Pulse oximetry in low-resource settings

Summary Pulse oximetry is used to detect hypoxaemia. It is widely used in both the pre-hospital and hospital settings in developed countries and has become a basic standard of care. There are substantial differences in healthcare between developed and developing countries and it has been recorded that surgery is associated with a much higher number of complications and deaths occurring in resource-limited settings. To address this issue, the World Health Organization (WHO) introduced the Safe Surgery Saves Lives Programme in 2007. With this programme, the WHO Surgical Safety Checklist was launched. Included in this checklist is the step to ensure that a pulse oximeter is on the patient and functioning. WHO now has the Global Pulse Oximetry Project, an initiative to promote the use of pulse oximeters in every operating room in the world. The Lifebox project is a charity that aims to help the supply of pulse oximeters at low cost to anaesthesia providers in low-resource settings.

Increasing availability of pulse oximetry in low-resource settings is relevant to all physicians because hypoxaemia is a common complication of many illnesses, particularly pneumonia. Pneumonia impacts developing countries disproportionately, and accounts for over 2 million deaths a year worldwide. Hypoxaemia is a recognised risk factor for death, correlates with disease severity and is difficult to detect clinically until cyanosis is present. Oximetry plays an essential role in early detection of hypoxaemia and in guiding oxygen therapy, which is often a scarce resource.