Pulse Oximeters and the issue of Skin Colour: A PATIENT SAFETY ISSUE!

It is 2023 and years after the issue of bias in readings when it comes pulse oximeters and Black Skin was first raised, it has still not been fixed, leading to harm being caused to Black patients due to incorrect readings that lead to delayed or improper treatment.

“Since the start of the pandemic, the popular medical device has been indispensable for measuring oxygen in the blood, but dangerously inaccurate in patients with darker skin. Now the FDA is in the hot seat and Black researchers are working on a cure”.- Forbes

According to a recent article in Forbes by Amy Feldman , in one year alone, 11 hospitals in and around Baltimore had sent home 1,012 Black patients who had dangerously low, life threatening, low oxygen levels despite having normal readings on Pulse Oximeters! That alone should send shivers down our spines if you look at the numbers globally, since these devices are used worldwide.

This is even more shocking given that during the pandemic ( which is still ongoing, with long lasting effects), people were encouraged to buy pulse oximeters and keep them at home, as a safety measure, because it was found that one indication of deteriorating health, despite one feeling well, was a low oxygen saturation level. But we have since found out that, they give false readings when it comes to those of us with darker skin!

Although the article focuses on the American population and their own regulatory bodies i.e the FDA, this has far reaching implications for patients everywhere, even here in the U.K, given that these devices are used in every hospital and around peoples homes and also the fact that the UK government is moving healthcare to the home via ‘Virtual Wards’ , which rely on data produced by these devices and others linked to phones or smart watches. If the bias in reading is not fixed, then i fear that more harm will be caused to a population that is already bearing the brunt of medical racism! We have not even touched on Clinical Research Trials!

While some manufactures are tweaking their devices to correct this huge, life threatening anomaly, there is still a danger posed by pulse oximeters that are manufactured abroad and sold online on sites like Amazon and online stores with the danger being that they have not passed rigorous testing and approval by regulatory bodies like the FDA in America and the Medicines and Healthcare products Regulatory Agency (MHRA) here in the UK.

I hope that the MHRA will follow their American counterparts in holding the manufactures of these devices to account and also protect the public from defective, life threatening pulse oximeters that are sold online and in stores, by allowing only tested, regulated and licensed pulse Oximeters, to be used in all clinical settings ( Research Included), as well as in our homes( with regards to those purchased online).

We should not be harmed or worse still, die because of the Colour of our SKIN!

Advocating for your Health.

“Health is wealth”, as the saying goes and when your health is not right, you are not feeling yourself, you look to the experts to help you make sense of what is wrong and how they can help you get better. More often than not, it takes several attempts/ appointments for you to even be listened to, let alone get the treatment you need. This is a scenario that Black people, especially Black Women are familiar with and can make an already worrying and anxious situation even more frustrating.

We are going to share some tips below on how you can advocate for your own health and in some way help you take charge of your health/treatment.

Health Advocates take control of their health care experience. You and your doctors make decisions as a team. You speak up with your questions, needs, concerns, and preferences. Webmed.

1) Keep a Symptom Diary.

If you are anything like me, by the time you rock up to a doctors surgery or pick up the phone to call your GP, you have suffered for awhile and have tried all sorts to get better but you have now reached a stage where you have now acknowledged that something is indeed wrong and that none of your self treatment options are working and you need help! Problem is your Doctor/ healthcare provider doesn’t know that and will base their opinions or treatment options on whatever you are most likely presenting with at the appointment, which always happens to fall when you are relatively well and symptom free! To help your doctor/healthcare provider make sense of what is happening, it helps to have a clear picture of sorts, hence a symptom diary would be of help to them and you as well. It shows a pattern.

• How did it start?

• possible triggers

• what makes it better or worse?

• what treatments have you had self and prescribed?

It would also be a good idea to know your medical/ surgical history if any and any allergies you might have as this is not always recorded correctly or might be missing from your medical notes. In short: KNOW YOUR BODY.

2) Research.

Are your symptoms unique to you or is there a family history of the same? Ask family members, they may tell you about an aunt or grandmother etc who had the same complaints as you. Some illness are hereditary/genetic and knowing your family history can be of great help, including treatment options that they had if any and at what age(s) their symptoms/illness started and outcomes. This can help speed up treatment options/ referrals.

Treatment options that are out there/ available on the NHS and which ones you prefer, also who are the specialists and where they are located because some illness are rare and not all hospitals have a specialist or a dedicated treatment center. It also helps to know what help in terms of support is out there in the community, like support groups, charities and how you can access them if you need to. They can help you navigate timelines by providing more information like how long it takes to see a doctor , get a referral and test times and what is involved.

3) Ask Questions.

Don’t be afraid to ask questions, for example: about your illness, treatment options, if you do not understand what is being said, during your appointment. If you think you might be overwhelmed and not remember what you need to ask, you can write them done prior to your appointment or take a trusted family member or friend who can ask on your behalf or remind you. If English is not your first language and you need the information in your native language, let the doctor/healthcare provider know.

4) Keep Records.

While we may have one healthcare system, The NHS, the various parts of the system rarely talk to each other, let alone use one central system. Which means your hospital records and what is contained in them varies from one part of the hospital/ specialty to different NHS Trusts and are completely separate to your G.P records. This can be very confusing and frustrating when you finding yourself having to explain, recall and recount your medical history, tests and referrals each time from memory. Keeping a record of all your hospital appointments, times, specialist names, tests, results, basically anything and everything will help ensure that nothing is missed and that you have a clear timeline and record that you can refer to each time.

5) Know when you need a second opinion.

Get a second opinion when you feel like your concerns are not being listened to or that you are not being taken seriously and are being fobbed off. You will know when the doctor or healthcare provider does not seem interested in what you are saying or your experiences and tries to hurry you along or not allow you to ask questions or seems to dismiss your questions. You may not be a medical expert but you are an expert on your own body and if something doesn’t feel right then it probably isn’t.

The medical community has a long way to go when it comes to believing women about their health - Meredith Fineman.

Here is a link to an interesting article and we hope the tips above help. Let us know in the comments.

https://www.shondaland.com/live/body/a19878029/how-to-advocate-for-your-health/