Oximeters for home monitoring

[Orangeblossom78]

Just thought I would share this article I read today. I have had a look and seem to be quite a few easily available online.

Has anyone used one / wondered if might be helpful to share experiences or any issues. Thanks.

In the Times today, www.thetimes.co.uk/edition/news/coronavirus-finger-clip-device-gives-warning-on-oxygen-level-v35qkzz0p

*Coronavirus: Finger-clip device gives warning on oxygen level
A simple device that monitors oxygen levels at home could help to identify people who are falling severely ill with Covid-19, doctors have said.

Experts are concerned that significant numbers are not receiving care quickly enough, which leads to a hard-to-detect form of viral pneumonia.

Richard Levitan, an American doctor, said that the volume of patients who need a ventilator could be reduced if people with symptoms such as fever and cough monitored themselves using pulse oximeters. These are small devices that clip on a finger to measure oxygen levels in the blood.

“We are just beginning to recognise that Covid pneumonia initially causes a form of oxygen deprivation we call ‘silent hypoxia’ — ‘silent’ because of its insidious, hard-to-detect nature,” he wrote in The New York Times.

Pulse oximeters, which can be bought for £23, had helped to save two of his friends, he added. Detection of low oxygen levels, early treatment and close monitoring also appeared to have helped Boris Johnson.

British experts agreed that pulse oximeters could provide a valuable early warning but said that the NHS would have to be geared up to respond.

Professor Babak Javid, consultant in infectious diseases at Cambridge University Hospitals, said: “Many of the features of Covid are strikingly reminiscent of other lung infections that interfere with the ability of the lungs to oxygenate the blood. However, in some people that may be previously fit and well, this may not be apparent.”

He cautioned that pulse oximeters might not pick up warning signs when patients had been resting. “In a number of patients, it may be that mild exercise, such as walking for a few minutes, would push up their oxygen demands so much that the lungs can no longer cope, and their blood oxygen saturation dramatically falls,” he said.

“These patients are likely to be at risk of becoming severely unwell in a few hours, or a day or two, but if this ‘post-exercise saturation’ test is not performed, they may be falsely reassured that they are not seriously unwell.”

Whether a patient is admitted into hospital depends on several factors, including their age, frailty, underlying health conditions and their condition, which would include oxygen levels.

Andrew Farmery, professor of anaesthetics at the Nuffield department of clinical neurosciences at the University of Oxford, said that the viral pneumonia caused by Covid-19 appeared to be unique. “Many have commented that phenotypically it’s more like altitude sickness than pneumonia, with patients hypoxic and breathless without significant pneumonic inflammation,” he said.

Dr Levitan described how he spent ten days in New York’s Bellevue Hospital, where he helped to insert breathing tubes into Covid-19 patients. He was surprised to see that patients admitted for other reasons and who did not realise they had Covid-19 were showing signs of pneumonia, where the lungs become inflamed and fill with fluid*

First of all, I wondered say if someone where to call 111 would they then be able to share this info with the phone line perhaps, might be helpful in that way.

There’s another thread on this somewhere. Even the cheap ones work OK but the problem we’re going to have is knowing when to worry. Unlike temperatures where there is a pretty well established ‘normal’ that people know about, Spo2 isn’t known to lay people and the danger is lots of worried calls to 111 or GPs saying ‘my sats have dipped from 98% to 95% should I be worried?”. Even people with COPD (who often run at lower sats levels) often don’t know their target sats.

I’d like some more detail before I’d be buying a sats probe.

I've got one. It was actually issued by work as part of the kit I take out, but I used it when I had Covid symptoms.

It was ok. Readings fluctuate a bit depending on which finger and hand I used it on. I did become a bit obsessed with checking myself every ten minutes along with my temperature.

I'd also recommend using it in conjunction with respiration rates - how many breaths a minute. Normal for adults is around 13-15 or so. If it's over 22, you'd want to be calling for medical advice.

Spartan, what % saturation would you have become concerned at? I'm thinking of getting one of these for my elderly parents.

Normal respiration rate is actually 12 -20.

When my son was 2 his were in the 70s, he was admitted then (pneumonia)

Circle - If they haven't got any other respiratory conditions, you'd want to keep an eye on them at 94%, and call 111 for advice if it drops to 92% or below.

I have one for my son who has asthma, bought on amazon for £15 a few years ago. His target o2 is 95% or over. I tend to use it when he’s wheezy or seems like he’s starting an asthma attack to monitor. Got it after I took him to gp mid asthma attack and she didn’t test his o2 levels just spent 10 minutes talking about hayfever and sent us home, ended up being admitted to hospital less than 2 hours later. I find doctors pay more attention when they have an idea of o2 levels.

He also has a peak flow meter with instructions what to do if lung capacity drops to certain levels, it’s useful to check how bad breathing is and have a plan of action. Other things we look out for include retractions which is when the skin pulls in between ribs and at collar bone and means the body is working hard to get enough oxygen, this is a straight to A&E sign. I’m sure all these things would be useful indicators for anyone struggling with breathing due to Covid 19.

Thanks Spartak and Professor!

Thanks, these sound useful, might think about getting one

Buy the best you can afford.

I've had several for work, some of the cheaper models (£30-£50) can underestimate spO2 by 3-5%. There are many factors that can alter sp02.
Smoking, obviously.
Nail varnish can affect readings too. As can low blood counts.

A good buy is a 'Nonin' - expensive tho.

Cold fingers can give a low result too.

Oh tricky, so with a cheap one it could give a lower reading and un-necessary worry? Thanks

Interesting - DH was v breathless about a week ago so used my pulse oximeter (bought after I suffered a PE a couple of years ago) and it was showing sats between 88% and 95% throughout the day. I freaked out (ex nurse) and said we needed to get him looked at but he refused and we compromised in that if he didn't feel better we had to speak to someone.

Anyway, the feeling of breathlessness went, but his sats have still not improved much - very occasionally gets to 96% for a few seconds but not often. But he's had no other symptoms AT ALL - no cough, no temperature - nothing.

Am jumping from thinking he's had some insidious form which is now affecting his lungs, to hoping that if he's not got any symptoms at all (which he hasn't, other than the shitty O2 readings) then he can't be too ill. But will he see/speak to anyone? Will he hell.

Another article in the Times today saying Dominic Cummings wife used one on him after he collapsed due to the virus, said it told her he should be in hospital when he seemed Ok in other ways. It says she got one off Amazon

Vino I wonder if my DH had this also back in Feb after a trip abroad; he too would not see anyone. we had no meter to test sats, anyway after about a week of it I finally managed to convince him to let me call the GP. They rang back and spoke to him on the phone. In case that helps. I get that they are scared of going in, I suppose, not easy. But yours might need oxygen. Hope it is OK.

Won't help in the UK as we are not admitting covid patients until they are critically ill. Even if you found you were hypoxic, NHS 111 would tell you to stay at home unless you meet the criteria for admission

What are the criteria then Pocketem? Not being low in oxygen? Would the GP help, particularly if an underlying condition? Thanks; genuinely interested.

You can use the 111 coronavirus screener online here
111.nhs.uk/covid-19/
The call handlers will ask the same questions and follow the same script. Nothing about having hypoxia

Ok, what is the best plan for those on immune suppressants call the GP who knows the history or 111? As in the past the GP could call ahead to A&E - is that still the same or not? Thanks

It's tricky to use that screener without filling in all the personal details etc, maybe you could explain further, thanks

@Vinosaurus please seek help. This was the whole point of the NYT article - people presenting with none if the typical symptoms suddenly deteriorate and cannot always be saved. He might feel fine but could be developing hypoxia

Op I've already decided that if 111 don't send help then I will ring ahead to the hospital and go to A&E. This treatment pathway they are currently adapting is killing people. I wish someone would ask the government this

There's no personal details needed, the only thing they ask is your postcode to detect which health serves are available in your region, you can just use Boris's postcode if you like - SW1A 2AA

@pocketem you are talking nonsense. If you are at home, sick with coronavirus, an oximeter is invaluable. Firstly for reassuring you that even though you feel you cant breath (v, v common symptom) your blood oxygen is at safe levels. Alternatively for telling you that, even though you dont feel so bad, you are actually getting into difficulties and need urgent medical assistance (NY Times article on "Happy hypoxia").

Current NICE guidelines are for hospital admission for anyone w an o2 SAT of 92% or less (may be different for people w certain medical conditions). The cheap oximeters may not be as accurate as the clinical ones but they will give you a far better idea of what is happening to you than how you are feeling.

I bought a lower-end oximeter recently. It takes consistent and believable readings from me and my teens, but struggles with dh. Possibly large fingers? It can only seem to read dh's little finger.