We are massively monitoring the temperature. Should not oximetry also be a value to be systematically detected in the event of a suspicion of COVID-19? It is clear that, in these times, this early measurement of oxyhemoglobin saturation has real diagnostic and prognostic importance, influencing medical decisions.
Moreover, from the beginning of March, the WHO invited countries to equip themselves with pulse oximeters, information which was widely reported in the press. The pulse oximeter, or "pulse oximeter", is a tool widely used in hospitals, both in children, adults and the elderly. But it can also be used in practice or by individuals. What are its functions?
The pulse oximeter continuously measures the amount of oxygen circulating in the arteries. We speak of arterial saturation with hemoglobin (a molecule that carries oxygen to the tissues). When hemoglobin carries oxygen, it is said to be "oxygen saturated". It is used to measure the heart rate and the level of oxygen carried by the blood. Advantage: it is a non-invasive examination, because it does not require any injection or any blood sample.
What situations can distort the measurement?
Also pay attention to the size of the finger, toe, etc. If it is too big compared to the sensor, the light may not be detected, and the sensor damaged. Be careful that the device has the right sensors for multiple use (neonatal, pediatric, adult).
For patients prone to cardiac pathologies, pulmonary problems, loss of consciousness, it is useful to monitor their pulse or arterial oxygen saturation. The oximeter can also be used for monitoring during anesthesia, to control breathing capacity in case of distress, or to monitor the beating of the heart.
It is clear that when COVID-19 pneumonia begins, quietly, some patients do not feel short of breath, even when their oxygen levels begin to drop. It has also been observed, in the course of certain cases of influenza-like syndrome (suggesting COVID-19), banal and benign, lasting 8 to 15 days, with a more or less significant impact on the general condition, an unexpected subsequent worsening. In addition, it has been recorded in France, since the start of the epidemic, a very important and lawful recourse to teleconsultations.
If we refer to the data of Public Health France and the statements of the Health insurance, there have been, since the beginning of April, up to 350,000 weekly consultations, of which three quarters by teleconsultation. In the last week of April, the number of consultations was reduced by four, but almost 90% were teleconsultations. The measurement of SpO2 (pulsed oxygen saturation) can be carried out in the emergency room or in the doctor's office, but it is also a means of securing the teleconsultation, if the caller who consults can have at home a pulse oximeter. The result of the measurement can indeed modify the medical decision. Many were aware of this observation of an American emergency doctor: "I have seen patients with still unknown pneumonia, in whom SpO2 could have collapsed, up to 50%. Many had been sick for a week, or more, but had not noticed any shortness of breath until then. In a few hours some found themselves in a critical state ".
We have also seen in France, a number of cases of acute asphyxiation occurring at home and not always recovered, despite the intervention of the SAMU. Such observations have also been published in Italy. It is therefore clear that a teleconsultation which can include a measurement of SpO2 appears very reassuring, and that the monitoring of the patient followed at home should include this measurement.
In conclusion, the pulse oximeter has long been part of our daily lives. The peculiarities of COVID-19 pneumonia further enhance its usefulness and make oximetry a must for the initial examination.