The following is posted with the approval of it's author, Mary Burns, R.N. and Exec VP of PERF 

Altitude, Oxygen Levels and Oximetry

Summer vacations are upon us and some of you have expressed concerns about going to higher altitudes, either by flying, or by driving up to the mountains. You may remember that as you ascend in altitude the available amount of oxygen in the air decreases. That means that your arterial blood oxygen, and your oxygen saturation, also decreases. Pulmonary patients, who already have low blood oxygen at sea level, may have a problem at altitudes as low as 3,000 ft. (Remember that planes are pressurized at about 5,000 to 8,000 ft and occasionally even higher!) 

Before we get started with a discussion of oxygen needs, it is important to point out that many people with lung disease, even fairly severe disease, have been evaluated and found to have no significant problem with oxygen levels in their blood. If this is true for you, great! If not, read on.

High Altitude Simulation Test (HAST)

How can the doctor tell if you need to increase the liter flow of your oxygen, or if you need to be put on supplemental oxygen when you fly across the country, or drive up to the mountains? Needs vary with the individual and can be hard to estimate in the individual with lung disease. 

Your doctor may refer to a nomogram, which provides an educated guess about your oxygen needs. He may order a HAST (High Altitude Simulation Test) which provides accurate information and is easily done in a pulmonary function lab. Another option is to perform a walking test to see if you desaturate, and how much, with walking. This can help him to estimate your oxygen needs at various altitudes.

Oximeters - Oximetry

Many patients, who have gone through pulmonary rehab programs and gotten sophisticated about their oxygen saturations, purchase their own oximeter. This usually requires obtaining a doctor's prescription and license number before your purchase from a medical supply company. On rare occasions, an insurance company will reimburse the purchase cost if you get a prescription. It is worth checking on.

If you wish to purchase an oximeter there are several small ones on the market. We've had the most experience with the little Nonin 9500 Onyx finger probe oximeter, which can be purchased for about $350.00, plus tax. But, we know other patients who have been price gouged for as much as $700.00! Shop around.

There are several places where you can now buy a small Nonin Onyx oximeter without a doctor's prescription. The Nonin 9500 is a little bigger than the size of a thimble and provides your heart rate in addition to your oxygen saturation. It comes with a long cord and can be carried around your neck like a pendant. 

Richmark Medical Supplies sells the Nonin Onyx for $340.00 plus shipping if you live in IL, WI or IN. If you live in another state it is $359.00 plus shipping. Call 1-800-882-889 and ask for Tom. 

Aeromedix sells their Nonin 9500 for $346.00* including shipping. Look up their website at or make a toll free phone call to 1-888-362-7123 for further information.  ( *Edited remark:  Late note.  If you mention EFFORTS or Pulmonary Paper, you can buy it at $340.00 )

Oximeters are great for patients who have gone through rehab and are very knowledgeable about oxygen, oxygen saturations and oximeters. Their physicians are often comfortable with having them titrate their oxygen according to their saturations. If, however, you haven't gone through rehab, or your program hasn't relied on oximetry, there are some concerns about using this technology without a thorough understanding of its limits. You should definitely get your physician's advice on this. Remember, oxygen is a drug, and the dose (the liter flow) should be prescribed by your doctor and changed only with your physician's advice and permission. 

Breathing Techniques

We are going to provide a little crash course on oximeters, dedicated to Iris Patton of Neff, Ohio who asked us to tell her know more about them. 

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Last Update 05/29/2009
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