Buyers Guide

Patient Monitoring and Triage for COVID-19

Why Triage and Monitoring are Important in COVID-19 Response

To limit the spread of COVID-19, it is important to promptly identify and separate ill patients. Moreover, COVID-19 is also spread by people who are infected but are not experiencing any symptoms. Triage with infrared thermometer and fingertip oximeters can be important for early triage or screening to identify suspected cases, as well as for workflow management to prevent cross-contamination of patients within facilities.  

 

Monitoring patients who are receiving clinical care for COVID-19 is important to prioritize resources and understand if people are deteriorating, stabilizing, or resolving.   Pulse Oximetry is especially important during oxygen therapy, and multi-parameter patient monitors given an even more comprehensive “clinical status” of patients.

For Types of Triage and Monitoring Devices

Triage is the process to quickly screen, separate, and prioritize potential COVID-19 patients, both infrared thermometers and pulse oximeters can be used as point of care, highly portable solutions.

 

Infrared Thermometer Forehead infrared thermometers provide instant readings without contact making it a useful tool for triage, and quickly screening large numbers of people in clinical and community environments.

Pulse Oximeters for triage can identify lower oxygen saturation even before a patient may exhibit other clinical symptoms of hypoxia or respiratory illness.  Fingertip Oximeters are a more efficient tool for triage (spot checking) than tabletop or handheld portable pulse oximeters.   See below for more information on Pulse Oximeters. Handheld pulse oximeters are more versatile as they can be used for triage as well as monitoring and management of seriously and critically ill patients more effectively than both fingertip and tabletop but Tabletop pulse oximeters are good for more advanced clinical care and monitoring.   If these will be used on pediatric and newborn populations, appropriately sized probes will be necessary and therefore handheld pulse oximeters are more versatile.  (SEE Buyers Guide for Pulse Oximeters)

 

For ill patients, monitoring vital signs during clinical care is essential to understand disease progression or resolution, and the need for other interventions.  

 

Patient Monitors.  Multiparameter patient monitors for case management are critical, those with EKG are preferable but the other parameters are also very important (non-invasive blood pressure (NIBP), oxygen saturation (Sp02), temperature, respiratory rate(RR)).  Make sure that sensors and cables are either included or purchased separately.

For Monitoring

For ill patients, monitoring vital signs during clinical care is essential to understand disease progression or resolution, and the need for other interventions.  

Pulse Oximeters for triage, and management of serious or critically ill patients. Handheld pulse oximeters are preferable as they can be used for management of seriously and critically ill patients more effectively than both fingertip and tabletop. See below for more information on Pulse Oximeters.  If this will be used on pediatric and newborn populations, appropriately sized probes will be necessary and therefore handheld pulse oximeters are more versatile. 

Patient Monitors.  Multiparameter patient monitors for case management are critical, those with EKG are preferable but the other parameters are also very important (non-invasive blood pressure (NIBP), oxygen saturation (Sp02), temperature, respiratory rate(RR)).  Make sure that sensors and cables are either included or purchased separately.

Key Considerations for Purchasing Infrared Thermometers and Pulse Oximeters

When selecting a pulse oximeter, it is important to keep in mind a few things. The right device will depend on the clinical use and patients (adults and pediatric and newborns), and there are also factors related to upfront cost versus recurring costs of a pulse oximeter.  Probes, which are either reusable and need to be replaced periodically, or disposable probes, are a recurring cost as are batteries, and other accessories like sensor wraps or adhesives which should be factored into the total cost of ownership.   Accuracy is very important for pulse oximetry. Devices should have Sp02  accuracy at least within + 3% for all patients and Sp02 detection range of 70-99% (fingertip and 70-100% (handheld and tabletop); and pulse rate accuracy should be within + 3 beats per minute (bpm) and pulse rate range should be 30-240 bpm.

Types of Pulse Oximeters

There are different types of pulse oximeters, each with unique advantages and drawbacks, and specifics for intended clinical use. It is important for any user or buyer to understand how the device would be used, and on what patient population prior to selecting.

Portable Pulse Oximeter
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Best for:
  • Spot checking
  • Single probe size
  • Personal Use
Measures:
  •  Sp02
  • Pulse Rate
Accessories:
  • Batteries and replacements
  • USB cable for charging
Advantages:
  • Low upfront cost
  • Portability
  • Self-contained
Drawbacks:
  • Not appropriate for neonates
  • Device failure likely requires replacement
  • No internal memory
Power/Electric Considerations:
  • > 21 hours of operation of spot checking (at rate of 30 second intervals) on a single battery or charged battery.
Portable Pulse Oximeter
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Best for:
  • Spot checking or Continuous (need alarm settings for continuous)
  • Varied sizes for adults, children, neonates
  • Personal or Clinical
Measures:
  • Sp02
  • Pulse Rate
  • Maybe others
Accessories:
  • Probes (sensors) in sizes for patient use (adults, children, neonates) which may need to be replaced after 1 year
  • Batteries and replacements
  • USB cable for charging
Advantages:
  • Multiple use cases (adults, pediatrics, neonates)
  • Portability
  • 12+ hours operational capacity with rechargeable battery
  • Capability to download or transmit data
Drawbacks:
  • Reusable probes can be prone to wear and tear with heavy use; single use probes can be expensive and reliant on supply chain.
Power/Electric Considerations:
  • Operating either on single use or rechargeable battery (preferred), should have a run time of at least 12 hours on battery only (if not using a main power supply)
Portable Pulse Oximeter
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Best for:
  • Continuous monitoring
  • Clinical use in secondary or tertiary facilities
Measures:
  • Sp02
  • Pulse Rate
  • Maybe others
Accessories:
  • Probes
  • Power/charging cable
Advantages:
  • Multiple use cases (adults, pediatrics, neonates)
  • Large Internal memory to store data
  • 12+ hours operational capacity with rechargeable battery
  • Capability to download or transmit data
  • High accuracy
Drawbacks:
  • High upfront cost
  • Less portable
  • Reusable probes can be prone to wear and tear with heavy use; single use probes can be expensive and reliant on supply chain
Power/Electric Considerations:
  • Rely on local power supply with a rechargeable backup battery. The running time on battery only should be at least 6 hours
*adopted from “WHO-UNICEF technical specifications and guidance for oxygen therapy devices.” 2019

VIA Global Health is committed to supporting health systems access affordable and appropriate medical products to improve the health in their communities. Products included in our Buyers Guides are available for purchase at VIA Global Health.  

References and Acknowledgments

(1) World Health Organization, Interim Guidance and Essential Equipment and Supplies. April 2020.

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