Reissued: Accuracy of pulse oximeters at low oxygen saturation

This Safety Alert was first published on 26 August 2020, and is now being reissued to include latest information from the Therapeutic Goods Administration, Australia (TGA).

Pulse oximeters may overestimate arterial oxygen saturation (SpO2) for patients with non-white skin when SpO2 falls below 90 per cent. This disparity widens as SpO2 falls, is more pronounced in individuals with darkly pigmented skin, and is likely to be clinically important below SpO2 80 per cent.

Studies published in the mid-2000s1,2 investigated this phenomenon. An August 2020 article in the Boston Review highlighted the significance of this in the context of patients with COVID-19 using pulse oximeters to monitor their oxygen saturation at home.

In January 2022, the TGA issued a Medical Devices Safety Update on Limitations of pulse oximeters and the effect of skin pigmentation. We ask fellows who may be using pulse oximeters to care for patients to ensure they have a current understanding of the issues with these devices.

Last updated 14:52 11.01.2022