Oxygen levels 89-93 for three days

[Pasturesorange]

Good morning,

I wonder if you can advise please? My three year old DS has a cough and had a temperature which has now passed. He’s had a PCR - negative. We have a oximeter at home as my DD has asthma so I’ve been using this on him and his oxygen levels aren’t going above 93 - generally sitting at 90, 91.

We called 111 yesterday morning and took him to urgent care. The dr got the same readings but decided he didn’t need any further support as not showing other signs of respiratory distress and chatting.

He’s now not slept properly for three nights as waking coughing and gasping, he isn’t able to play, as coughing as soon as starts walking around. He’s been sick twice but is eating a little and drinking.

Steam isn’t helping, cold air made him cough to vomit. He’s laying propped up and I’ve tried giving him Benadryl glycerine to ease raw throat.

It’s strange for me that he was just sent home as my daughter has always been given nebulisers, oxygen when her sats got low.

Any ideas how I can make him more comfortable?

Thank you!

Did they not give you any advice on what to do if he didn't improve when you took him in? I am no expert, but I thought sats that low would need some treatment. I'd call 111 again.

I'd say he needs to be seen again

I am also no expert but would be calling 111 again at least I think. If you don't get anywhere today could you take him to the normal GP tomorrow?

Another one saying to take him back in again to be re-assessed given there’s been no improvement and you know the machine is working (as urgent care got sane readings) . Hope he’s soon on the mend

I thought 92 was the minimum acceptable level? Dd1 would have been on oxygen at home on 92 or less, and I would have called an ambulance for less than that (although low sats would have always been couples with resp distress).

The dr view was upper respiratory viruses can last up to 10 days so ride it out. I wouldn’t say he’s any worse than when he was seen but not improving either.

I’d be in a&e with my child -and have been due to sats that low. Go now

I’m an ICU and A+E nurse - we’d have that kid on oxygen and be doing investigations immediately. Even if he’s had an upper respiratory tract infection, that is a very abnormal sao2 reading. Take him in now.

As a nurse I'd be at A&E and wouldn't budge! Anything under 95% is a worry for me. Hope your little one recovers soon xx

My daughter had bronchiolitis when she was 1 and her sats were like that. She was on oxygen for the most part and then overnight obs (she was right as rain by morning). Would definitely take him back in, what are your instincts saying?

Take him to A&E.

Paramedic here and have a severely asthmatic child. His sats were stuck around 92 a few weeks ago - despite everything I could at home. He spent the day in A&E being monitored and they tweaked his inhaler routine (10 pumps every 4 hours)

Put him in the car ans go - do not bother with 111.

Do not call 111.... just go in your own car / taxi please

Agree, go to A and E ASAP xx

Just to add we once got sent home in similar situation and 12 hours later had an ambulance and 5day stay in hospital Witt bronchiolitis

He needs to go back to A&E today. My two year old was admitted and in for three days with sats like that in the summer with bronchiolitis. They wouldn't release him until they were consistently above 95%.

If @nadgersbadgers and @metallicalover said A&E then A&E it is. Hope you are on your way.

I think you need to ring again and see if you can get a plan and some more advice. Hope he feels better soon.

Yes I would go again it seems very odd that you were not given a nebuliser as well that would seem to be fairly standard at home treatment

Echoing others above - straight to A&E. don't bother with 111 again.

@Pasturesorange any update?

Hi, thank you for all your replies. Sorry for the late update - it’s been a long day. We went to a and e where we were sent back to urgent care (they are on the same site - next door to each other) and saw the same dr again due to Ds having signs of covid (a cough) and this being the dr taking these cases this weekend. He looked over ds again - still the same numbers - no sign of respiratory distress so thinks we should just ignore the numbers.

Back home again… ds is actually a bit brighter this afternoon and evening. I’m going to stay at home with him tomorrow and get a dr appointment. The 111/a and e/urgent care set up seems a bit weird to me that moment.. but dr was sure he was fine and I was worrying over nothing. (That being said I also had to queue for an hour standing up on one leg outside a and e 22:00 last summer when I’d broken my foot so covid has put some weird procedures into place!)

Ds had rsv when he’d just turned one and was on a ventilator for a week. DD has probably had 25-30 hospital stays for her asthma (viral induced so starting school meant she was always back and forward for oxygen). I tend to think I’m a bit of an old hand with kids and chest issues but this has made me really second guessing myself. We have never had this kind of reaction to low sats.

It’s weird but thank you for replies - another night of little aleeep on its way now

That’s really concerning. Is there any way you could go to a different hospital? Im an ICU and A&E nurse and no way do we ‘ignore the numbers’, especially in children. That’s madness. I’d be kicking up a stink. Im sorry you’re having to go through this.

Odd. I'd have expected those sats to have resulted in a referral to paeds.

Sounds like you need to go to a different hospital. What kind of Dr ignores the numbers. I'd be seriously concerned

Adult crit care nurse here, continuous sats at that lower end of the 90s definitely warrants further treatment/investigation, esp a child?! Awful (and quite concerning ) your having to go through all this rigmarole. Get onto gp and insist on further tests. Hope you’ve both got some sleep.