31 July 2021

NHS Update Guidance On Blood Oxygen Monitors

In April 2021, the NHS Race and Health Observatory published a rapid review with recommendations into the accuracy of Pulse Oximeter readings for people from black, Asian and minority ethnic backgrounds.

The review outlined a series of recommendations for national healthcare, regulatory and research bodies to address misleading readings, amplifying higher levels of oxygen in blood, for individuals with darker pigmentation and skin tones.

NHS England and NHS Improvement have now reviewed those recommendations and accordingly published enhanced clarification on the potential limitations of these devices for people with dark or black skin.

Details of the updated guidance can be found under the FAQ section of the NHS England website and on NHS.UK.

Director of the NHS Race and Health Observatory, Dr Habib Naqvi, said:

“We need to ensure there is common knowledge on potential limitations in healthcare equipment and devices, particularly for populations at heightened risk of life-changing illness, this includes black, Asian diverse communities using pulse oximeters to monitor their oxygen levels at home.”

Ranjit Senghera-Marwaha and her husband Harjeet Marwaha, both of whom contracted the virus last year have welcomed the updated guidance.

Ranjit, an NHS Volunteer Responder and Carer, from Birmingham, who had  suffered from pleurisy, was hospitalised with Covid-19 pneumonia in December 2020, she said:

“I was part of the Imperial College Covid testing study and in September found out I had covid antibodies. I started doing some online research and bought an oximeter from Amazon as my oxygen levels kept getting lower and lower.

“No one ever told me about pulse oximeters, had I known before I would have been checking my oxygen levels instead of struggling to breathe at home and waiting to see the GP. I had never been offered one nor asked if I had one.”

“It’s really sad. We’ve lost so many black and minority ethnic people to Covid.  Maybe if some had known about these devices, they could have made informed decisions.

“I was diagnosed with Covid-19 pneumonia and spent 10 days fighting the virus in hospital and needing oxygen. Having the oximeter reading was a powerful wake up call, had my readings got much lower than 86, it could have been so much worse.

Harjeet Marwaha recalled calling for an ambulance on Boxing Day and being told by paramedics Ranjit’s oxygen levels were borderline, Ranjit was admitted to hospital the following day after they fell even further.

He added: “These oximeters are simple machines that can really help but people need to know how to use them properly and take into account that the readings may not be 100 percent accurate due to skin tone.

“The risk is that people are sat at home relying on the display and not being aware their oxygen levels could actually be slightly lower than shown. It’s important the community is made aware of these risks.”

The couple have since made sure that relatives and friends, who have purchased oximeter devices, know about the risk of variations in readings.

A few days ago Marika Mason from London, learnt her daughter Natasha had contracted the Covid-19 virus.

“I spent days searching for a pulse oximeter so Natasha could monitor her blood oxygen levels accurately at home and detect early signs of deterioration. I was wrong however because I have since discovered pulse oximeters are not as effective in detecting oxygen levels in people with darker skin.

“The guidance warns people with brown and black skin to be cautious about the risk of inaccuracy of oxygen level readings but these are potentially life-saving, affordable medical products. It’s a shame these devices may not work equally as well for people who are already disproportionately affected by severe Covid symptoms and death.”