When I found myself in the world of respiratory care in 1980, believe it or not, school and credentialing were not required for a person to work in respiratory care!* We learned as we worked by watching our colleagues and by doing. Connie, a registered respiratory therapist and the assistant director of our department, was knowledgeable, compassionate, and practical. I followed her to all areas of the hospital, and she stood with me at the bedside and taught me how to do respiratory care. Something I learned right away was to always look at the patient first. She said, “If you’re working in ICU and hear a ventilator alarm, don’t look at the machine right away. Always look at the patient first and figure out if something’s going on with them. Sure, the settings on the ventilator—the numbers— are important, but always look at the patient first.”
How about you and your home respiratory equipment, specifically your pulse oximeter? Do you look at yourself first? Yes, it’s important to know that the numbers—oxygen saturation and heart rate— are at safe levels. Yet, it’s not good to get too carried away with the numbers only. If you see a drop in your oxygen saturation, you can ask yourself: Has something changed? Am I more short of breath than usual? Has this happened before, and if so, what happened next? Do I have any early warning signs of exacerbation? Are my lips and fingertips a pinkish color, or are they blueish or gray? Can I speak in full sentences without stopping to take a breath? Am I thinking clearly?
Knowing how to look at yourself and be aware of signs that you’re doing okay or not, is essential in keeping a balance between looking at the numbers on that little screen and understanding what’s happening in your body. When you find this balance, you are empowered to figure out what’s going on.
In order to do a self-assessment using correct information, you should be sure that the numbers on your pulse oximeter are accurate. Let’s look at just a few ways you can get the most out of using your pulse oximeter.
Before you start using your pulse oximeter, ask your doctor, “What is the lowest oxygen saturation number that is safe for me?” And if your oxygen saturation numbers drop lower than that, ask if you should call your doctor, go to the emergency room, if you are on supplemental oxygen should you dial up your liter per minute (lpm) flow, or do something else?
Note: If you think you may have been exposed to COVID-19, talk with your doctor about monitoring your oxygen saturation even if you are not short of breath. (Yes, doing this is kind of an exception to what we’re talking about here, but it’s that important!)
When checking your pulse oximetry:
- Watch for the flashing light, flashing heart, or wave form to make sure your oximeter is picking up every beat.
- Keep the pulse oximeter on your finger for 20-30 seconds for an accurate reading.
- Keep your hand as still and as relaxed as possible.
- Try doing pursed-lip breathing (and diaphragmatic breathing if you are able) while using your pulse oximeter to see if your oxygen saturation number goes up. Breathing Techniques | COPD Foundation
- Do not use on a finger with dark nail polish or an artificial nail.
- If you have poor circulation in your hands, you may need to use a sensor other than the finger clip (pulse oximetry can be done accurately with a sensor on your ear or forehead).
- Keep in mind that if your oxygen saturation is okay when you’re sitting down, it may drop when you stand up and exert.
So…how about you? Do you look at yourself first? Or do you depend, maybe a bit too much, on the numbers? If you’ve learned how to keep a good balance between looking at the numbers and looking at yourself first, we’d love to hear about it.
Let’s talk! I look forward to hearing from you!
*Respiratory therapists are now required to obtain an associate’s, bachelor’s, or master’s degree from an accredited respiratory therapy education program. Graduates then must pass written and clinical national board exams in order to work as a respiratory therapist. I began my respiratory care schooling in 1981 and obtained my certification in July, 1983.
For more information, talk with your doctor and check out these resources:
Which Pulse Oximeter is Right for You?
Pulse Oximeters: Do you have questions?
Teaching with a Twist - Oxygenate
How a Pulse Oximeter Works | COPD Foundation
Breathing Techniques | COPD Foundation