Oximeters could give “seriously misleading” results for BAME people and possibly contribute to rising Covid-19 death rates, according to an NHS review.
Pulse oximeters attach a clip-like device to a person’s finger, toe, or earlobe and send out a beam of light to measure oxygen levels in the blood.
The resulting SpO2 reading can be used to monitor the oxygen levels of people with various conditions, including people at home with coronavirus, as well as to assess patients in the hospital.
However, a new article cites a “growing body of evidence” that pulse oximetry is less accurate in patients with darker skin.
This could contribute to health inequalities such as rising Covid-19 death rates of patients belonging to ethnic minorities, according to a study conducted for the NHS Race and Health Observatory.
He calls on the Medicines and Health Products Regulatory Agency (MHRA) to urgently review pulse oximetry products intended for ethnic minorities used in hospitals and by the British public.
The review, by Olamide Dada of Cardiff University School of Medicine, cites evidence from over three decades of inaccurate and ambiguous readings for people with darker pigmentation and skin tones.
A 1990 study found that inaccurate pulse oximetry readings were more than twice as common in black patients as in white patients. Other trials have found overestimated SpO2 levels in people with dark skin and low blood oxygen levels.
And, a 2020 University of Michigan study found that pulse oximeter readings of blood oxygen levels were three times more likely to be inaccurate in African American patients.
The review said: “Given the increased mortality among ethnic minority patients during the Covid-19 pandemic, it is possible that the differential accuracy of pulse oximetry is a contributing factor to this health inequality. ”
Serious clinical implications could include delays in seeking medical attention or insufficient oxygen delivery to patients, she warns.
And that could lead to coronavirus intensive care patients receiving premature “withdrawal” treatment.
Dr Habib Naqvi, director of the NHS Race and Health Observatory, said: ‘At this pivotal moment, we cannot afford to ignore this rapid review and the recommendations for action that may prevent late hospitalizations and help improve the health of blacks and ethnic minorities. people at risk or recovering from Covid-19.
“This review underscored the need to ensure that health equipment and devices are culturally competent and sensitive, without contributing to the range of current and historical inequalities in health. ”
The Director of the Royal Pharmaceutical Society for England, Ravi Sharma, said: “This review exposes an area of health inequality where one treatment may give more effective results for one group of patients compared to another. is not acceptable and needs to be resolved urgently.
“Pharmacists and other healthcare professionals who use pulse oximeters in their practice or provide them to the public should take ethnicity into account when assessing their effectiveness in users. ”