Dear all,

 

I have a question.  We recently went to the ER for an asthma attack.  My 7.5 year old son, with CVA, had a flare up accompanied with fevers for 4 days.  We maxed out his medications at home on his care plan and he was still in the red zone on his peak flow.  After a 5 hour wait in the ER waiting room (his O2 sats were 99% upon arrival due to all the treatments) they began his nebulizers.  Upon receiving 2 nebulizer treatments of atrovent and albuterol ( I believe), his O2 saturations came up from 91-92% to 94%.  They were ready to send us home, but due to radiology forgetting to read the X-ray (thank goodness), we had to wait.  He has a croup like presentation that at that point only responds to oral steroids.  They finally consented to administering the oral steroids and about 1.5 hours post ingestions, his O2 saturations started to creep up to 97%/98%.  These are my questions:

 

1) At what saturation level is it o.k. to discharge a patient in this condition?

 

2) Currently, he has about 4-5 bouts/year that are fairly serious.  We've spent many a day in the pediatricians office receiving steroids, nebulizers, etc. but have never been admitted.  Is it worth it for us to buy a home pulse oximeter?  For us, we gage his oncoming attack (and recovery) by his peak flow and his level or hoarseness.  He doesn't tend to wheeze. 

 

3)  Also, when he becomes compromised, the steam shower seems to be quite helpful.  Do you think that a warm saline nebulizer would be helpful in opening up his airway?

 

Thank you in advance for your advice.  Please feel free to post these questions if you feel it may help others.

 

Thank you,

 

Tess