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Children's health

ds (2.6) oxygen levels 93 - heart rate 130, is this ok?

36 replies

hazeyjane · 23/01/2013 19:03

Ds just seen nurse at surgery, he has had temp for 5 days, she heard crackles in his lung and has prescribed abs. She tooks his sats and hear rate which were 93/130 (his temp was normal when she took it).

Anyone who knows anything about chests! Does this sound ok?

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Haemadoots · 23/01/2013 19:05

sorry your ds isnt well, sounds like he has a chest infection, hope he is better soon

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BeaWheesht · 23/01/2013 19:05

I'm surprised he wasn't sent to hospital with 93 sats tbh. I think I'd call NHS in your situation.

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beautifulgirls · 23/01/2013 20:10

I agree those sats are slightly low. If you are at all concerned I would ensure a doctor sees him this evening - A&E is probably your sensible option as if a GP is worried from here that is where they would send you anyway. How does his breathing look - is his respiration rate increased or the effort to breathe? Are his lips pink or purplish?

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Sirzy · 23/01/2013 20:10

What did the nurse do?

I would hope she sent you straight to A and E for monitoring!

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Boggler · 23/01/2013 20:13

A child with oxygen saturation of less than 97% should be seen by a paediatrician ASAP, I think he sounds very poorly.

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GinandJag · 23/01/2013 20:15

He should be in hospital with 93%. With that breathing rate, he is obviously working extremely hard to get oxygen around his body. If he tires of this, his SATs will drop and he will need extra oxygen.

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elfycat · 23/01/2013 20:53

I'm a nurse and I think those sats are too low. Call NHS direct straight away, or the GP but only if you get to speak to them without waiting.

Can't believe any nurse wouldn't flag that up!

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dikkertjedap · 23/01/2013 21:03

His symptoms indicate pneumonia. He may need IV antibiotics and possibly an oxygen mask.

I hope you have been able to see a doctor and your ds is getting the care he needs.

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Seriouslysleepdeprived · 23/01/2013 22:44

Sata are too low and with a temperature as well he should be seen by a doctor at least. Hopefully he has seen one by now. Hope he feels better soon.

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hazeyjane · 24/01/2013 07:27

Goodness, I have only just got back onto mumsnet.

We weren't sent to hospital, and we have been home, another night of sitting up with ds coughing, and his temp spiking in the middle of the night.

Ds has frequent chest infections and pneumonia, and he doesn't usually show the usual signs of low o2, as his low muscle tone disguises the fact that he is struggling. The usual sign is that he becomes very floppy, and obviously low sats, but looking back at my notes, we have been sent home from a+e before when his sats have been 93.

We have never seen this particular nurse at the surgery before, so I was worrying.

We have to take him to the hospital for a cardiology appointment this morning, so I will call children's ward before we go, and ask if we can wait and see a paed.

Thankyou for all your advice, and sorry I wasn't back sooner.

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DameSaggarmakersbottomknocker · 24/01/2013 09:24

Good luck today hazeyjane.

Does ds have a heart defect? I would confirm with cardiology what his baselines are and what level you should worry at because they won't be the same for a 'normal' child. eg dd's resting heartrate is way higher than a normal child's so can be worrying for the uninititated and her normal temp is low (bordering on hypothermic!) so I get concerned when her temp hits 37. Some children with CHD are perfectly fine at 93% sats and no amount of oxygen will get them higher.

He doesn't sound well though - poor thing.

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hazeyjane · 24/01/2013 12:54

Just back from ds's appointment. The nurse took his sats whilst we were there and they were up to 97. He is pretty ill, so we are keeping an eye on him, and will get him back to hospital if he seems to be struggling.

The cardiologist did an ultrasound which showed that he has a duct in his heart which hasn't closed up, so he wants to review him regularly, and has ordered a 24 hour ECG. Ds has a possible diagnosis of a rare genetic condition, which can be related to heart problems, which is why he was referred to a cardiologist.

Thank you everyone for your thoughts, and advice.

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DameSaggarmakersbottomknocker · 24/01/2013 17:10

I did a quick search after I posted this morning and realised I replied to you before on another thread. I'm assuming they've diagnosed a PFO or PDA which can be common in prem babies. Is the genetic condition 22q/Di George? [nosey]

Glad his Sats are a bit better Smile

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hazeyjane · 24/01/2013 19:24

Yes, I found that thread! I think PDA was mentioned, but can't be sure as ds was screaming so much. I am going to email the consultant, and ask for a report.

He asked if ds was prem, he wasn't but he was in nicu when he was born with respiratory distress and jaundice.

The genetic condition that he is being tested for is Kleefstra syndrome (9q34.3 deletion). The initial test was negative, but his geneticist and the Kleefstra team in Holland felt he fits the syndrome so well that he is part of a study which is investigating novel candidate genes and the syndrome.

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Inmyopinion1 · 27/01/2013 03:58

Right, people need to leave the nurse at your surgery alone as sats of 93% do not require admission or oxygen therapy. They are on the cusp but they are above the threshold and so no one would have done anything. The heart rate was a little high but could well have been anxiety related given it was recorded in the absence of fever. It's be something worth repeating at the time.

IV antibiotics should only be necessary in children who cannot tolerate oral antibiotics or are severely unwell.

There is a lot of misinformation and scare mongering being written here by people who clearly don't know what they are on about.

Hope your little one gets better soon.

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Sirzy · 27/01/2013 06:59

They do require monitoring though!

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Inmyopinion1 · 27/01/2013 08:01

Wouldn't fully commit to this without seeing the child, but you would not routinely admit a child for sats of 93%. Beds are scarce, if you don't need oxygen you don't come in. Admitting for what might happen is decadent.

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Sirzy · 27/01/2013 08:04

which is why I said that I would want monitoring in A and E. I agree that some peoples reactions were over the top but at the same time I would expect at least a couple of hours in A and E with regular SATS checks just to ensure the situation isn't worsening.

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GinandJag · 27/01/2013 08:19

How is he now, Hazy?

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Seriouslysleepdeprived · 27/01/2013 08:22

Erm...he did have a fever though. The OP said he has had a temp for 5 days.

A temp, sats of 93%, an elevated pulse, we don't know what his resps are but likely to be elevated. He is two and a half. Most importantly his mum feels uncomfortable and so has posted in the Internet.

Should really be seen by someone really, even if its just for reassurance.

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DameSaggarmakersbottomknocker · 27/01/2013 12:19

Sounds like he's quite 'interesting' hazyjane (from a medical POV). I have one of those. Smile

Hope he's feeling better.

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hazeyjane · 27/01/2013 20:13

Well,very briefly - we are in hospital,ds has pneumonia. We took him to a+e yesterday morning,and he was given a chest xray,put on oxygen and is having iv antibiotics. Hopefully we'll go home tomorrow,but they are a bit concerned about his o2 levels and think there is an underlying problem so want to do a sleep study.
Thankyou for all your advice, it was really useful. Ds has got a complicated medical history,and sometimes it is hard to know when to gear up and get into action,and when it is ok.

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Sirzy · 27/01/2013 20:14

hope he is better soon x

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Seriouslysleepdeprived · 28/01/2013 08:03

Sorry to hear that, poor thing. Pleased you got him seen. My DS is a bit complicated too, so understand how you feel. These things always seem to happen at the weekend.

Hope he makes a speedy recovery. Smile

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larrygrylls · 28/01/2013 09:24

"Right, people need to leave the nurse at your surgery alone as sats of 93% do not require admission or oxygen therapy. They are on the cusp but they are above the threshold and so no one would have done anything. The heart rate was a little high but could well have been anxiety related given it was recorded in the absence of fever. It's be something worth repeating at the time.

IV antibiotics should only be necessary in children who cannot tolerate oral antibiotics or are severely unwell.

There is a lot of misinformation and scare mongering being written here by people who clearly don't know what they are on about.

Hope your little one gets better soon."

Umm, well, when our child was 15 months, we took him to A&E with very similar sats (93%, tachycardic). He was given oxygen and an aerosol bronchodilator and then observed for a couple of hours. His sats were then 97/98% and they were still keen to admit him and only let us take him home after a period of observation to see that he was stable.

Although a child can have 93% for a while, it is very tiring and could easily dip to a dangerous level overnight. Where is it that they discharge a child with these sats?

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