While variability in infant SpO2 is a well-known phenomenon, the amount seen here was unexpected. For example, the range of true saturations frequently recorded was quite wide at a reported mean SpO2 of 90% (from 81 to 94%; but, the range was only from 92 to 98% at a mean SpO2 of 96%). A normal SpO 2 is 95 to 100%. A value below 95% is reduced but considered adequate if it is above 88%. In fact, for oxygen to be paid by an insurance company, the SpO 2 needs to be 88% or below. The oxygen saturation is normally measured by a pulse oximeter placed on a finger, but a Wrist Bracelet can also be used. The brain gets affected when the SpO2 level falls below 80-85%. Cyanosis develops when the SpO2 level drops below 65%. The normal oxygen levels in a pulse oximeter usually range from 95% to 100%. Note: Normal levels may vary if you have lung disorders. Your doctor can tell what levels are normal for you.
As noted in the article, an SpO2 of 90% correlates well with a PO2 of 90. Back when I started as an RT 20 years ago, we wanted to keep patients at 92% or better. This was basically to play it safe. Today, we use 90%. Medicare uses 88%. For instance, you must have a walking SpO2 of 88% or less to qualify for home oxygen. Oxygen saturation is the fraction of oxygen-saturated hemoglobin relative to total hemoglobin (unsaturated + saturated) in the blood.The human body requires and regulates a very precise and specific balance of oxygen in the blood.
Doctors will often monitor your oxygen levels. These can be monitored by using a pulse oximeter. You can monitor your own oxygen levels at home by purchasing your own pulse oximeter. Still, what is the best way of interpreting your oxygen levels? What do they mean? Here’s what to know.
What is partial pressure of arterial oxygen (PaO2)?
This is the most accurate oxygen level that we monitor. It’s how much oxygen is inside your arterial blood. A perfect reading would be 104. However, anything between 80-100 is considered acceptable. A PaO2 of 60-79 is considered mild hypoxemia. A PaO2 of 40-79 is considered moderate hypoxemia, and a PaO2 of less than 40 is considered severe hypoxemia.
Hypoxemia is a fancy term for a low arterial blood oxygen level. Most experts accept the PaO2 value of 60 as the baseline value we want to maintain. If COPD is causing a PaO2 of less than 60, supplemental oxygen is indicated. Usually, with COPD, all that is needed is a low flow of 2-3 LPM. This is usually all that is needed to maintain a PaO2 of 60 or better. If you want, you can read my article, 'How To Qualify For Home Oxygen Therapy?'
There is only one way to learn what your PaO2 is. It is to draw blood from one of your arteries. The artery we usually draw it from is the radial artery. This is an artery that is near the surface on the thumb side of the back of your wrist. This test is called an Arterial Blood Gas (ABG). This is an invasive blood draw.
What is oxygen saturation (SpO2)?
SpO2 is another oxygen level. It’s the percentage of oxygen molecules you inhale that make it to your arterial blood. A perfectly normal value is 98%. However, anything greater than 90% is considered acceptable. For some people with COPD, doctors consider anything between 88-92% to be acceptable.
This value is determined using a pulse oximeter. It’s a small, hand-held device that you slip over a finger, toe, or earlobe. You can purchase these in stores. The ones you buy for your home are usually ones that slip over your finger.
These devices can be purchased for less than $30. You can get them from online stores like Amazon. I have seen them at stores like Aldi. The trick here is that you will want to make sure the one you buy is FDA approved. This will ensure that you are getting an accurate reading.
How are pulse oximeters helpful?
Pulse oximeters are helpful because they offer a simple, noninvasive way of determining your oxygen level. But your SpO2 level can also help determine your PaO2. This is by means of the 4-5-6-7-8-9 Rule.
It goes like this.
- 40 PaO2 equals an SpO2 of 70%
- 50 PaO2 equals an SpO2 of 80%
- 60 PaO2 equals an Spo2 of 90%
Basically, you take your SpO2 value minus 30. This gives an 'estimate' of where your PaO2 stands. By doing my own experiments, I have determined this 'estimated' PaO2 to be pretty accurate.
So, if your pulse oximeter gives you a reading of 90%, this means that your estimated PaO2 is 60. That’s right about where we want it. This is why the hospital I work for has a policy of maintaining a SpO2 of 90%. There are some exceptions that we can discuss in a future post if you want.
Spo2 Chart By Age
A helpful tool
Pulse oximeters are nice. They allow you and doctors to monitor your oxygen level at pretty much any time and place. It’s simple, painless, and accurate as long as you have a pulse oximeter that is FDA approved. You should talk to your doctor about determining what SpO2 level is best for you. For most people, it’s 90% or better. However, with some people with COPD, 88% is acceptable too. To learn what oxygen levels are best for you, talk to your COPD doctor.
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Low oxygen levels will rob you of your eye sight, short term memory, and your energy. Eventually low oxygen levels will weaken your heart muscle.
Heart Failure IS -> Progressive weakening of your heart muscle! (Read that sentence again. It is that important.)
The world is facing an epidemic of heart failure! This ONE health crisis will rob more productive work years from Americans than any other.
Why should you be concerned about oxygen?
Oxygen isn’t typically something you worry about. If you are looking into “low oxygen levels”, you likely heard the term from your doctor. As the caregiver of a loved one, you
might become familiar with the importance of oxygen as a life saving requirement, but fail to realize how effective it can be in minimizing discomfort and maintaining quality-of-
life.
Everyone worries about high blood pressure, carrying extra weight and other issues routine blood work can reveal. It’s all part of the natural aging process and your growing
concern for your health. After all, you don’t ignore your bad health until it kills you if you know better, right?
Being over-weight increases your risk for many diseases, especially heart disease. So, you diet and attempt to get “regular exercise”. Maybe you join a gym, or consider
gastric bypass surgery. You do what it takes because health is important.
High blood pressure is called the silent killer, because it can be deadly without symptoms. Most people know that it’s important to get their blood pressure checked
regularly, just to be safe.
You’ve been told you should worry about your cholesterol levels. Everybody seems to know that reducing your bad cholesterol is important, so your doctor will likely offer
you a prescription to lower your cholesterol if it is elevated. Even if your cholesterol isn’t elevated, your doctor may prescribe Statin medication as a “precaution” when you
have other risk factors for heart disease. (That so called preventative medication might not be such a good idea.
There are plenty of risk factors to worry about. Why add oxygen to the list?
If your doctor is expressing concern about your blood oxygen levels, you should be concerned, too.
You may be inclined to argue with your doctor if he/she would like to see you using oxygen 24 hours a day. It’s fair to say that round-the-clock oxygen therapy is inconvenient and irritating.
It’s also difficult to understand why it is necessary.
What is there to be concerned about?
Consequences of Low Blood Oxygen Level:
• damage eye sight
• deteriorate short term memory
• weaken muscle (your heart is a muscle)
• increase pain
• reduced clarity/focus
• loss of your natural charming disposition
• potentially create life threatening cranial nerve stimulation
Since low-flow home-oxygen is completely safe and doesn’t cause side-effects you are better off to use it than to resist using it and suffer the consequences of low blood oxygen. It isn’t an easy to swallow pill, but it might just be more important than every pill in your pill box.
Oxygen is one prescription you don’t want to second guess.
If your doctor wants you on oxygen, you are crazy to argue.
Does your doctor monitor your blood oxygen levels routinely?
Not all doctors have oximeters (oxygen measuring devices) in their office. If they don’t have one, they have no way to routinely monitor your oxygen level during your physicals, check-ups and illness related appointments.
This isn’t at all unusual. Even if doctors have oximeters, they may not use them unless you have some sort of breathing complaint. It isn’t widely understood, even with doctors, that low oxygen is most often NOT accompanied by shortness-of-breath.
It isn’t at all uncommon for doctors and nurses to minimize the importance of oxygen therapy and to dismiss low oxygen readings if they only last a short period of time.
This approach is much like waiting for things to get worse.
Whether your doctor monitors your blood oxygen level or not, YOU SHOULD.
There is no doubt about it. Taking an active role in your health care can cause you more stress than putting blind trust in your doctor, but if your doctor doesn’t offer you thesolution you need, who will?
Doctors are making educated guesses and doing the best they can. Luckily they also have the benefit of a well educated team with many years of combined experience. Good health care requires team work. It can be tempting to allow your doctor to lead the team but NO ONE is more motivated and invested in finding solutions to your suffering than YOU are.
It’s important for you to be aware that your participation is the key to positive results.
Certainly, if your health care team doesn’t successfully uncover the cause of your suffering and eliminate it or otherwise address it, you are the only one who will suffer the consequence. Ultimately, you pay the price for oversights and mistakes.
Unfortunately, low blood oxygen causes devastating consequences.
If your doctor is advocating for oxygen therapy, you are fortunate. Most doctors overlook the harm low oxygen levels are causing and shrug off the importance of monitoring and meeting oxygen needs.
Good quality-of-life is your goal. The damage caused by low oxygen levels prevents you from functioning the way you normally would. How much joy would you lose if your
eyesight slowly deteriorated?
As you age, you tend to think you are just getting old and out of shape. The progressive muscle weakening caused by low oxygen levels effects your heart muscle. When your
heart muscle is weakened by low oxygen levels your whole world changes, but it doesn’t typically happen all of a sudden.
When you suffer a heart attack part of your heart muscle dies. With congestive heart failure things [more often than not] happen very slowly. The progressive weakening of your heart muscle is gradual. For years your doctor will tell you “your heart is fine”.
Once you know you are living with congestive heart failure, you should understand that oxygen is the key to protecting your weakened heart muscle and to strengthening it.
Low oxygen is a BIG deal.
If your low oxygen levels are caused by lung disease, it’s important to remember that keeping your blood oxygen level above 92% is important to protect your heart.
If your low oxygen levels are caused by heart disease, it’s important to remember that failing to address low oxygen levels will further weaken your heart muscle.
So how low is too low?
7 Facts to Remember About Blood Oxygen Saturation Levels
1. When oxygen saturation levels fall below 92%, the pressure of the oxygen in your blood is too low to penetrate the walls of the red blood cells. It is a matter of gas laws.
2. Your insurance company may not pay for oxygen unless your levels fall to 88% oxygen saturation. This has nothing to do with what is best for you, it is just the point at which your insurance is willing to pay.
3. Every time your oxygen level falls below 92% saturation the cells of your body are oxygen starved.
4. When you fail to meet your oxygen needs, every organ in your body suffers the consequences.
5. Low oxygen levels may be present only at certain times.
Spo2 92-93
- when retaining excessive fluid
- when airways are reacting to irritants
Spo2 92
- with respiratory illness
- sleep apnea
- about 3:00am when you wake gasping for air
- with activity when your heart muscle has become weak, though isn’t technically “congestive heart failure”….. yet
6. Recurring low oxygen levels are harmful and should be treated with supplemental oxygen.
7. The problem is that your doctor may not witness your oxygen levels at 88%, and if he doesn’t see that reading on an oxygen meter (oximeter), then most insurance companies will not pay for it, and therefore doctors don’t order it.
Low oxygen levels are definitely something to worry about!
If you feel you may be experiencing low oxygen levels be sure to ask your doctor to check your pulse oximetry reading.
Symptoms of low oxygen are:
- shortness of breath/ difficulty breathing/ dyspnea
- extreme fatigue
- chest tightness
- mental confusion
- tingling fingers
- water retention (especially feet/ ankles)
- chronic cough
If you are experiencing blood oxygen saturation levels below 92% now, waiting for your doctor to witness it below 88% and order oxygen is equal to sitting around waiting to get worse.
Are you concerned?
92 Spo2 Level
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