COVID 19 Adapting Practice and Remote Monitoring

The last few months have brought significant changes to the healthcare landscape across all sectors. In primary care there has been an overnight change in practice with almost exclusive reliance on telehealth and remote consultations via video or phone.

Pulse Oximetry in the fight against COVID-19 is proving vital.

These relatively simple medical devices provide valuable info when assessing patients with many respiratory conditions – especially COVID-19.

Given the importance of the data – our practice has been sending them out to our members for no charge.
Likewise, local NHS services have started to provide remote pulse oximetry for suspected COVID-19 cases.

In conditions like asthma and pneumonia, patients are usually significantly short of breath before oxygen levels start to fall. However, with COVID-19 we sometimes see oxygen levels drop before shortness of breath develops – termed silent hypoxia – for patients in the community it may be an early warning sign.

Similarly, some physicians stress patients by getting them to exercise whilst monitoring oxygen saturations. A significant drop in oxygen levels can indicate serious underlying lung pathology and can be used to identify those patients who need hospital admission and close monitoring (not something I would recommend doing remotely).

I’ve remotely consulted with patients with COVID-19 in the NHS and private sector who were not short of breath but during regular follow up their oxygen levels were found to be low. They were admitted into hospital and treated with oxygen (did not require ventilation), made a good recovery and discharged after a few days.

Picking up low oxygen levels early into the illness may result in better outcomes. A pulse oximeter, together with a thermometer and blood pressure machine provide information that can potentially influence decision making in a particular case.

It’s not to say that 02 levels are the only factor, those with normal levels may also require hospital admission. A full clinical assessment is always necessary, but pulse oximeters provide a key piece of data.

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