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NHSE changes oximeter guidance after device found to be ‘less accurate’ on darker skin


By Isabel Shaw

02 Aug 2021

New evidence suggesting that blood oxygen monitors — pulse oximeters — produce ‘inaccurate and ambiguous readings’ for people with darker skin prompted NHS England to update their guidance on the device.  

Back in April, NHS Race and Health Observatory published a rapid review on the limitations of oximeters for people from black, Asian and minority ethnic backgrounds. It found that the device can produce inaccurate readings for people with darker or pigmented skin as they may show higher readings of the oxygen level in the blood.  

The review also published several recommendations on how NHSE can address these misleading readings.  

Pulse oximeters are used to detect early signs of dangerous reductions in oxygen levels in both hospital and community settings. They have been specifically recommended for patients who are recovering from Covid at home. 

In its updated guidance published this week, NHS England acknowledged that oximeters can be ‘less accurate’ for people with darker skin.  

It concluded that: ‘Patients with darker skin who have been provided with a pulse oximeter should continue to use it to monitor changes to their readings.’  

It suggested that patients take multiple readings rather than just one. This means that patients will still be able to see if oxygen levels are going down, even if the original reading is not accurate.  

It also stressed that everyone who is offered an oximeter should speak to a health or care professional before they use the device if they have any questions.  

They have also been advised to take readings when they are first given the oximeter and regularly afterwards. 

Dr Habib Naqvi, director of the NHS Race and Health Observatory, 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.’ 

NHSE said it was ‘keeping this situation under review’ and had asked the National Institute for Health Research to ‘support further research so that we can understand more about how this may apply to people with darker skin who have Covid-19 and are using pulse oximetry’. 

Previously, NHSE called on pharmacies to get involved with local voluntary and community organisations to connect with people who would otherwise not have access to healthcare.

This was to ensure more people have easy access to healthcare after research found that Covid-19 disproportionately impacted certain populations, mainly those who are already subject to health inequalities and struggle to obtain healthcare.

Last year, The Pharmacist reported that Black and Asian patients with dementia in the UK received a worse quality of care than white patients due to differences in prescribing.

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