Asthma Support Group

I had a similar experience in the ER - SOB and gasping and coughing - my O2 was 98 and I asked the nurse how that was possible and she said by gasping I was forcing air through my lungs - so it wasn't a true reading until the breathing treatments. I wasn't sure that was true until another bout of same thing at the clinic where I go and they hooked me up to a moniter and were going to send me the hospital - my sats were around 85 or so - I started gasping and my levels went up to 98 and I got antibiotics, shot, breathing treatments at home and got over it - hate the ER since they pump me full of pred in large doses.

I can relate to these experiences. What causes my 02 to drop suddenly can be due to either a server allergic reaction that I had, or the level can drop due to poor air quality in the out doors environment .

Hey sorry you ahve had a worry with your asthma.

I wouldnt get too hung up on your sats too much. in a normal person you can run on sats of between 95% and 100%. the sudden drop is due to the brionchospasm and the lungs not getting enough oxygen in.

I will often have an attack and my sats will be about 85% (this is normal for me) and then they drop to the 60's this can be withion a very very short space of time. and to get them to increase i need supplement oxygen and breathing treatments whihc calms the brionchspasm and bringsd your sats back up.

also if the sats were done with a finger tip oximeter than can be a bit inaccurate during an attack and if the attack continues and is very severe an artial blood gas will be talen so the drs can tell exactly of much o2 and how much co2 you ahve in you blood and therfore how well you lungs are working. this is the most acurate way but the finger tip oximter whihc are foten used initially by drs can seomtimes me a nit misleading.

olive

What is going on here is a physical chain reaction that only gets worse before it gets better.

The more the body/lungs/brain fight/vie for oxygen, the more whatever oxygen is available is conserved within the vital organs (brain/heart) and shifted away from the periphery including arms, legs, and the general blood supply - thus O2 stats drop and will continue to drop until the vital organs get what they need and the situation begins to stablize. (There is something similar that occurs during severe blood loss called DIC in which the body alternatively fights between clotting and bleeding.)

Yes, O2 stats (including peak flow) will generally drop over time with copd/asthma but this is a different slow and long-term process due to damage rather than the severe drops that occur during an acute crisis due to entirely different processes.

Thanks for the responses. I now have a better idea about what was going on. You all are much more patient and more informative than an overworked, frazzled 28 year old ER doc.
In his defense, the place was very busy. Still, a better explanation would have been helpful.
Thanks all,
Tom

I read in a few places that an O2 reading from an extremity (during an asthma attack) can be high due to excess carbon dioxide. Maybe once you received your first treatment, the excess carbon dioxide was cleared out and a true oxygen reading showed....

Asthma is complicated...lots to learn and too much trial and error to get all the info needed.

One of the reasons I don't like the ER is because they herd you through like cattle and then almost ignore you. You do get treated, but they don't answer your questions. I think they take advantage of the fact that you are feeling crappy and hope you will just give up and stop asking questions. Its not like you went in for a small minor injury, you were there for a life threatening condition. They should spend some time with you and answer your questions. This might help someone from having to come back for further treatment....

Hope you are feeling a bit better today,

Robin

Sorry you have had to go to ER and hope you are feeling better.
One thing 'good' out of all this thp is that you are not alone. This happens to me and I accept it as normal these days.
I have even had ER say to me when i come in and they hook me up "oh your'e not too bad your sat is 97/98%"
There are other things going on, you can die at 97%!
I take it when you say 'treatment' you mean you had a nebs (nebulizer)? (sorry different country different terms) and this would have been given with oxygen and not air?
I know with me when my condition starts to improve, I am so worn out i start to breathe slower and shallower, then my saturation falls. Give a few good deep breaths and up she comes.
I have proven this at home when i am well, by breathing slower and shallower I can drive my sat down to 93/94, give a few good deep breaths and it returns to normal, (98 for me, when i am well, and when I am desperately ill)
Go by how you feel and don't worry too much about the instruments.

I didn't know that there was different terminology. Sorry. By treatment I meant a series of medicated breathing treatments given by nebulizer. In my case it was atrovent and albuterol. When my O2 level fell, the tech placed the oxygen tube in my nostrils and started me on oxygen. I don't know what percentage. I was too surprised to ask. (first time on oxygen).He then gave me my other rounds of medication via neb treatment by placing a mask covering the tube and my nose and face.
It's interesting that you mention that your drop happens when you are breathing more normally. I was just sitting quietly on the examination table (couldn't lie back...too hard to breathe). I was feeling better and was startled when the tech told me the oxygen level had dropped.
I did see the pulmonologist and he thinks the drop was due to the attack.
I usually am able to self manage my asthma symptoms at home by following my action plan and using my nebulizer to take my meds when necessary. This new development makes me less comfortable doing that. I'm getting a pulse oximeter to help with monitoring my oxygen. I'm also going to ask the pulm about a "just in case" supply of oxygen as was suggested to me by one of our veteran members. (good idea).
The way you describe what happens to you matches my situation completely. I was breathing slower and the attack had taken a lot out of me. Strange to think your situation is improving when it' actually not.
It doesn't get any easier does it?
Thanks for your input.
Tom

Tom,
The attacks never seem to get any easier, but knowing what to expect when they do happen makes that part easier I found.
You mentioned the oxygen tube up your nose. That was probably a nasal canula, and you also mentioned oxygen percentage. Depending what flow rate they use i.e. how many litres a minute they turn the knob to on the medical oxygen flow meter, will govern what % oxygen you get. Air has 21% oxygen. If the flowmeter is set to 1Lt/min you will be getting 24% oxygen, 2Lt/min gives 28% and so on.
I can understand your confidence being a bit shattered after this episode. Hopefully you won't have another one for awhile. Do what I have done, have your oxygen at home, your nebs machine, pulse oximeter,whatever, because every attack you ward off is better in the long run for you.
It can be scary, but that gets easier. I manage my condition at home and when it does get out of control I just say to my wife "Looks like I am off to hospital" and off i go knowing what to expect.
Here in Australia when we have a nebulizer it is commonly called a "nebs". If we have salbutamol (Ventolin)(equivalent to your albuterol) then it is called a "vet nebs".
Good luck with it