What are pulse oximeters and why can they be useful for tackling sepsis?
Pulse oximeters are devices for measuring the amount of oxygen in someone’s blood, called blood oxygen saturation. When combined with other clinical signs, health workers use this information to identify patients who require urgent medical attention, including those with sepsis. This can lead to faster treatment for these patients and improve their likelihood of survival.
Image rights: Nidhi Chauhan 2018
Accurately measuring blood oxygen saturation with a pulse oximeter requires training. Current pulse oximetry devices were designed for continuous monitoring of blood saturation. However, in many low- and middle-income countries (LMIC) they are used by nurses to take spot check measurements, and the accuracy and reliability of pulse oximeters when used in this way is unknown. A recent planned secondary analysis led by undergraduate Action on Sepsis trainee Ahmad Asdo, Action on Sepsis Cluster Member Dr. Mark Ansermino, and the Institute for Global Health’s Technical Lead Dustin Dunsmuir attempted to tackle these gaps. Their analysis used data from nearly 4,000 children presenting to two referral hospitals in Uganda to provide important guidance for taking spot-check measurements with pulse oximeters in young children.
The team found that the repeatability of a pulse oximeter’s measurements improved with longer periods of observation and higher signal quality. Repeatability improved significantly with periods up to 35 seconds of measurement, with minimal improvement with longer periods. This is an important finding that can be incorporated into training for health workers using pulse oximetry. Device manufacturers can also use these findings when designing new devices and incorporate prompts that remind or force users to collect sufficiently high-quality data for at least 35 seconds. Manufacturers can also incorporate features that filter out low-quality data.
Pulse oximetry is a critical measure in triaging pediatric patients with sepsis, as the information is invaluable for decision-making in LMIC. This provides all the more reason to ensure that measurement repeatability is optimal for the best sepsis triage and patient outcomes.
- Ahmad Asdo
More about the authors
Ahmad Asdo is an undergraduate trainee with the Action on Sepsis Research Cluster in the Bachelor of Science program at the University of British Columbia. This study represents his early explorations in research through our cluster and his passion for improving healthcare quality in resource-limited environments, including Uganda. Having begun his medical education in Syria prior to emigrating to Canada, Ahmad is committed to using statistics and data analysis to support LMIC by helping eliminate healthcare inequities.
Dustin Dunsmuir is the Global Health Technical Lead for the Institute for Global Health at BC Children’s & Women’s Hospital. Having completed his graduate training in visual analytics, his research interests center around creating innovative digital health solutions, such as data visualization dashboards and risk prediction mobile applications, for implementation in the health systems of LMIC.