South Central Ambulance Service first in country to supply Covid-19 patients with home oxygen monitoring kits

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South Central Ambulance Service Credit: Leon Neal/PA Archive/PA Images

Paramedics at South Central Ambulance Service (SCAS) have become the first in the country to supply Covid-19 patients with home oxygen monitoring kits if they don’t require immediate admission to hospital.

The initiative, which began in Hampshire and is now running across the Thames Valley, will ensure patients who have mild symptoms but have other risk factors, such as age over 65 years, cancer or other health conditions, can monitor their oxygen levels from home.

The packs contain a pulse oximeter device, a symptom diary and a set of strict guidelines and are only distributed to patients who require emergency assessment.

It follows recent research by clinicians at SCAS which identified that just a slight drop in blood oxygen levels - but within the normal range - could be an early important warning sign of deterioration in patients.

The service says that in most cases of bacteria and non-Covid pneumonia, shortness of breath appears relatively early in the disease and ahead of any significant drop in oxygen levels, known as hypoxia.

However, with Covid-19, a drop in oxygen levels often comes first, which is referred to as “silent hypoxia”, and patients can be significantly unwell by the time they become breathless.

Pulse oximeter Credit: SCAS

The team studied almost 20,000 patients who called for an ambulance between March 1 and July 31 2020.

They then analysed the oxygen levels of 1,080 confirmed Covid positive patients at the point they were initially assessed by paramedics at home.

Patients whose blood oxygen levels dropped only 1% to 2% below 96% - still within the normal range of 94% to 98% - and showed no signs of shortness of breath often went on to require admission to intensive care and had a lower chance of survival.

The study was led by Dr Matthew Inada-Kim, a Consultant in General and Acute Medicine at Hampshire Hospitals NHS Foundation Trust.So far around 300,000 packs have been supplied to patients across the country by local health systems.

They work by placing a clip on the end of a finger to measure oxygen in the blood and heart rate.

If oxygen levels drop to 94% or 93%, patients are asked to call their GP or NHS 111 – or 999 if it falls to 92% or less.

SCAS Medical Director Dr John Black said: "It provides patients with the reassurance that they can keep regular check on their oxygen levels independently and seek the help they need if their levels drop below 95%, while for us it means our clinicians can leave patients knowing they have the ability to spot any change promptly and take swift action.”

Dr Inada-Kim, who is also the National Clinical Lead for Deterioration at NHS England, 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."