O2, Question for medics.

[FZ[_2_]]

There are a few hundred oxygen masks and O2 tanks in a gliding community. Are those of any potential use in a CronaVirus emergency?

[Tango Whisky]

What is needed are breathing apparatus.
Completely differnt game.

[Dave Walsh[_2_]]

At 05:38 20 March 2020, Tango Whisky wrote:
>What is needed are breathing apparatus.
>Completely differnt game.
>
Not a medic, just a biochemist. Hard to see what harm could be
done using gliding oxygen to help someone with breathing
difficulties. But one might ask why such a person was not already
in a hospital?
The main 'problem' is the small size of gliding oxygen cylinders;
now if one happens to have a big oxyacetylene welding kit in the
garage that's a different matter.

[Martin Gregorie[_6_]]

On Fri, 20 Mar 2020 11:54:57 +0000, Dave Walsh wrote:

> At 05:38 20 March 2020, Tango Whisky wrote:
>>What is needed are breathing apparatus.
>>Completely differnt game.
>>
> Not a medic, just a biochemist. Hard to see what harm could be done
> using gliding oxygen to help someone with breathing difficulties. But
> one might ask why such a person was not already in a hospital?
> The main 'problem' is the small size of gliding oxygen cylinders;
> now if one happens to have a big oxyacetylene welding kit in the garage
> that's a different matter.

I think that in this case 'breathing apparatus' means a medical
ventilator, which assists the action of breathing as well as supplying
oxygenated air to the patient. The systems we use require the user to be
able to breathe without assistance.


--
Martin | martin at
Gregorie | gregorie dot org

[Matt Herron Jr.]

On Friday, March 20, 2020 at 6:25:33 AM UTC-7, Martin Gregorie wrote:
> On Fri, 20 Mar 2020 11:54:57 +0000, Dave Walsh wrote:
>
> > At 05:38 20 March 2020, Tango Whisky wrote:
> >>What is needed are breathing apparatus.
> >>Completely differnt game.
> >>
> > Not a medic, just a biochemist. Hard to see what harm could be done
> > using gliding oxygen to help someone with breathing difficulties. But
> > one might ask why such a person was not already in a hospital?
> > The main 'problem' is the small size of gliding oxygen cylinders;
> > now if one happens to have a big oxyacetylene welding kit in the garage
> > that's a different matter.
>
> I think that in this case 'breathing apparatus' means a medical
> ventilator, which assists the action of breathing as well as supplying
> oxygenated air to the patient. The systems we use require the user to be
> able to breathe without assistance.
>
>
> --
> Martin | martin at
> Gregorie | gregorie dot org

but breaths need not be as deep on oxygen, yes? So maybe some help?

[Duster[_2_]]

-
> > Martin | martin at
> > Gregorie | gregorie dot org
>
> but breaths need not be as deep on oxygen, yes? So maybe some help?

Someone in respiratory distress usually has impaired breathing, so a nose cannula might not be as helpful as a face mask to get them more oxygen. What might be more helpful is to loan your pulse oximeter to those at higher risk. This would help them decide if they should seek medical treatment, e.g., when ox sat falls below 90% (a common threshold to receive resp support is 88%). The catch is (no pun intended) a hospital is a good place to get pneumonia if you don't already have it.

[John Foster]

On Thursday, March 19, 2020 at 10:02:00 PM UTC-6, FZ wrote:
> There are a few hundred oxygen masks and O2 tanks in a gliding community. Are those of any potential use in a CronaVirus emergency?

If the face mask and oxygen are used to help get someone in respiratory distress to an emergency room, then yes. Otherwise no. As already said, someone needing respiratory support will get all the oxygen they need once at the hospital. The bottleneck lies in the availability of ventilator machines to mechanically support/breathe for them if they are in sufficient respiratory distress. So far (as far as I know) the shortages do not include oxygen or oxygen masks.

[son_of_flubber]

A pulse-oximeter quantifies pulmonary function.

What is the O2 saturation that should trigger a trip to the E-room?

[[email protected]]

I was sick last October, achy, fever, congested. Five or six days later I woke at night and could hear chest rattle high in my lungs.
Brain finally kicked on, I said 'I'm hypoxic'. Dug out my oximeter and saw variable 80's. Sent hubby out to dig out a bottle from a glider in a trailer. Rest of the night I ran the mask on a low flow. Headache was finally gone.

Next morning the urgent care sent me to hospital. All I wanted was a prescription for the right antibiotics. Xray, five different folks listening to me take deep breaths with cold stethoscopes (hyperventilation anyone?).

Gave me IV dose of some -cillin, wrote a script, said go home and rest. $4500.

[John Foster]

On Friday, March 20, 2020 at 4:35:27 PM UTC-6, son_of_flubber wrote:
> A pulse-oximeter quantifies pulmonary function.
>
> What is the O2 saturation that should trigger a trip to the E-room?

It depends. For normal healthy people anything in the low 90s is abnormal and needs to be evaluated. However, for someone with COPD, who normally lives in the upper 80s to low 90s, it could be normal to have an O2sat of 89%.

If you are feeling bad and your O2 sat is in the low 90s (90-93%), then get checked. If you aren't sure, get checked. It's better to be safe than sorry.

[Dan Marotta]

Excellent advice, Cindy.

And, whereas I have an absolutely zero propensity for panic, I will
bring my oximeter home today.Â* Heck, I might even remove the bottle and
dual MH system while I'm at it.Â* I'll even recharge it from my big bottle.

I'm very fortunate to live in sparsely populated mountainous country,
have an open interstate drive to Moriarty, and a Stemme!

On 3/20/2020 11:35 PM, wrote:
> I was sick last October, achy, fever, congested. Five or six days later I woke at night and could hear chest rattle high in my lungs.
> Brain finally kicked on, I said 'I'm hypoxic'. Dug out my oximeter and saw variable 80's. Sent hubby out to dig out a bottle from a glider in a trailer. Rest of the night I ran the mask on a low flow. Headache was finally gone.
>
> Next morning the urgent care sent me to hospital. All I wanted was a prescription for the right antibiotics. Xray, five different folks listening to me take deep breaths with cold stethoscopes (hyperventilation anyone?).
>
> Gave me IV dose of some -cillin, wrote a script, said go home and rest. $4500.
> Two hours.
> I knew what I needed before I drove in.
>
> I borrowed a MH regulator, filled a fat big bottle. Wore the oximeter and snuffed oxy for five more days, whenever I dropped under 90. Took three weeks to rebound. Three more to mostly normal. I am a seriously healthy human before this event.
>
> I now believe the rate of pneumonia deaths in elderly isn't the lung congestion, it's the crappy decisions while in severe hypoxia.
>
> Should we think to use a glider oxy system to assist in emergency support? Absolutely. Pushing oxygen saturation back up to support not killing brain cells IS important. The typical pulsedemand or constant flow systems only support normal across tissue transfers by increasing the percentage of oxy available to absorb.
>
> Will using oxygen help a severe covid19 case? Not likely. Oxygen won't drain fluid from lungs. Most folks don't have a pressure breathing system, like an old A-14 regulator.
>
> How low will you go in O2 sats before going to the hospital? Anything under 90 should take corrective action.
>
> Cindyb

--
Dan, 5J

[Duster[_2_]]

On Saturday, March 21, 2020 at 11:03:45 AM UTC-5, Dan Marotta wrote:
> Dan, 5J

I too live where we might not see a neighbor for weeks. However, Amazon will gladly deliver your own coronavirus to your door within or less than 24hrs. In spite of the article's headline, read down: the virus can stick to surfaces and last for that time period (though rather poorly). Delivery companies have largely suspended the signature requirement, but assume he/she has handled the package quite recently. Sometimes you just can't hide from trouble!

https://amp.usatoday.com/amp/2862947001

[Dan Marotta]

Hey, maybe the porch pirates will take a vacation.Â* Or get a dose.

Thanks for the reminder, I'll leave packages on the porch for a couple
of days.Â* I can count the times my door bell has rung during the past 10
years on both hands.

On 3/21/2020 2:20 PM, Duster wrote:
> On Saturday, March 21, 2020 at 11:03:45 AM UTC-5, Dan Marotta wrote:
>> Dan, 5J
> I too live where we might not see a neighbor for weeks. However, Amazon will gladly deliver your own coronavirus to your door within or less than 24hrs. In spite of the article's headline, read down: the virus can stick to surfaces and last for that time period (though rather poorly). Delivery companies have largely suspended the signature requirement, but assume he/she has handled the package quite recently. Sometimes you just can't hide from trouble!
>
> https://amp.usatoday.com/amp/2862947001

--
Dan, 5J

[[email protected]]

Dan ur waiting for a “big package� from overseas, what did u order another bird?

[BobWa43]

On Friday, March 20, 2020 at 12:02:00 AM UTC-4, FZ wrote:
> There are a few hundred oxygen masks and O2 tanks in a gliding community. Are those of any potential use in a CronaVirus emergency?

The short answer is no. Oxygen delivery to the tissues is a result of a complex interaction of the circulatory and respiratory systems. In the case of the Corona virus, the problem is pneumonia which leads to abnormalities in the perfusion/ventilation ratio which no amount of oxygen can correct. Mechanical ventilation and other supportive measures are required.
As aside, I would also note that pulse oximeters are great but they are not infallible. There are many reasons why you might get an incorrect reading, especially in the less expensive models.

[son_of_flubber]

On Monday, March 23, 2020 at 7:19:53 AM UTC+13, BobWa43 wrote:

> As aside, I would also note that pulse oximeters are great but they are not infallible. There are many reasons why you might get an incorrect reading, especially in the less expensive models.

Dr. Dan pointed out in his SoarRX article a few years ago that pulse oximeters are designed to be used sitting quietly in a chair, indoors and on the ground. Sitting in a glider in turbulence, a bit cold, and in bright sunshine is a rather different challenge for a device that relies on light transmission through the finger.

[Duster[_2_]]

A pulse oximeter is quite reliable at cold altitudes in turbulence. It does not measure oxygen or hypoxia, but rather some molecule bound to hemoglobin that changes light absorption from 2 different LEDs (one IR, one red). Many units can't differentiate between wavelength absorp of bound carbon monoxide or oxygen, so you could get a reading of 98% but still have carbon monoxide poisoning (there are CO oximeters available) or hypoxemia. In any case, we've gotten off message. If you have a pulse oximeter, you can use it to assist your physician in determining if you should get tested for coronavirus or be hospitalized. When you have real data (temperature, low PO reading) rather than subjectively (under)-reported symptoms, that will almost surely get their attention....it's evidence. If you have minimal training, buy/borrow a cheap stethoscope or amped microphone and have someone listen for "crackling" sounds over both lungs from the back. Fluid buildup sounds like when you scratch your scalp on the hair line. I'll make you a deal; if you can't afford a basic PO ($8-$30), are >70 yrs old or care for such, I will commit to deliver at least 5 units (1/ea) to those making a request. That includes outside North America if AmazonGlobe-worthy. PM me


>Someone in respiratory distress usually has impaired breathing, so a nose >cannula might not be as helpful as a face mask to get them more oxygen. What >might be more helpful is to loan your pulse oximeter to those at higher risk. >This would help them decide if they should seek medical treatment, e.g., when >ox sat falls below 90% (a common threshold to receive resp support is 88%). The >catch is (no pun intended) a hospital is a good place to get pneumonia if you >don't already have it.
>Duster

[Dan Marotta]

You, Sir, are a hero!

I have both a pulse oximeter and a stethoscope and almost 72 years old,
but thanks for the offer!

On 3/23/2020 10:44 AM, Duster wrote:
> A pulse oximeter is quite reliable at cold altitudes in turbulence. It does not measure oxygen or hypoxia, but rather some molecule bound to hemoglobin that changes light absorption from 2 different LEDs (one IR, one red). Many units can't differentiate between wavelength absorp of bound carbon monoxide or oxygen, so you could get a reading of 98% but still have carbon monoxide poisoning (there are CO oximeters available) or hypoxemia. In any case, we've gotten off message. If you have a pulse oximeter, you can use it to assist your physician in determining if you should get tested for coronavirus or be hospitalized. When you have real data (temperature, low PO reading) rather than subjectively (under)-reported symptoms, that will almost surely get their attention....it's evidence. If you have minimal training, buy/borrow a cheap stethoscope or amped microphone and have someone listen for "crackling" sounds over both lungs from the back. Fluid buildup sounds like when you scratch your scalp on the hair line. I'll make you a deal; if you can't afford a basic PO ($8-$30), are >70 yrs old or care for such, I will commit to deliver at least 5 units (1/ea) to those making a request. That includes outside North America if AmazonGlobe-worthy. PM me
>
>
>> Someone in respiratory distress usually has impaired breathing, so a nose >cannula might not be as helpful as a face mask to get them more oxygen. What >might be more helpful is to loan your pulse oximeter to those at higher risk. >This would help them decide if they should seek medical treatment, e.g., when >ox sat falls below 90% (a common threshold to receive resp support is 88%). The >catch is (no pun intended) a hospital is a good place to get pneumonia if you >don't already have it.
>> Duster

--
Dan, 5J

[[email protected]]

This link

[Duster[_2_]]

For COVID-19 victims with poor O2 sat or high flyers, has anyone looked into a portable oxygen generating system to use at least as an adjunct to compressed O2? I've seen some that are battery powered and fairly light with several models claiming they work at 10,000ft - 13,000ft or more.

[Bob Gibbons[_2_]]

On Thu, 19 Mar 2020 21:01:57 -0700 (PDT), FZ >
wrote:

>There are a few hundred oxygen masks and O2 tanks in a gliding community. Are those of any potential use in a CronaVirus emergency?

On this topic, there is a company south of Dallas that is currently
shipping hyperbaric oxygen hoods for meeting Covid-19 demand in
hospitals.

Sea-Long Medical Systems
https://www.sea-long.com/

See the following stories.
https://www.nbcnews.com/news/us-news/texas-mom-pop-business-flooded-orders-helmet-ventilators-amid-coronavirus-n1173466

[son_of_flubber]

On Monday, March 23, 2020 at 12:44:30 PM UTC-4, Duster wrote:
> A pulse oximeter is quite reliable at cold altitudes in turbulence.

Another factor to ponder is the effect of bright sunshine on a device that depends on a red LED.

https://www.danlj.org/~danlj/Soaring/SoaringRx/2012-06-Pulse-Ox-Accuracy-p18-20-22.pdf


On the other hand, pulse oximeter ARE designed to work indoors sitting quietly in a chair or resting in bed.

[Martin Gregorie[_6_]]

On Thu, 09 Apr 2020 13:57:46 -0700, son_of_flubber wrote:

> On the other hand, pulse oximeter ARE designed to work indoors sitting
> quietly in a chair or resting in bed.

What about units such as those sold by https://www.welluehealth.com/
like their Sleep-U with the electronics on a wrist-band with the sensor
clipping on a finger at the end of a flying lead or the Contec CMS50F,
where the entire unit is on your wrist.

Sure, the Sleep-U is probably unsuitable, though I like its physical
setup, which is unlikely to get in the way in the air, while the Contec
unit advertises itself as suitable for sports use, though not while
exercising, but that probably isn't a problem for us.

I'm curious about the medical-grade devices because I bought one of the
El-cheapo ($25) Anapulse units 4 years ago before a trip to Scotland in
search of wave, which never materialised. Had me doubts about it from the
start because its a bulky *******, but seemed work OK when I bought it.

I put new batteries in recently to see if it still worked. Turns out that
it detects my pulse, but seems to have entirely lost its ability to
measure O2 percentage - nothing on the display works apart from the
flashing pulse...pulse... bar graph. No O2 percentage or pulse rate are
shown. IOW its now a piece of junk.


--
Martin | martin at
Gregorie | gregorie dot org

[son_of_flubber]

On Thursday, April 9, 2020 at 5:38:04 PM UTC-4, Martin Gregorie wrote:
> On Thu, 09 Apr 2020 13:57:46 -0700, son_of_flubber wrote:
>
> > On the other hand, pulse oximeter ARE designed to work indoors sitting
> > quietly in a chair or resting in bed.
>
> What about units such as those sold by https://www.welluehealth.com/
> like their Sleep-U with the electronics on a wrist-band with the sensor
> clipping on a finger at the end of a flying lead

Those are nice. Nonin has similar for $$$s.

The last time I had hypoxia-induced euphoria in flight, I had to resist a very strong urge to climb higher. Funny how euphoria works.

[Duster[_2_]]

son_of_flubber wrote:
>
> > On the other hand, pulse oximeter ARE designed to work indoors sitting
> > quietly in a chair or resting in bed.
>

You can test this pretty easily, of course. I have 4 different models, only one of which went into error mode when moved real close to an incandescent bulb. It first must capture your HR via arterial pulse, then will read out saturation. Not as accurate as measuring arterial SaO2 via blood draw. You can find units that will send an alert if your SpO2 goes below a set %. If you want to fly with one, the finger units are too cumbersome when handling the stick, so you could consider buying an earlobe PO that isn't.

https://heymedsupply.com/clip-pulse-oximeter-sensor-ear-reusable-oximax-ear-clip-dura-y-sensor-d-yse-each-1/?gclid=Cj0KCQjwj7v0BRDOARIsAGh37ir-bgBC1dMCgIRlipNDotpD5zNtjBu0NjaiUU4Aa-GIdEDlDQlgLX0aAi5DEALw_wcB

https://erj.ersjournals.com/content/48/suppl_60/PA3702

[son_of_flubber]

On Thursday, April 9, 2020 at 6:32:47 PM UTC-4, Duster wrote:

> You can test this pretty easily, of course.

Testing is good. One of the reasons I find the Logging Pulse-Oximeters attractive is that I might gradually (over multiple flights) gain confidence in the unit by reviewing that the log captured expected O2 saturation vs. altitude (post-flight review).

These units also log heart rate. An exercise physiologist told me that heartrate commonly increases in parallel with altitude induced reduction in O2 saturation.

Physiology is complicated.