Experts call for urgent review of pulse oximeters – a vital tool that can save lives

A summary of a letter published in the European Respiratory Journal (ERJ)

A pulse oximeter is a small electronic device that can be clipped onto a fingertip to measure the level of oxygen in the blood. It is used to help identify people at risk of severe pneumonia. This has been even more important since 2020 because of pneumonia caused by COVID-19.

Despite the value of this tool, and of oxygen therapy, which is used to treat people with low oxygen levels, they are not widely available. This is especially true in areas with high levels of pneumonia, such as Latin America, South Asia and sub-Saharan Africa.

There are some potential issues with how pulse oximetry is currently being used. Recent research has highlighted that the oxygen levels that indicate whether someone needs further support would be different for people living at different altitudes. What is classified as a low level of oxygen – or fast breathing – for one person, may not be the same for another living at a higher altitude. Further studies have found that pulse oximeters do not provide accurate readings for people with darker skin and the thresholds should be reconsidered for this group.

In a letter to the editor of the ERJ, a group of leading experts is calling for immediate action to review the accuracy of and access to these devices and access to oxygen therapy. They believe that urgent reform of this device is needed to ensure that it can be used as effectively as possible. Supported by 16 scientific societies, the group is calling on regulatory agencies to assess the accuracy of the device in all populations.

As a vital tool in the fight to combat childhood pneumonia and to manage severe outcomes in people with COVID-19, it is essential that pulse oximeters work accurately and, along with oxygen therapy, are equally available around the world.

Read the original letter

Pulse oximetry is an essential tool that saves: a call for standardisation