Posted on 04/23/2020 8:24:17 PM PDT by Zhang Fei
There is a way we could identify more patients who have Covid pneumonia sooner and treat them more effectively — and it would not require waiting for a coronavirus test at a hospital or doctor’s office. It requires detecting silent hypoxia early through a common medical device that can be purchased without a prescription at most pharmacies: a pulse oximeter.
Pulse oximetry is no more complicated than using a thermometer. These small devices turn on with one button and are placed on a fingertip. In a few seconds, two numbers are displayed: oxygen saturation and pulse rate. Pulse oximeters are extremely reliable in detecting oxygenation problems and elevated heart rates.
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.
Widespread pulse oximetry screening for Covid pneumonia — whether people check themselves on home devices or go to clinics or doctors’ offices — could provide an early warning system for the kinds of breathing problems associated with Covid pneumonia.
People using the devices at home would want to consult with their doctors to reduce the number of people who come to the E.R. unnecessarily because they misinterpret their device. There also may be some patients who have unrecognized chronic lung problems and have borderline or slightly low oxygen saturations unrelated to Covid-19.
All patients who have tested positive for the coronavirus should have pulse oximetry monitoring for two weeks, the period during which Covid pneumonia typically develops. All persons with cough, fatigue and fevers should also have pulse oximeter
(Excerpt) Read more at nytimes.com ...
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Below 90 should be concerned, Covid or No Covid.
Does the slimes think hypoxia is an infection?
Partisan Media Shills update.
I use a recording pulse-oximeter to monitor my blood SpO2 while sleeping because of my sleep apnea. I decided to do this on my own even without my sleep doctor’s recommendation. You don’t even notice the device while you are sleeping. This is one more reason to use it.
The hypoxia is likely due to the effect of the virus on hemoglobin, which destroys the ability of the hemoglobin to carry oxygen throughout the body. Voila! Hypoxia.
Pelosi would register negative numbers.
Bookmarked.
The pulse oximeters offered as phone apps are garbage.
[Below 90 should be concerned, Covid or No Covid.]
So the pulse oximeters would, in his view, be an early warning system. It would be ironic if these little gizmos ended up being the linchpin that dramatically lowered the mortality rate of covid19 instead of masks, social distancing or the much hyped ventilators or miracle drugs on tap. At the moment, it’s another data point but nonetheless an intriguing one.
[Pelosi would register negative numbers.]
Got one after a case of pneumonia a few years ago. Doctors offices routinely use them for checking for lung function loss long before major breathing problems become obvious.
I’m assuming the 90% threshold is an issue if it’s constantly at that level or below? I average 95 to 96 when relaxing. But when I first start to move around it can drop to the 80’s. On an exercise bike, it will do the same but climb to around 98 or 99 once I’m going strong. Lots of variability. Granted, I have an as yet undiagnosed issue of occasionally passing out. Done the EP study and so forth. Docs have no idea.
Overheard on the interwebs, re hypoxia, from a guy who says he’s a doc:
Some people would feel euphoric, some people would get a terrible headache, some people would have other reactions. The idea was that they needed to know what their reaction was, so that if their oxygen failed on a mission and they started suddenly got a terrible headache while over Hanoi they could realize what was going on and fix the problem before they blacked out.
Anyway, that’s what they told me, never had the eyesight to fly myself so maybe it’s not true. The one thing they would not feel is a feeling of suffocation or shortness of breath because, (not to keep beating this drum) that feeling is caused primarily by excess carbon dioxide, not lack of oxygen. That’s the danger of hypoxia–you are suffocating, but you don’t feel like you are suffocating.
This is also part of the reason why doing things like climbing Everest are so dangerous. On top of Everest, you inhale much less oxygen, but you exhale the same amount of CO2 that you would at sea level. Breathing faster would help you stay oxygenated (somewhat–not as much as you would think, but it does help) but you don’t have a physiologic drive to hyperventilate because your CO2 elimination is normal.
So if these guys walking in to the ED had hypoxia but not hypercarbia I wouldn’t expect them to feel short of breath–that’s not terribly surprising. The question is why would they be so hypoxic without being markedly hypercarbic; that is unusual. Oxygen has a lot more trouble diffusing across the alveolar membranes than CO2, so if this virus damages those membranes you might get bad hypoxia with relatively OK CO2.]
Amen
I bought one last year for my STOMP kit, and I’m glad I did.
The floor of the 4th ventricle has a nucleus (funny, can’t remember the name) that detects the bicarbonate anion. That is the place where the respiratory drive as a function of bicarbonate exits. There are preparations where respiratory drive can take over if this nucleus is “removed”, several and their breathing patterns are characteristic. Read Plum and Posner. When a human dies from cerebral herniation each of these diagnostic breathing patterns is released.
Except for RBCs aren’t the unique target, every cell in the body is. So NOT voila.
This really bothers me. On the floor of the 4th ventricle, a place I have been (surgical bragging) you can see it and I can’t recall the name. When I took my Neurosurgery Board I knew it, believe me. If there was a named part of the brain I knew it.
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