by Alan Lindemann, M.D.
This presentation was designed originally for pregnant women, but the guidelines here can be helpful to everybody during these times. It is not intended to replace the advice and services of your health care provider, It is rather meant to assist you to get the help you need at the time you need it.
Be especially attentive to blood oxygen saturation levels (O2 sats) for children. In children, oxygen levels tend to run at 99, 98, and 97 percent. While adult oxygen saturation can run at 92 and 93 percent and be O.K., this is not the case for children. For children, an oxygen saturation level of 95 percent should be the bottom cutoff, the point at which medical attention should be sought.
This presentation is designed to be useful for all adults, whether they have not had, have presently, or have had COVID-19 and are recovering from it. Please keep in mind that many patients with COVID are managed as outpatients. If patients are not hospitalized, these recommendations will help patients decide whether their outpatient care is succeeding or whether they need to return to their clinic or ER.
Get a Pulse Oximeter
You need to know how to use a pulse oximeter and how to put the results from the pulse oximeter into perspective. With pulse oximeters, you need to know that one size does not fit all. Normal O2 sats are different depending upon your age and general health. With children and young healthy adults, O2 sats will be around 99, 98, or 97. Older adults will likely have lower numbers.
At our hospital, all employees, including physicians, must sign in after our temperatures and O2 sats are measured. Many days when I sign in at our hospital, my O2 sats are 89 to 93. I do not test positive for COVID and I am asymptomatic. If you have a normal baseline like mine, a reading of 85 to 88 will be the low for you. If you are worried about your baseline oxygen saturation and any changes you record, call your physician.
Remember, this equipment is called a pulse oxymeter, so it also checks your pulse. A normal heart rate is 61-100 beats per minute. As with your oxygen saturation levels, get to know your baseline pulse rate. If your pulse goes up beyond your baseline and your oxygen saturation goes down, call your physician or go to the ER.
Know your Baseline Temperature
The normal or baseline body temperature is said to be 98.6 degrees. That’s no longer considered to be the norm. Every day when I go to work I need to know the answer to three questions: 1) my O2 sats need to be greater than 89 percent, 2) my temperature needs to be less than 100 degrees, the number my clinic and hospital use. The CDC uses temperatures between 100 degrees and 100.4 degrees for their marker for possible COVID infection.
Because I live in a rural area, there have been only four positive tests for COVID in our county, and no deaths. Our low rate is due to many factors. Certainly, social distancing is a way of life here, but I go to work daily and we have learned from more populated areas which were hit first.
The Canary in the Mine
COVID kills because we are unaware that our blood oxygen levels are decreasing. A low O2 sat does not stimulate us to breath or cause us to feel short of breath. It is rather the CO2 blood levels which drive the sensation of dyspnea, or shortness of breath. While you may not be able to feel the shortness of breath as your blood oxygen levels decrease, they are the canary in the mine. If your oxygen levels are dropping from what is normal for you, even though you don’t feel short of breath, get medical attention. If you wait until you are short of breath, it is too late.
P.S. For the editor mavens out there, yes, I know the 2 in O2 should be a subscript, but coding is not my thing. I will, however, entertain any suggestions for accomplishing subscripts from those in the know.