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Mysterious, amazingly low oxygen levels, a pulse oximeter may give the first warning of coronavirus

Pulse Oximeter

A pulse Oximeter     | Image Thinkpaul: Wikimedia

A cheap device might keep people off ventilators and be the first warning of trouble

In coronavirus blood oxygen levels can silently drop to unheard of levels. People may be unaware they even have coronavirus as oxygen levels fall to the point, medicos are rewriting the record books. This is a hypoxia crisis — it’s a defining feature of the disease. In the UK, the demand for oxygen at hospitals is so great that the NHS is running out, rationing it, and asking docs to lower their blood oxygen targets.

People are monitoring their “blood oxy sats” at home so they get an early warning that they need more serious medical help. Normal blood oxygen levels are 95-100% saturated. Doctors used to get uppity at levels below 92%, and hospital alarms often go off if children with asthma fall below 90%. At 88% doctors are putting people on continuous oxygen therapy. Levels below 80% are considered dangerous enough to start causing organ damage. But medical staff are finding conscious covid patients with levels so low they are unheard of — an unbelieveable 50 percent. I read somewhere an ambulance medic found someone with a reading of 35%.

Dr Levitan, an emergency doctor in New York recommended a week ago that a pulse oximeter at home would save lives and prevent patients from ultimately needing the highly invasive, expensive ventilator treatment which was so dangerous and such a drain on hospitals.

Oximeters are cheap devices, bound to be disappearing off chemist shelves and from Ebay and Amazon right now, but if you are high risk, or in a high risk area, it might be worth trying to track one down.

The Infection That’s Silently Killing Coronavirus Patients

Richard Levitan in a New York Times op-ed

…almost all the E.R. patients had Covid pneumonia.

Apparently, some of those asymptomatic cases are already suffering from pnumonia. This wasn’t the point of the article, but the message implied in here is that there may be walking cases of Covid who think they are fine, but they are already suffering lung damage.

Even patients without respiratory complaints had Covid pneumonia. The patient stabbed in the shoulder, whom we X-rayed because we worried he had a collapsed lung, actually had Covid pneumonia. In patients on whom we did CT scans because they were injured in falls, we coincidentally found Covid pneumonia. Elderly patients who had passed out for unknown reasons and a number of diabetic patients were found to have it.

And here is what really surprised us: These patients did not report any sensation of breathing problems, even though their chest X-rays showed diffuse pneumonia and their oxygen was below normal. How could this be?

Normally people with low oxygen levels are struggling to breathe, gasping, working their intercostal chest muscles between their ribs. They are in distress. But with Covid patients they may feel OK, and be able to talk on the phone. By the time they get to the hospital they already have fairly serious case of pneumonia and the chest x-rays show it. About 20% of these patients will go on the the more serious “wet lung” type of pnumonia which needs a ventilator. The hope is that people who get treatment early may be able to avoid the ventilator stage.

…when Covid pneumonia first strikes, patients don’t feel short of breath, even as their oxygen levels fall. And by the time they do, they have alarmingly low oxygen levels and moderate-to-severe pneumonia (as seen on chest X-rays).

 He recommends all people who have tested positive for coronavirus, or have respiratory symptoms use an oximeter for two weeks.

Pulse oximeters helped save the lives of two emergency physicians I know, alerting them early on to the need for treatment. When they noticed their oxygen levels declining, both went to the hospital and recovered (though one waited longer and required more treatment). Detection of hypoxia, early treatment and close monitoring apparently also worked for Boris Johnson, the British prime minister.

 Teams are currently working on all kinds of ways to monitor blood oxygen levels, including with Raspberry Pi’s.

Not all medicos think this is a good idea, but for a smart audience who can weigh up the pros and cons and give themselves a bit of training, it’s a cheap bit of insurance. I’ve got one and have used it for years.

 What’s A Pulse Oximeter? Is It A Good Idea To Buy One?

Laurel Walmsley

 …a pulse oximeter might signal that you’re in trouble before you realize it. That’s what Levitan saw when he spent 10 days working in the ER at Bellevue Hospital in New York City earlier this month: Many COVID patients were already very sick with COVID pneumonia by the time they arrived. They were breathing rapidly, their blood oxygen levels dangerously low. Like mountain climbers, the patients had grown accustomed to gradually decreasing levels of oxygen and didn’t realize they were in distress.

Many of them said they only recently started feeling short of breath though they had experienced symptoms of COVID-19 for days. By the time the patients went to the hospital, says Levitan, the virus had already damaged their lungs, and many were in critical condition. He saw COVID pneumonia patients with oxygen saturation levels as low as 50 percent.

NPR goes on to discuss reasons to get one, as well as reasons not to — with warnings and instructions. Read the NPR article and other links, but most of the warnings about using them probably don’t apply to the well educated person. The warnings about untrained users sound like anti-mask messages did — contradictory and patronising. Bright lights can skew the readings, as can nail polish or pre existing conditions like anemia, asthma or lung disease, so using one when you are healthy is good practice to get the “normal” trendline.

Like masks and PPE, pulse oximeters are suddenly going to become hot property, and thus, mass produced.

Curiously, sales of pulse oximeters dramatically rose in the US on Jan 20th when the first case of coronavirus was recorded in the US, but it seems to me more likely to be a sign of our friendly CCP agents at work — posting meters to China without mentioning to the people around them that they might be useful to have at home.

Note to commenters: Since lives and livelihoods are both at stake, good manners and grace will go a long way. Sometime the worst scaremongers are the ones complaining about other scaremongers.

h/t Mum.

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