Covid patients given early warning home oxygen monitors by paramedics

Coronavirus patients who call an ambulance but are not yet sick enough to go to hospital are being given new home oxygen monitoring kits to help spot those who may deteriorate earlier.

Across the Thames Valley region, thousands of patients will be given the kits which include a pulse oximeter device to monitor blood oxygen levels, a diary to track their symptoms and advice on what to do if they become sicker.

South Central Ambulance Service Trust (SCAS) has become the first ambulance service in the country to launch the scheme after research showed a small drop in oxygen levels among some patients could be an early warning sign of serious complications.

Patients with pneumonia and non-Covid lung conditions often experience shortness of breath before a drop in oxygen levels. But with coronavirus, patients can suffer what has been called ‘silent hypoxia’ where their oxygen levels can fall before the patient becomes breathless and calls for help.

In a study of 1,080 confirmed Covid positive patients who called an ambulance between 1 March and 31 July, those patients who saw a blood oxygen level drop of only 1 or 2 per cent below 96 per cent – still within the normal range of 94 to 98 per cent – often went on to need admission to intensive care and had a lower chance of surviving.

NHS England has supplied almost 300,000 oximeters to community patients across the country.

The oximeters work by placing a clip on the end of a finger to measure oxygen in the blood and heart rate and, if oxygen levels drop to 94 or 93 per cent, patients are asked to call their GP or NHS 111. If levels fall to 92 per cent or less they should call 999.

SCAS medical director Dr John Black said: “Our original research helped to inform the wider rollout of the Covid Oximetry at home project to enable patients in high-risk groups to monitor their blood oxygen levels directly and help ensure timely referral to hospital when indicated. We are pleased to be the first ambulance service to offer pulse oximeters to patients along with guidance once we have assessed them and determined they don’t need to be taken to hospital but are at increased risk of their condition changing.

“It provides patients with the reassurance that they can keep a regular check on their oxygen levels independently and seek the help they need if their levels drop below 95 per cent, while for us it means our clinicians can leave patients knowing they have the ability to spot any change promptly and take swift action.”

He added: "It is hoped that prompt identification of hypoxia through home oximetry will lead to earlier admission to hospital for patients who subsequently deteriorate. This has the potential to improve the clinical outcomes of Covid-19 patients who develop complications.”

Dr Matt Inada-Kim, a consultant in general and acute medicine at Hampshire Hospitals Foundation Trust and lead for the study said: “SCAS has produced groundbreaking research that has informed national policy and led to the evolution of the Covid home oximetry model and its staff are again leading the way with this new project to help identify patients at risk as early as possible.”