Tutorial presented by Tanya Howells, Respiratory Nurse Specialist, HDUHB.

Severe COVID-19 infection causes oxygenation failure. Emerging evidence suggests that people may not present with breathlessness despite significant hypoxaemia. If uncertain, a low threshold for pulse oximetry is advised.

Taking an SpO₂ measurement from a patient should follow these simple steps to ensure the test result is accurate and a true reflection of their oxygenation status:

• The patient is rested and calm.
• The finger is warm, well perfused and there is no nail varnish on the sample site.
• The oxygen probe is applied to a finger for at least 30 seconds to stabilise, but preferably for the duration of the consultation to ensure the patient is fully rested.

The SpO₂ result, together with the patient’s risk criteria (age, co-morbidities, BAME) categorises patients into three risk categories:

Low risk

• SpO₂ greater than or equal to 95%, AND under age 65 with no co-morbidities

Moderate risk

• SpO₂ more than 92% but less than 95%, OR over age 65/under age 65 with co-morbidities, BAME

High risk

• SpO₂ less than or equal to 92%, OR SpO₂ less than 88% (or more than 5% below their normal baseline) in any patient with an underlying diagnosis of COPD (or other respiratory disease)