The Deal with Pulse Oximeters

November 9th, 2011 | Author: COPD Coach

Dear COPD Coach,

Some friends of mine have told me that it is a good idea for a COPD patient to have a pulse oximeter. Is it worth spending money on and what should I look for in buying one? I have seen several on the internet but some are very inexpensive and some and very expensive.


Dear Confused,

Having a pulse oximeter can be a useful tool for any COPD patient, and if used properly, can indicate when you might be experiencing a problem (and hopefully catch it early). A pulse oximeter measures the percentage of oxygen in your blood along with your pulse rate (hence the name pulse oximeter). While useful, the unit is often not accurate enough for medical diagnostics and is not always as accurate as the kind your doctor may use.

Let’s start by detailing what a pulse oximeter does: It measures the percentage of oxygen in your blood (saturation or SpO2) along with your pulse rate. If your percentages are lower than what they normally are it could mean that you are in the beginning stages of an exacerbation.

A pulse oximeter, from

Or, if you are using supplemental oxygen a low “Sat” could indicate a problem with your oxygen source. Used during exercise, it can tell you when you have reached your tolerance, or need to increase your liter flow.What a pulse oximeter doesn’t tell you is if you are retaining carbon dioxide, (CO2, common to  some COPD patients) or have carbon monoxide, (CO), in your blood. In the case of either one, you saturations may read as normal but the presence of CO2 or CO in any significant amount will impact your breathing.

Remember, there are two elements of breathing: the first one is taking in oxygen into your body and the second part is getting carbon dioxide out of the body. It possible for someone to be getting enough oxygen into their body but not getting rid of enough carbon dioxide. And for some people, keeping these gases at safe levels can be a delicate balance!

Your oxygen is carried only on the red blood cells – the hemoglobin. So if you are anemic it will not be shown on the pulse oximeter, because as you remember, the pulse oximeter  measures the saturation in your hemoglobin. In other words, you could show up as being 100 percent saturated (which sounds great) but you might actually be low on oxygen if you have a low  hemoglobin. The only way to determine if you are anemic is with a blood test.

It is important to remember that pulse oximetry measures only oxygen saturation and pulse rate, not ventilation. In other words, it gives just a snapshot of your lung function. If your doctor wants to know more, he or she may order an ABG (arterial blood gas). ABG’s provide a full picture of the way your lungs are functioning in relation to your kidneys and other body systems.

Some things that will cause a pulse oximeter to give false readings are nail polish, fake fingernails, calloused skin or if your fingers are cold. Movement while taking your saturations will either cause the unit to give false results or take longer to display results.

You should monitor your pulse rate along with your SpO2 because they are predictors of health problems. If you have abnormal readings even for a short period of time, see a doctor. If for example your oxygen saturation appears normal but your pulse rate is high, it may indicate that your heart is working harder to keep your saturations high.

As for what units are best, in most cases, cheaper is not better. There are any number of inexpensive units out there, but in a majority of cases they are either inaccurate, difficult to use, or don’t last. I tried 5 different units and never once got a reading. I would recommend buying a meter from a local pharmacy where you can easily return it if it proved to be defective or unsatisfactory. If you purchase from an internet supplier, read the reviews and make sure they have a good return policy. It is never a bad idea to bring your unit to your doctor appointment or to pulmonary rehab class and check your readings against his unit. Make sure whatever unit you purchase takes regular batteries not special medical batteries, which are very expensive to replace. Bottom line is purchase the best unit you can afford and you will get far better results!

As with any device that uses technology, you must know how to use it, and interpret results properly. Once you get your meter, take your readings over several days at different times during the day. This will give you a base line to determine what is normal for you. In many cases your normal saturations will be lower at some times and higher at other times.

Word of caution: Don’t become obsessed with it! Some people feel the need to check their saturations every few minutes. If you get a low reading, don’t panic or over react. Wait a few minutes and take it again as you may have gotten a false reading the first time, which is not uncommon. If your readings continue to be abnormal, consult with your doctor. If your readings remain very low, get medical help!

Happy Breathing,

The COPD Coach

Ask the Expert is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice.

If you would like to submit a question to the Coaches Corner email us at We would love to hear your questions and comments. You can address your emails to any of the following: COPD Coach, Caregiver Coach, COPD Doctor or COPD RT.


  1. Jennyct says:

    A very close relative died last week – we’re not sure exactly what happened because they don’t do autopsies on elderly people with COPD – but I am absolutely convinced he would have called the doctor immediately if he had one of these.

    After having increasing difficulty in breathing, he refused to call 911. Later that day, he collapsed and died.

  2. Deb B says:

    What is the highest parameter for heart rate on most pulse oximeters? If the heart rate is extremely high is the pulse oximeter able to read the oxygen saturation?

  3. Melissa says:

    Good to know. I’ve been battling Anemia for the last year and have had bronchitis for the last two weeks. I get fluid in my lungs and feel like I’m SOB and drowning, but the pulsox shows 100%. How can I feel like I’m drowning but have enough oxygen, I wondered. The only relief I get is that I cough so hard I almost throw up. Eventually when the crap comes out, I feel better. i tested negative for pneumonia. It’s very frustrating.

  4. Michelle Muske says:

    I have COPD and i am currently on 3 liters of oxygen at night. I also have to use a portable oxygen container just to go for walks. I was hoping that maybe through the COPD foundation I could receive a pulse oximeter, as I can not afford one myself. I noticed recently that my O2 levels are getting worse.

  5. Majd says:

    My father was diagnosed with COPD ,. He uses all the time the O2 concentrator with 3 L. and Vipap during the night 10-16 .
    I find in the medical equipment companies several tools to make the life for him easier
    1. Capnograph CO2 monitor . Does it measure the CO2 by using the pulse ?
    2. New masks for vipap without the head gear. Is it suitable ?
    3. I read from the comments that there are treatments for theCOPD ….. ?


  6. Juls says:

    I was diagnosed in may 2011 with COPD. since then have had problems with vitamins D and B-12, (that I know of)when they stop the injections of b-12 within 2 months it drops to dangerously low levels, and immediately back on injections, even though the whole time I was also taking pill form, same with D taking 50,000 units cant get level above 25 after 4 yrs, any idea if it could be somehow related to meds or disease, taking these from my system?

    Exhauted 😉

  7. nikki says:

    Thats good to know!! I believe i am low in iron…and i was suffering some the ailments, terrys nails etc, I was vegan for a few years and got myself into serious vitamin deficaincy….i took 80 mg of iron a day for month..still am..and its helped alot, terrys nails has gone away and the colour came back in my skin. Anyways was havibg issues breathing a whileback…did i pulminary test on me..and i do have obtruction in my lungs, every time they they tested my oxygen levels it was 100 percent tho, but nails would be alittle blue. Good to know this might be lack of iron. Im also definitely deficaint in B12 aswell….suffered alot in that too. Anyways SLOWLY getting better…

  8. terry s says:

    Answer to roncanning, they tell me that all the time too, everything is normal, I was diagnosed with cold in 03 and no one has ever told me about my pulse rate or anything, that is why I am on here today. I kept asking all my drs if my finger says I have enough oxygen in my blood then why do I feel like I am suffocating and like I’m going to have a heart attack (which I do have heart trouble too)? Not once in 13 years did I hear about pulse rate, they just acted like I was nuts cuz I said I can’t breathe. Can’t wait to see what they say now, thanks for the site!

  9. Kim says:

    My dad was diagnosed with copd and emphysema 9 years ago and everg couple years, hes gotten sick, but nothing too serious and nothin other thsn lung troubles. But since about a year ago hes had tinnitus real bad, ringing in just one ear and no pain but just in the last week or so one of bhis hands keeps going numb and all hes done is sleep for about 4 days niow cohld tbhis all be caused by copd? I got one of the oximeters on ebay for 17$ and it reads pretty normal, except once is said 75% but i assumed it was a fale reading.

    • Dan says:

      In my experience with them, they do give false readings sometimes. Try on different fingers and even toes and select the most consistent reading. If you’re getting 75% all over the body there’s probably a problem with breathing.

  10. Anonymous Mus says:

    Heart skipping beats might be because of body vitamin & mineral imbalance from the antibiotics. Wait a few days and it should revert to normal

  11. Ron Canning says:

    i have had copd for sometime and have been treated recently for an mrsa infection that i had four years ago and now it has colinized in one lung, i stopped anti -biocics 6 days ago, but i notice the last few days when i get short of breath my heart starts skipping beats, is thia something to worry about? i had an ekg and they said it was unchanged since the previous one i had

    • Jennyct says:

      Have you done a holter monitor? You wear a monitoring device that records your heart activity, and you call when you have symptoms.

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