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Health Forum    Respiratory Diseases
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Additional D...

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 Which of the following endotracheal airways have specially designed cuffs in reduce trauma?
i. Lanz tube
ii. Bivona tube
iii. Kamen Ghia tube
iv. Passy-Muir tube

a. I and II only
b. II and IV only
c. I, II, and III only
d. I, II, III, and IV...

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My friend Just started getting Panic Attacks and has never had them before why is this? She also sometimes faints....

Terrie B
Is a blood Oxygen level of 88 and blood pressure reading of 90/54 dangerous?
My mom is 88 and her health has been failing since April 2009. She has severe dimentia. Hospice is involved.
Last nght...her oxygen level in her blood was 93....this morning it was 88 and tonight it is 84.
Her blood pressure tonight is 90/58.
We are told that she is very close to the end.
Can you how low her oxygen level and Blood pressure can get and her still be alive?
I am 3000 miles away, so I am not able to actually SEE how she is for myself and her doctors wont tell me anything because I am not there.
I am finding out my info thru relatives....but none of them really know or understand whats going on.

Her oxygen saturation is extremely low. Normal O2 saturation shouldn't fall below 95. Her blood pressure (BP) is also low. As a baseline, normal (or texbook BP) is 110/70, though this changes as we get older and have more disease, ie: atherosclerosis.
It sounds as if her O2 levels will continue to decrease. I presume she is on oxygen, though this doesn't help with some disesaes ie: if the lung tissue (called alveoli) are destroyed by a disease, there won't be enough of them for oxygen and carbon dioxide transfer anyway, so extra O2 won't help much but is given anyway especially as a comfort measure. Medication can also be given to raise her BP as well. If she has fluid on her lungs or around her heart, etc diuretic medication can be given to alleviate her symptoms.
I would call when I could and talk to her treating Dr - u can't always tell what is happening thru relatives, as they will be distressed as well. But if she is in a hospice, perhaps things will not improve I hate to say. But best talk to her treating Dr.
I am terribly sorry for you and your Mom. I will say a prayer for her tonight.
God be with u & ur family.

There is alot of info in what you have typed.
--The first is that Hospice is involved. Around here in NC, patients are required to be 6 months from death before Hospice becomes involved. You stated "We are told that she is very close to the end" and I assume that this statement comes from either the Hospice staff or the doctor. Seriously trust what they say. No one is psychic and predict the date and time for you so you must understand that.
--Oxygen levels that are below mid 90's and dropping are not good. It means that she is getting less oxygen in with each breath and it will start affecting organs rather quickly.
--90/58 is a low BP but not intolerably low. If it continues to drop, she will definitely have problems tho, especially combined with that oxygen level. They are not good signs when combined together.
--You can call and ask to speak with whom ever is taking care of her with Hospice, or have one of your relatives ask her to call you. Explain your distance situation and ask is it time for you to come. They will answer your questions. When I worked with cancer patients and we saw "changes" in patients that we thought indicated the end was near, we would notify the family "If there is anyone that wants or needs to come, they need to come now." Everyone has different terms they use for this time, but the meaning is the same. It's not news that is pleasant to deliver, but one that is felt important to get to the family. Understand? Good luck.

Yes both of those levels are bad, although you do not mention if this blood level is her spO2 or her PO2. SpO2 measures how much oxygen is bound to the blood with a normal usually between 90-100% but can change in a matter of minutes. PO2 measures how much oxygen is actually in the blood and is a good way to tell how well the lungs are doing their job. An 84 on this scale would not be bad, although considering how often their checking the "oxygen" it's probably the less invasive spO2.

The blood pressure is also a bad sign, BP is a combination of how much your heart puts out in each beat (stroke volume) your heart rate, and the resistance in the arteries. If her heart rate slows or the heart doesn't pump as well it will drop. This causes less oxygen to go to the tissues and as it gets lower the organs will start to fail.

It's always hard to guess when a person will actually pass as some go quickly when their vital signs drop and others tend to stick around for a while. However her vitals do not sound reassuring and she may be close to the end. If you are able to go see her I would try and get there as soon as possible. People have been known to live with extremely low vital signs, but she seems to be going downhill and may not have much time.

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