Blood Oxygen Test
Lynn*E
clip. It was 99% at rest. We then walked to another building to review
a chest xray I had the day before (came up abnormal but they don't know
what it is yet--nodules of some kind) When I returned I was totally
winded. For me this is not normal. He had them do the finger clip
again, this time it was 90%. He then requested that I have a blood gas
needle test done. Is a drop of 9% bad? It didn't seem all that much to
me.
I heard that this proceedure is painful since they go so deep. Anyone
else have one? How was it?
I did have blood drawn today for a pneumonia check--negative. Sinus is
clear. Since June I have had a wet mucus cough that is not responding
to any treatment. My cough variant asthma had been under control at
that point with my inhalers. It is a different type of cough. The
asthma cough is dry and sounds like a barking dog. Plus I feel it in my
chest as a tightness. The sputum tests were negative.
If this all sounds familiar--I wrote about this recently under "Cough
Advice" Now they are going to send the findings to a specialist.
Lynn Eberle
Chuck
First, you need to know how the body transports oxygen, measured in
something called "Oxygen delivery" (DO2). This is the "brass tacks." All we
doctors are truly interested in is, "Can the patient deliver adequate oxygen
to the organs that need it?"
DO2 is determined by your heart's ability to pump blood (called cardiac
output or CO) and the total amount of oxygen in your blood (Oxygen Content
or CaO2 - the 'a' is for 'arterial'). This can be represented by the
equation: DO2 = CO x CaO2
Let's assume your heart is fine (most asthmatics' are), so ignore the CO
part.
CaO2 is actually simple: The amount of oxygen carried by your blood
(specifically, the hemoglobin - Hgb - in your blood) plus the amount simply
dissolved in the water (plasma) which surrounds your blood cells. Each gram
of hemoglobin carries about 1.34 ml of oxygen. The part carried by the
hemoglobin can be calculated by: Percent Saturation of Hemoglobin SaO2 times
the amount of Hemoglobin you have times that value "1.34": 1.34 x SaO2 x
Hgb. The part dissolved in your plasma (abbrev'd PaO2) is very small, and
can only be measured by that blood gas test: 0.003 x PaO2. PaO2 is usually
around 100, for an amount of 0.3, and cannot exceed 600, or 1.8 by this
calculation. So, the dissolved oxygen part doesn't matter much to your body.
And to make it simpler, let's say you aren't anemic. (Assume the value of
Hgb is OK.)
Putting that all together...
DO2 = CO x CaO2
CaO2 = (1.34 x Hgb x SaO2) + (0.003 x PaO2)
So, a drop of almost 10% in your SaO2 is a BIG drop in DO2. The finger
oximetry test signaled a real problem and should not be ignored.
Now, it happens that when a person's PaO2 drops below 55, the arteries in
the lungs get tight, and cause high blood pressure in the lungs. Most
heart's cannot tolerate this increase in blood pressure, and catastrophic
things can happen (like dying or going to the ER or ICU). That is usually
when I see those patients.
Your doctor wanted to check your blood gas to be sure your PaO2 hadn't
dropped this far, placing your life at risk! He was very appropriate to ask
to do this test.
The needle stick for an Arterial Blood Gas is done (usually) from the artery
in your wrist. You know, the one you check your pulse from. While it is more
painful than an IV, most people can lie or sit quietly while the respiratory
therapist is taking the blood. Hold the injection site tightly for at least
5 measured minutes when s/he is done so that you don't get a painful bruise.
Many people find the test not all that painful.
Hope this helps.
Dr. Chuck
Bill Ellis Fleenor
SaO2% is one of the parameters used to diagnose an asthma
exacerbation. Per EPR2, >95% is mild, 91-95% is moderate,
and <91% is severe exacerbation. From mild exercise.
Sounds like this needs to be diagnosed by a specialist, with
probably more testing. 7 months is a long time to have such
an exacerbation.
I've had lung congestion for a couple of months, apparently
a virus. Its coming under control now that I switched my
steroid inhaler to Pulmicort.
Ellis
cao...@redsuspenders.com
ebe...@earthlink.net wrote:
> I was at the Dr's today. He had my blood oxygen measured with a finger
> clip. It was 99% at rest. We then walked to another building to review
> a chest xray I had the day before (came up abnormal but they don't know
> what it is yet--nodules of some kind) When I returned I was totally
> winded. For me this is not normal. He had them do the finger clip
> again, this time it was 90%. He then requested that I have a blood gas
> needle test done. Is a drop of 9% bad? It didn't seem all that much to
> me.
That sort of drop from the very mild exercise of walking is quite serious.
>
> I heard that this proceedure is painful since they go so deep. Anyone
> else have one? How was it?
It hurts, make no mistake; and IMO, it probably isn't necessary as often as
it is done. Every time a doctor asks to get a ABG on me, I ask, 'What
information will this give you that might change the way I am being treated?'
When it is put in those terms, most of them either come up with a good
reason or decide that they don't really need the test at all. [IMO, this is
a good question to ask EVERY time a doctor wants to order a test . . . I have
my regular ones trained to the point that they now give the explanation
without the question -- and, I have noticed that they don't order 'routine'
tests for me, either . . . which saves on the insurance increases.]
Chris Owens
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Dianne Shelton
>
> I was at the Dr's today. He had my blood oxygen measured with a finger
> clip. It was 99% at rest. We then walked to another building to review
> a chest xray I had the day before (came up abnormal but they don't know
> what it is yet--nodules of some kind) When I returned I was totally
> winded. For me this is not normal. He had them do the finger clip
> again, this time it was 90%. He then requested that I have a blood gas
> needle test done. Is a drop of 9% bad? It didn't seem all that much to
> me.
>
> else have one? How was it?
>
> clear. Since June I have had a wet mucus cough that is not responding
> to any treatment. My cough variant asthma had been under control at
> that point with my inhalers. It is a different type of cough. The
> asthma cough is dry and sounds like a barking dog. Plus I feel it in my
> chest as a tightness. The sputum tests were negative.
>
> If this all sounds familiar--I wrote about this recently under "Cough
> Advice" Now they are going to send the findings to a specialist.
>
> Lynn Eberle
Lynn,
I have had my share of blood gas tests. It truly depends on who is doing
the procedure. First, the nurse will numb the area with a lidocaine
injection. Next, the nurse will make a deep injection and *look* for the
artery. This is where it can be painful. If you are not having an asthma
attack (or coughing attack) during the draw, it will make it easier.
Just try to relax. Once again, it all depends on how skilled the nurse
is on arterial blood draws.
Good luck,
Dianne
Stephen & Collen Mills
While it is more
>painful than an IV, most people can lie or sit quietly while the
respiratory
>therapist is taking the blood. Hold the injection site tightly for at least
>5 measured minutes when s/he is done so that you don't get a painful
bruise.
>Many people find the test not all that painful.
>
>Hope this helps.
>
>Dr. Chuck
I am a respiratory therapist and I do on average of 30 ABGs a day
and being on the recieveing end has made me alot more aware of what my
patients go through. I am known in our department as the "dead eye" when it
comes to difficult abg sticks.
Colleen
>
>
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