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swright2 Asked May 2018

Will there be lasting affects from this incident?

My mother 87, atrial septal defect (just diagnosed this year), CHF, and on oxygen 24/7 at a level 3, in an assisted living memory care floor. Visited her after lunch, walked her to her room with her O2 tank then hooked her up to the concentrator which has a container of water that the air bubbles through. Mom was going to lay down to take a nap. Five minutes later I could see her shoulders heaving up and down like she couldn't breathe. I asked her if she was getting air and she said yes. Went to get an oximeter from the nurse to check her level and it was 85%. She kept breathing hard and the level kept dropping. The nurses came in to check on her and increased the level to a 5. Her O2 level continued to drop into the 70's, so I told them to call hospice which they did (she's been under care for 2 weeks now). I called my husband over and my sister as I thought this was it. Her levels were hovering in the low 70s and reached a 69 at one point. Mom started to get angry at me for dumping her in there and really didn't make much sense. She also said her stomach hurt. The head nurse kept coming in to check on her and asked if I wanted to give her some morphine to help her breathe. I told her to wait until my sister got there and hospice. So she was like this for about 3 hours until my sister got there and she went to adjust mom's nose canula and said - there's no air coming out! Husband looked at the concentrator and the bubbles were still going through the water but nothing at the other end. There was an extra hose so he put it on the machine and low and behold her O2 levels came up to 92% in a matter of minutes (or so it seemed)! Hospice showed up and checked mom's lungs and no rattling and all was good. Looks like there was something wrong with the machine so they are going to bring a new one. The nurses checked on mom more frequently last night. Very scary situation and wondered what would have happened if my sister hadn't checked the nosepiece. After this was all done we walked to dinner and she was fine and ate all of her food. I just wondered if those hours of hypoxia did any damage?

DeeAnna May 2018
GardenArtist, thank you for that great explanation about the water bottle. I have had the same problem with the water bottle.

Swright2, one thing that you can do before you put the nasal cannula on your Mom is to turn on the oxygen concentrator and put the nasal cannula close to your hand to determine whether you can feel any air coming through the tubing. If you feel air movement, then put the cannula on your Mom. If you can’t feel any air movement, then ask the nurse to check the concentrator to determine why there is no air coming through the tubing. I noticed that you stated that after your husband put different tubing (nasal cannula) on the oxygen concentrator; your Mom experienced higher oxygen saturation levels. As Ahmijoy mentioned, this might have been a case of everyone thinking someone else checked the hose and cannula. In other words: Human error…it happens.

I wouldn’t blame the nurses too much for what happened as sometimes they are looking more at the disease symptoms and how to treat them than thinking that there might be some equipment malfunction. You stated that when you asked your Mom if she was “getting any air” that she said “Yes” so her response could have misled the nurses.

Your Mom's oxygen saturation levels were in the 60-70's for approximately 3-4 hours. I see no need to subject her to lots of tests to determine whether she suffered any lasting negative effects due to the hypoxia.

Apparently your Mom has some major respiratory problems related to her CHF since she is on HOSPICE. As she journeys through the natural dying process, she will experience more and more episodes of low oxygen saturations and hypoxia that are caused more by her CHF than by her oxygen concentrator malfunctioning. Watching someone have difficulty breathing is terrifying. I hope that the Hospice Nurse can help your Mom experience minimal respiratory distress the last days of her life.

May God be your strength today, tomorrow and every day. God Bless!

Daughterof1930 May 2018
We have an adult son with an hypoxic brain injury. It was acquired due to low oxygen levels as an infant for a sustained period of time. We’ve seen his levels in the 50’s. I’m no doctor but for us, we’ve seen the injury more common to those who have low oxygen saturation levels over a longer period of time. I know when you’re in the midst of a crisis, it feels like forever, especially when you feel like no one is acting to help the situation. But often people can withstand brief periods of low oxygen, I’m hoping this is the case for your mom.

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GardenArtist May 2018
Okay, here's what happened. This happened to my father once and in a panic I had to call the oxygen concentrator supplier.

It's the water bottle, not the tubing or cannula.

Distilled water has to be added, usually daily, to the water bottle, which moisturizes the oxygen as it flows through the tubing, up into the cannula and out into the nostrils.

The water bottle has to be PRECISELY screwed back to be completely level. And it's not that easy to do unless you sit down on the floor and either look closely at the bottle's level or actually use a contractor's level.

If it's not 100% level, there's an impedance in the flow, and even though the water is bubbling, it's impeding oxygen flow. The bottle has to be unscrewed, replaced, and made completely level.

The bottle sits within a recessed area in the concentrator, and it's hard to just eyeball and be assured that the bottle is completely level.

I asked the supplier if there was any way to measure the bottle's level status other bending over and eyeballing it, or sitting on the floor with a level. None. I tried to get a contractor's level underneath the bottle to check for leveling, but the level was too large. I had to literally lay down on the floor and eyeball the bottle before I could be comforted that it was screwed on and the bottom was precisely parallel to the floor.

The cannula and tubing can be good and working properly, but if that bottle's not screwed on completely level, the oxygen won't get through the tubing.

This was a really scary situation. I thought it might be easier to just use a humidifier in the room.

As to long term effects, I think you'd probably have to have a pulmonologist measure lung capacity and compare to medical notes before this incident, and/or follow the suggestions above.

I'm sorry you and your family had to experience this. It is a very scary situation, but there's no real blame. When I filled the bottle that particular time, it looked perfectly level to me. But it wasn't.

Someone needs to manufacture a concentrator with a water bottle that's at a more reasonable and accessible level. People shouldn't have to lay down on the floor and use a contractor's level to ensure the bottle is properly screwed on.

Ahmijoy May 2018
I wonder if this wasn’t a case of everyone thinking someone else checked the hose and canula. Human error, so to speak. Thank God your sister checked! And I’m sure that from now on, the staff will check those things regularly, or at least I’d hope they would.

If Mom is ok now, I’m not sure I’d subject her to all that testing. It sounds like she’s at a good facility and they will keep tabs on her.

Eyerishlass May 2018
You can take your mom to the doctor for a full battery of tests to see if the hypoxia affected her or you can wait and see. If it did affect her you should be able to tell very shortly.

JoAnn29 May 2018
Not getting enough oxygen would cause confusion. I would think the nurse would have tried to find out why.

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