SaO2 and PaO2

WolfpackRed · Jul 19, 2007

Two questions for the group: 1) What is lowest acceptable SaO2 or pulse-ox value you would accept for the average patient? 2) What is the lowest acceptable PaO2 you would accept for the average patient? Thanks

SaO2-89-90%

PaO2-80 mmHg

cardiacRN2006, ADN, RN · Jul 19, 2007

It's really depends on a lot of factors.

Are they on a vent, are they a COPD'r, what's their FIO2, what's thier Dx...?

Sao2, I don't like below 90, Pao2, I don't like near 60.

Belinha · Jul 19, 2007

i would allow lower satO2 than 90 for a COPD pacient but it will depend of all other gasimetric values...

CritterLover, BSN, RN · Jul 19, 2007

in what situation? much of it depends on your perspective.

speaking from the triage point of view......

in a normal, healthy individual, i really don't like to see sats below 97%. i'll take 96%, though. 95% makes me nervous. below that, there needs to be a reason (keep in mind that smoking doesn't lower your sa02). i'll do a more in-depth respiratory assessment in the triage chair, listen more closesly to lung sounds, probe a little deeper with my questions.

in someone with a moderate history (mild copd, etc) i'm happy if the sats are above 94%. anything less than that (unless i can pull old records that show their sats are consistently low 90s) will cause me to probe a little deeper.

in someone with a significant history, anything above 88% makes me happy. less than 88%, and i need to know that is their baseline.

of course, i'm assuming all of the above are relativly asympomatic on first glance (no obvious respiratory distress, as that will generally trump an o2 sat).

with asthmatics, i like to see the sats a tad bit higher than another copder, since decreasing o2 sat is a late sign in asthma.

i had a kid come in recently with a "near drowning" episode. i put that in quotes, because people can exagerate at times. (a head dunk does not equal a near drowning). he was walking ok, seemed to be breathing ok, but wouldn't talk to me. he was in his late teens. i took him into triage right away, but really wasn't too concerned at first. he seemed more frightened that in any sort of resp distress. when he did finally talk to me to answer some questions, he kept his answers short, but didn't have any difficulty speaking. when i put the pulse ox on him, my initial sats were 89%. i gave it some time, checked his bp, listened to his lungs (a bit wet). sats came up, but never above 95%, stayed mostly in the 93-94% range. that concerned me. not that he was in any immediate danger of dying on me, but that he needed to be watched very closely, because that isn't normal in a healthy teen.

on the other hand, when i worked in icu, i didn't get too concerned until their sats were 92% or below (i worked surgical icu, not medical). if i saw them falling during the night -- say they had been 97-98%, but were now down around the 94-95% range, then i'd have them work a little harder on their coughing/deep breathing, is. but i wouldn't get worried about it yet.

as for pa02, i don't see that nearly as much since i work er instead of icu, but i would start to get concerned in the low 70s, depending on the diagnosis.

keep in mind, though (esp when reading everyone's opinions), that pao2 is elevation-dependent, and different parts of the country will have different "normals" based off of how high above sea level the area is. i went to school in tucson, which is not at sea level. i had to learn a new set of "norms" when i moved to a city that is at sea level.