to check.