Resting oxygen saturation in clinic is the least informative measurement you will take on a patient with fibrotic lung disease, and it is usually the only one recorded. Exertional desaturation determines oxygen assessment, rehabilitation prescription and prognosis, and it will not appear unless someone walks the patient.
A corridor walk with a finger probe takes a few minutes and needs no equipment beyond what is in the room. Record the resting saturation, the lowest saturation, the distance and whether the patient stopped, and write the time it took to recover. Note also what the patient says while walking — the person who talks continuously and desaturates to 86% is telling you something different from the one who stops at fifty metres with a saturation of 94%. Without that line in the notes, the next clinician sees a normal saturation and a breathless patient and has no way to reconcile them.
- Walk the patient rather than recording only a resting saturation
- Record resting saturation, nadir, distance, and whether they stopped
- Note recovery time — slow recovery is as informative as the nadir
- Use the same probe and the same corridor for serial comparisons
- Document a normal walk test too; it is what makes the next abnormal one interpretable
Why it matters
Oxygen assessment, rehabilitation prescription and prognosis all hinge on a measurement that most clinic visits never take.
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