The oximeter, a device that clips on to your fingertip, could help revolutionise medical care, its role accelerated by the coronavirus pandemic.
During the early stages of the crisis in Sydney, pop singer Jaguar Jonze was treated at home by a ‘virtual hospital’ run by Sydney’s Royal Prince Alfred (RPA) Hospital.
The 28-year-old had some symptoms of coronavirus, but had difficulty getting tested and she didn’t want to “stress a system already overloaded with people in much more dire situations”.
So, she used a remote monitoring telehealth system featuring the oximeter, which gave RPA staff all the data they needed.
A pulse oximeter looks like a big clothes pin. The patient’s finger fits inside. The small device displays blood oxygen level – crucial to any respiratory diagnosis – and heart rate.
When Jaguar Jonze’s condition worsened, it was immediately picked up by RPA medical staff with access to her temperature, blood pressure, and oxygen levels via her mobile phone.
Nurses and doctors monitor the data and touch base with patients via telehealth appointments at least once a day.
“We have a virtual health model that uses telehealth to deliver the care,” RPA virtual hospital clinical director Dr Owen Hutchings said.
“It’s really a remote monitoring program that is focusing on detecting clinical deterioration.
“The clearest, most significant advantage for the virtual hospital model is that it prevents exposure of people to each other,” Dr Hutchings said.
“So, both healthcare workers to patients and patients to healthcare workers.”
In the United States, the pulse oximeter has proven useful for those who have or are suspected to have coronavirus but aren’t sick enough to be admitted to the hospital. They are sent home with a pulse oximeter and instructions to use it three times a day.
When the device picks up decreases in oxygen saturation, it can be a ‘lifesaver’.
The New York Times reports that patients with COVID-19 can experience a “dangerous drop in in oxygen saturation without having obvious breathing problems”.
“Without a pulse oximeter, they might never know it or get very used to how they feel, despite very low oxygen levels. By the time they go to the hospital feeling shortness of breath, their oxygen levels would have dropped significantly, and they could have very advanced COVID pneumonia.”
The benefits of pulse oximeters during the COVID-19 crisis has led to a debate among doctors about whether we should all have one at home.
“The American Lung Association advises against buying pulse oximeters unnecessarily and recommends people focus their awareness on other COVID-19 symptoms,” says Kathy Katella of yalemedicine.org.
Consensus is currently that only those with COVID-19 symptoms will gain much benefit from the device.
However, in the future, it may be that more patients with respiratory issues will be saved a hospital visit by using such devices.
Aaron Jones, chief nursing and midwifery information officer at Sydney Local Health District, told the ABC: “This entire pandemic has presented some opportunities for us to actually leverage off technology to connect to our patients and their community in ways that we’ve never been able to do before.”
Dr Stephen Duckett, health economist with the Grattan Institute and a fellow of the Academy of the Social Sciences in Australia, said the pandemic had forced a surge in health technology.
“We’re doing things now which are much more efficient than we’ve done in the past,” Dr Duckett said.
“Hospital in the home is a good example; why do you need to occupy a bed, which costs a lot of money and capital, when you can have someone at home visited by a nurse, visited by a physiotherapist, visited by a doctor?” he said.
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