SMS Sinch
Remote Oximeter Support for COVID19

SETUP

Many COVID-19 patients are dying because they have few symptoms and are getting to hospital too late, particularly with Delta. They may not realise their oxygen levels have dropped dangerously low. Hence, NHS England purchased 200,000 pulse oximeters to measure oxygen levels for the more vulnerable among those with coronavirus at home.

If you are a patient at home alone, or if the carer in the house could do with some help, we provide some free monitoring assistance for remote carers. The patient records their oxygen level say, every hour. The reading, e.g. 98, is sent as an SMS to our messaging system. Carers, who are simply friends or family, not necessarily health professionals, are automatically alerted if the level drops below a pre-set amount.

Carers can check on the readings without disturbing the patients unnecessarily. Trends in the readings are the key rather than individual readings. Pulse oximeter readings are just estimates, and may vary between patients and oximeters.

Steps:
1. Register: https://bit.ly/smsregall
2. Setup: Put the number in your phone Contacts & make it a Favorite
AU: 0480 018 010
UK: 07782561415
US: 415 528 2242
3. Use: send hourly readings to the SMS phone number
4. Monitor: your remote Carer sends CHECK to see last 5 readings.

SMS Sinch Timeline

SMS Sinch Timeline

How to use a pulse oximeter

  1. Wash your hands

  2. Make sure your hand is warm

  3. Hold your hand to your chest for five minutes

  4. Turn the pulse oximeter on

  5. Clip the device onto your index or middle finger

  6. Watch the numbers, and wait until they have stopped changing

  7. Record the final results

OxReading.png

How to register


Complete the questions at https://bit.ly/smsregall. You can do this on a phone, tablet or computer via a browser. For now, readings and checking is only done on a mobile phone via SMS messages.

Take some readings a few minutes apart to set a Base level for your skin tone & oximeter as a starting point for you & your advisors. It is a guide as to what you think is a reading for your healthy self as opposed to levels suggested in the various guidelines which might not be applicable to the Patient’s skin tone and oximeter.

Once regular readings are being submitted, the average of the last two readings compared to the Base level will be presented, along with the last 5 readings when doing a CHECK, Due to common issues including those below, relating to the individual Patient, and their particular oximeter, it is best to track trends rather than focus on individual readings.

To make things easier, add a new contact to your phone maybe called SMS Sinch with the phone number 0480 018 010 for Australia or 07782561415 for the UK or (415) 528-2242 for the US.

NB:

  • Two key words re oximeters are “estimates” and “trends”, according to the US FDA’s “Must Read” document “Pulse Oximeter Accuracy and Limitations: FDA Safety Communication” http://bit.ly/oxFDA

  • Estimates: “ if an FDA-cleared pulse oximeter reads 90%, then the true oxygen saturation in the blood is generally between 86-94%”

  • Trends: “make diagnosis and treatment decisions based on trends in pulse oximeter readings over time, rather than absolute thresholds.”

  • Click on the extract below to see the full NHS England’s leaflet re isolating at home.

  • The darker your skin, the more likely some oximeters incorrectly inflates readings.

  • Factors such as age and gender affect your outcomes with COVID-19

  • We will share our health research data with you.

  • So this information will help us, help you.

  • For our research, we strip out all names & phone numbers.

Patients

How to submit a reading

Do your Oximeter reading, and from the phone you registered, type in the reading e.g. 96, then send an SMS to SMS Sinch (0480 018 010). What you are doing is simply sending the reading of “96”. You should receive a confirmatory SMS, containing a health tip.

Repeat regularly say initially 4 x daily, moving to hourly when feeling unwell. Your Carer can monitor you without disturbing you unnecessarily.

CARERS

How to check on My Patient(s)

Add a new contact to your phone maybe called SMS Sinch with the phone number 0480 018 010 for Australia or 07782561415 for the UK or (415) 528-2242 for the US.

To check your Patient, send an SMS to the number using the phone registered to your name as the Carer. Type CHECK, then send, i.e. your message simply says “CHECK”

SMSTimeline1of4.jpg

If you have 1 Patient with more than 7 readings, you will get:

  • The drop in the average of the last 2 readings when compared to the average of the first 5.

  • The date and time of the first reading.

  • The total number of readings.

  • The last 5 readings with date & time


If you have more than 1 Patient, you will get each Patient’s last reading. Patients will be identified by the last 3 digits of their phone. A Patient with the phone 0400 123 456 will be identified as 456.

To see the last 5 readings for a Patient, type CHECK 456 if the Patient’s phone is 0400 123 456.

An example of what you may see when you CHECK readings via an SMS request.

An example of what you may see when you CHECK readings via an SMS request.

ACTION

When the oxygen level trends downward, confer with the Patient’s doctor, and most likely, get them to hospital ASAP, even if they feel OK. Doctors have died despite thinking their oxygen levels were fine, and not realising they were dangerously low. Here’s a NYT story of doubly lucky Dr. Lucky in terms of timing, and access to tech not available to most ordinary people:

“He Was a Doctor Who Never Got Sick. Then the Coronavirus Nearly Killed Him”

Here’s an informative article from the BBC: http://bit.ly/OxiCovSMS

Patient asked to re-do low reading. Confirmed levels trending down, so needs to go to hospital.

Patient asked to re-do low reading. Confirmed levels trending down, so needs to go to hospital.

Sleep

To let your Carer know you are about to sleep and are unlikely to send readings for a while, send an SMS with just the word SLEEP. The word “Sleeping” and a timestamp will show up on your list of recent readings when your Carer checks via the system. 

On awakening, do a reading which will let the Carer know that you are OK. Bottom line is that the Carer will know what time you tried to go to sleep, and when you are back taking readings. The Patient could wake up, take a reading and send it off, followed by a SLEEP message to indicate they are trying to get more sleep.

Patient sends SMS that about to try to sleep

Patient sends SMS that about to try to sleep

Other

Why not just SMS Carers direct?

The system has some smarts to check levels and trends, along with giving tips on oximeter use & COVID.

It means that Carers can check Patients when convenient rather than be inundated with hourly readings, and generally give everyone a little more peace of mind.

Skin Pigmentation

For skin types apply the Fitzpatrick Skin test numbers from 1 to 6. They are widely used in the medical profession. A clear explanation is provide on page 2 of this Australian Government chart used in nuclear medicine.
http://bit.ly/fitzskin
1 Pale white skin
2 White skin
3 Light brown skin
4 Moderate brown skin
5 Dark brown skin
6 Deeply pigmented dark brown to black skin

Help us get more answers on this issue by doing our survey: https://bit.ly/OxiSkinQ