What to Do When Your Oxygen Level Is Low

By John Bottrell, RRT

3 min read

In the realm of home oxygen therapy, optimal health demands a proactive approach. As someone deeply involved in the qualification process for home oxygen at our hospital, I've realized the importance of a pulse oximeter (pulse ox) for those relying on home oxygen.

Pulse oximetry and oxygen levels

Pulse oximetry is a vital tool that provides continuous monitoring of oxygen levels. It's a small, handheld device that easily slips over your finger, with the LED light on top displaying both your heart rate and oxygen level, expressed as a percentage.¹

At the hospital where I work, the objective is to maintain oxygen levels at 90 percent or better. But for some people with COPD, our goal is 88 percent or better. Your doctor can guide you in determining what is considered normal and low for you.

If you find your pulse oximetry reading to be low, it's essential to take prompt action. Here's what I would do if called to your room. Typically, it takes only a minute to run through each of these steps to find your solution.

Steps to take for low oxygen levels

Step 1: Check your nasal prongs

Are you oxygenating your airways or your cheeks? Trust me, I’ve seen this many times. Wearing oxygen all day, the cannula may slip out of your nose to cover your cheeks and you don’t notice.

Securing the prongs back into your nostrils may be an easy solution to your low oxygen levels. Likewise, if this is the problem, you won't have to bother with steps 2 through 6 below. However, if this is not the problem, move on to step 5.

Step 2: Check the source

Walk back to your oxygen source, whether it's an oxygen tank or concentrator. If you are using a tank, check if it still has oxygen. If not, replacing the tank with one that is full may improve your oxygen levels.

For concentrator users, ensure that it is functioning properly. Check for inadvertent unplugging or power outages. Consider switching to a tank if needed. Oxygen concentrators typically emit an audible hum, making it easy to know if they're working. However, in our busy lives, such cues can sometimes go unnoticed.

Step 3: Check the flowmeter

What liter flow are you supposed to be on? In my experience, the most common settings range from 2 to 3 liters per minute (LPM). However, your prescription may call for higher flows.

Ensure that the flow meter setting is where it is supposed to be. If not, a simple adjustment may be all that is needed to get your oxygen levels back to normal. If not, move on to step 3.

Step 4: Check the oxygen tubing

Is your oxygen tubing connected to the flowmeter? If not, reconnect it. Are you using connectors or swivel adaptors to give you more leeway while walking around your house? If so, check these to make sure that they are all connected.

In my experience, this step is the most common cause of low oxygen levels not caused by flare-ups. This alone may improve your oxygen levels. If not, move on to step 4.

Step 5: Call your doctor or resort to your COPD action plan

It's normal for oxygen levels to fluctuate throughout the day, and occasional variations are considered part of the normal range. However, if your oxygen level consistently stays low despite your efforts to improve it, the next best step may be to consult your doctor's office. Your doctor or nurse can provide guidance on the most appropriate course of action for your specific situation.

If you have a COPD action plan, use it as a valuable tool to guide your next steps and ensure a proactive approach to managing your health. An action plan typically outlines steps to take when experiencing symptoms, such as low oxygen levels. It may involve adjusting your oxygen level or treatment regimen. It also helps you determine when to call your doctor or seek emergency assistance.

Step 6: Seek emergency assistance

If your low oxygen levels persist or worsen – and especially if you are experiencing severe respiratory distress – it is crucial to seek emergency medical assistance right away. Call your doctor or emergency services for prompt evaluation and intervention.

Wrapping up!

Pulse oximeters are invaluable tools for monitoring oxygen levels. I strongly advocate for their use by anyone using home oxygen therapy. Your doctor can help you determine what oxygen levels are normal and low for you.

Simply slipping the device over your finger is an easy way to ensure your oxygen levels are in the safe range. If the device shows your oxygen level is low, the simple steps outlined here may serve as a practical guide to swiftly restoring your oxygen levels back to normal.

I hope these tips help you. If you have more advice, please share with others in the comments.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The COPD.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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njb Member
Don't forget to clean the filters! My home one from Inogen and portable have mesh filters on them. Take them out and wash with some soap, a toothbrush, dry, and put back in. Remind yourself to clean at first of the month so you don't forget.
1. Leon Lebowitz, RRT Member
 <inline-mention username="njb" user-id="2401198"/> Hi njb, and thanks for chiming in here. You make a good point. Much of the electronic equipment used for respiratory therapy (oxygen concentrators, portable compressors and nebulizer systems), do have filters that require periodic attention. It's always a good idea to check the operations manual so that any simple service that can be taken care of in the home setting won't be overlooked. We appreciate your input. All the best, Leon L (author/moderator)
2. Becky Brooks Moderator & Contributor
 <inline-mention username="njb" user-id="2401198"/> That’s a good tip. Once a year the Oxygen company cleans my concentrator but I don’t think to check it often. I do check the air filters in my home the first of every month and change them often. I will add checking my oxygen filters to the list. Thanks, Becky (Moderator)
njb Member
One of mine wasn't working well, and called company, and they reminded me! Cleaned filters and all was good. The filters get clogged up easily with dust! (Even in winter with the windows closed!) Please add this to your list of things to check. 😀 cause machine won't work good and won't get the oxygen you need if it's clogged up!
1. Lori.Foster Community Admin
 What a great reminder, <inline-mention username="njb" user-id="2401198"/>! Thank you. Best wishes. - Lori (Team Member) 
2. Leon Lebowitz, RRT Member
 <inline-mention username="njb" user-id="2401198"/> Hi again, njb - thanks for the update. I think your experience is a good reminder for our members who use this type of equipment in their homes. Clearly, there are maintenance items that can be performed by the home user/patient. This interaction between you and your medical equipment provider demonstrates that the companies may be expecting the user to provide this simple maintenance. Naturally, if someone does not feel capable of or confident in doing this, I am certain the company will take care of it on request. Keeping equipment properly maintained can insure trouble-free operation, which is what we all want from our respiratory therapy equipment. We value your input, njb. All the best, Leon L (author/moderator)
soldiergirl727 Member
on my check list I also have breathing treatment and or use my albuterol inhaler. I find if I'm really congested, I'll suck on a mentholated hauls cough drop.so far I've only had to call an ambulance 1x in the 4yrs. I've been on o2.
John Bottrell, RRT Moderator & Contributor
Thank you for joining the conversation and sharing what is on your "checklist." It sounds like you have a proactive approach to managing your COPD. It is good to hear that you've only had to call an ambulance once in the past four years while on oxygen. Keep up the good work. John. community moderator.