Coronavirus: Breakthrough blood monitor allows patients to be treated at home

Doctors can monitor coronavirus patients remotely after clinicians developed a platform that keeps track of their symptoms at home.

COVID-19 patient David Kirton used a device called a pulse oximeter to measure his blood oxygen levels when he was recovering at home. Picture: Aaron Francis

Doctors around the nation will be able to measure the blood oxygen levels of coronavirus patients ­remotely after clinicians at the Royal Melbourne Hospital developed a platform that monitors symptoms at home.  

The platform uses a device, known as a pulse oximeter, that clips onto the finger and shines a light through the fingertip to determine the saturation of oxygen flowing in the blood. Oxygen levels are one of the key markers of ­illness in COVID-19 patients, and if doctors can monitor oxygen ­levels remotely, patients are more likely to be able to recover from the illness at home, taking pressure off hospitals.

The RMH oximeter program, which was originally set up to ­assist with anticipated pandemic numbers of COVID-19 patients, is the brainchild of emergency physician Martin Dutch. It’s now set to be used by hospitals around the country to remotely monitor COVID-19 patients.

“The problem when you have a pandemic illness (is that) if you adopt that traditional strategy of admitting large numbers of people to hospital to look for that smaller subset who deteriorate, you rapidly run out of beds and human ­resources,” Dr Dutch said.

“Our group asked what is the solution to this problem because we can’t just fill our hospitals with people who may get sick.

“What we need to do is identify patients at the point when they get sick, admit them when we have something to offer them and then be able to discharge them back home when being in hospital is no longer any benefit.”

Dr Dutch said doctors needed three key pieces of data in order to safely monitor patients at home: blood oxygen levels, heart rate and temperature. RMH patients being monitored at home were supplied with a standard digital thermometer to measure temperature and the pulse oximeter to measure blood oxygen levels and heart rate.

COVID-19 patient David Kirton, 64, who participated in a trial of the pulse oximeter, said the fact the device allowed him to stay at home and monitor the illness remotely was a “godsend”. “It was quite simple to use,” Mr Kirton said. “It gave me peace of mind knowing that at least I was keeping an eye on how I was going and the hospital was keeping an eye on how I was going also.”

Mr Kirton participated in the pulse oximeter trial from April 9-14 after he had been diagnosed with COVID-19 five days earlier. He said he suffered body aches, fatigue, nausea, cold shivers and excruciating headaches with the virus. He said while he preferred to isolate at home, it gave him “peace of mind” to know doctors at the RMH were checking on him regularly.

The RMH purchased 1000 of the small electronic devices, which cost $10 each, to use in a trial that started on April 7. The device is usually clipped on a patient’s finger, but it can also be clipped on a toe or an earlobe.

So far, the trial has recruited 20 patients, who were asked to record their vital signs via a text message and report to the hospital using their smartphone twice a day. The text messages send a link to each patient, who complete their measurements in a “dedicated data entry portal”.

The information is then sent to the hospital where software developed by Dr Dutch collects and automatically analyses it. If the software records any abnormalities in the measurements, it will send a text to the patient to tell them that a doctor will call or that they should go to hospital.

Dr Dutch said patients who have “normal lungs” have oxygen levels of between 95 and 100 per cent, but with COVID-19 patients that can deteriorate quickly, usually around day eight of the illness.

“It is now clear that a subset of patients may have a very significant deterioration in their health in their second week of illness,” Dr Dutch said. “This deterioration can often begin to occur silently, without a significant worsening of symptoms. A number of international centres are now recommending the early identification of this subgroup of patients through use of pulse oximeters.

“We would closely monitor ­patients who drop below 95, and for patients who drop below 90 we request that they attend hospital.”