Can you help settle this argument about oxygen saturations please?

[elliejjtiny]

I have no medical qualifications but I have picked up some basic medical knowledge from working in a chemist, having dc who are medically complex and watching casualty.

MIL is often saying completely inaccurate medical information about people e.g. telling everyone who will listen that her nephew had psychosis when he actually had psoriasis, that kind of thing. It's a real bugbear of mine because I really worry when family members etc are ill so I hate it when she says the wrong information an would rather she just wouldn't tell me anything.

Anyway she was talking yesterday about a mutual friend who has breathing problems and she was saying that her oxygen sats were 80% and that anyone with sats lower than 95% needs to be in hospital.

I know 80% oxygen sats are bad and need treating. But the 95% thing is utter rubbish. I'm pretty sure there is no magic number that means you need to be in hospital, it depends on why your sats are low. And while 99-100% is the number to aim for, 95% isn't that bad at all and certainly not bad enough to need hospital admission for that reason alone. When my dc have been on sats monitors I get a bit concerned when it goes down to about 92% and that's normally when it starts beeping. I am concerned for my friend but the drs are aware and she is getting treatment. Although when I see her I will be checking the 80% sats thing as I don't trust what mil says.

Is she didn't know the difference between psychosis and psoriasis, why are you giving any headspace to any medical information she tells you? Just assume she's mistaken and move on!

It doesn't matter at all. She's not a doctor. Just let it go.

her nephew had psychosis when he actually had psoriasis

Laughing out loud at that!! Poor nephew!!

Anyway I hope your friend is better soon but I think you've got it. Normal o2 sats are about 95-100% for most people but that doesn't mean you're staying in the hospital forever more if it's lower. Some people have a far lower 'normal', say with chronic COPD. Hypoxemia (low O2 ) would need investigating and probably monitoring but not necessarily as an in patient. Depends on the circumstances.

If MIL is frequently wrong then ignore what she is saying. However since it's a mutual friend can you not ask the friend directly as you are worried?

Oxygen stats are the same as everything else, it will depend on what is normal for that person. When I was diagnosed with COPD and in hospital they released me when mine were 89% as they decided that was my normal.

So, it depends on how bad your friend's breathing problems are and whether they usually fluctuate, but personally I wouldn't worry unless they were showing an 8 at the beginning. Do they seem to be struggling?

I’m laughing out loud at psoriasis psychosis too.

ignore the oxygen thing. Leave her to it, I doubt anyone would take her seriously.

there are no magical numbers that warrant hospitalisation/treatment... it all very much depends on context. HCPs are more easily able to apply that context whereas 'normal' people aren't so much. So as a general rule if a non-HCP spots sats that are 'low' (and probably 93-94% is a sensible trigger point because that's close to the point at which the oxy-haemoglobin dissociation curve drops off sharply) then that warrants more thought by an HCP.... however, it doesn't necessarily mean there's a problem that needs hospitalisation. You can be profoundly unwell with completely normal sats and you can be completely well with 'dangerously low' sats... it's all about the context.

FWIW, sats probes are not the most useful monitors out there and the reliance/reassurance that people get from them in the community is quite worrying, particularly when people are using it to monitor their kids (children are well known to compensate really well despite being really sick, but then suddenly land in a massive heap quite quickly). They also aren't always accurate if the sats are genuinely low.

Sats are only one variable we look at when we're thinking about oxygen delivery (which is actually what we're interested in), and the sats need to be considered alongside cardiac output/BP, work of breathing, whether they're on oxygen, what their haemoglobin might be, whether there are any signs of poor tissue oxygenation....blah blah blah (doesn't mean those things all need measuring every time, but at least some thought needs to go into whether then need checking). All of that then needs considering with the likely underlying diagnosis/other medical problems/how the customer looks/whether it's getting better/worse/ and whether escalating treatment is appropriate.

Sats of 80% are never normal and do need some experienced brains to think about (for someone with severe COPD it may be that it doesn't ring massive alarm bells because their normal might be much lower than most people's, but that cannot be assumed every time/first time/by someone who doesn't understand the physiology) - those sats should never be ignored by someone without medical experience.

It's not that uncommon for people to mix up words like psychosis and psoriasis. Casualty stopped being a useful source medicine before I started training thousands of years ago (ER was much more accurate though).

Your MIL sounds like an idiot! Mine has always said 'they have the CoviT' 🙄

I agree with others, that sats alone are not a marker, its taken on the whole context of that person and other readings.

Years ago at uni we had an exam on burns and various treatments. If the skin becomes too tight, an escharotomy is performed to relief pressure. My friend had a complete brain fart, and through the entire exam, wrote episiotomy instead- which is a very different procedure!

Thankyou. I have talked to my friend but she always plays things down and then Mil is over dramatic. MIL 's nephew was thankfully too young to be aware of the mix up, although it caused a panic with some family members as it's not good for anyone to have psychosis, but it would be particularly worrying, and probably impossible tbh, at nephew's age.

I'm not particularly worried about my friend as I know she is getting treatment and getting better and tbh I don't trust MIL being right about the 80% either as she tends to massively exaggerate anything with numbers in it as well as spouting medical nonsense. She is always diagnosing people with tonsilitus and keeps telling me that I will get tonsilitus worse than most people because I had my tonsils out! I've explained to her multiple times that I was getting tonsilitus once a month before and then nothing in the 30 years since I've had them out. She still doesn't believe me though.