Pulse Oximeters and COVID-19

NHS England recently updated their guidance to support the remote monitoring, using pulse oximetry, of patients with confirmed or possible COVID-19.

It builds on the COVID Oximetry @home standard operating procedure, as well as the general practice and community health services standard operating procedures which were published last year.

Patients most at risk of poor outcomes are best identified by oxygen levels.

NHS England and NHS Improvement coronavirus have developed a standard operating procedure for using pulse oximeters to monitor oxygen saturation levels and an assessment pathway. Pulse oximeters can help detect asymptomatic presentations of “silent hypoxia” with low oxygen saturation but often with normal heart rate and other obs.

The assessment pathway classifies Oxygen saturation levels in to one of three classifications. Mild where O2 is 95% or higher, moderate where O2 is 93-94% or severe where O2 is 92% or lower. At a severe stage urgent admission to Hospital should be considered.

According to NHS England guidance an ideal blood oxygen level is between 95% and 99% and an ideal heart rate is between 50 and 90 beats per minute (bpm).

The NHS England Annex 2: Remote monitoring COVID-19 diary gives some practical tips on how to use a pulse oximeter correctly. These include

  • Remove any nail polish or false nails and warm your hand if cold.
  • Make sure you have been resting for at least five minutes before taking your measurement.
  • Rest your hand on your chest at heart level and hold still.
  • Pulse oximeters works best on your middle or index finger. It should not be used on your ear.
  • Keep still and keep the pulse oximeter in place for at least a minute, or longer if the reading keeps changing.
  • Record the highest result once the reading has not changed for five seconds.
  • Be careful to identify which reading is your heart rate and which is your oxygen level.

They have also produced a diary card which can be used to record results and any symptoms.

The link for the guidance and diary is below.