Where do pulse oximeter probes break?

Abstract

Pulse oximetry, a non-invasive method for accurate assessment of blood oxygen saturation (SPO2), is an important monitoring tool in health care facilities. However, it is often not available in many low-resource settings, due to expense, overly sophisticated design, a lack of organised procurement systems and inadequate medical device management and maintenance structures. Furthermore medical devices are often fragile and not designed to withstand the conditions of low-resource settings. In order to design a probe, better suited to the needs of health care facilities in low-resource settings this study aimed to document the site and nature of pulse oximeter probe breakages in a range of different probe designs in a low to middle income country. A retrospective review of job cards relating to the assessment and repair of damaged or faulty pulse oximeter probes was conducted at a medical device repair company based in Cape Town, South Africa, specializing in pulse oximeter probe repairs. 1,840 job cards relating to the assessment and repair of pulse oximeter probes were reviewed. 60.2 % of probes sent for assessment were finger-clip probes. For all probes, excluding the neonatal wrap probes, the most common point of failure was the probe wiring (>50 %). The neonatal wrap most commonly failed at the strap (51.5 %). The total cost for quoting on the broken pulse oximeter probes and for the subsequent repair of devices, excluding replacement components, amounted to an estimated ZAR 738,810 (USD $98,508). Improving the probe wiring would increase the life span of pulse oximeter probes. Increasing the life span of probes will make pulse oximetry more affordable and accessible. This is of high priority in low-resource settings where frequent repair or replacement of probes is unaffordable or impossible.

A profile of traumatic injury in the prehospital setting in India: A prospective observational study across seven states

“…The cost of equipment and maintenance can be a limiting factor to the growth of high-quality EMS in LMICs. For example, pulse oximeter probes are often unavailable in low resource settings or frequently break down due to everyday use [29] . In this study, oxygen saturation was most often not recorded because the equipment was not functioning or was not available (91% of cases without a recorded oxygen saturation).…”

“…In this study, oxygen saturation was most often not recorded because the equipment was not functioning or was not available (91% of cases without a recorded oxygen saturation). Probes often break due to wiring issues, which can be repaired, but often represent a significant expense [29] . More sustainable alternatives, which have been studied in LMICs, remain too costly for widescale implementation [ 30 , 31 ].…”

Pulse oximetry: why oxygen saturation is still not a part of standard pediatric guidelines in low-and-middle-income countries (LMICs)

“…This would require maintaining a steady supply and distribution of units and batteries. The cost of maintenance of components such as probes and their replacement is also high and can be prohibitive [ 29 ]. It can therefore be projected that the cost of implementation will be high even if the price of manufacture is lowered.…”

“…These should be used in feasibility studies to evaluate the added benefit of using pulse oximetry in the management of childhood pneumonia in LMICs [ 36 ]. Very little research has been done due to the use of low-quality, malfunctioning devices and broken probes [ 29 ], hence more operational research in this area can inform the production of better and more robust models and probes. More cost-effectiveness studies are needed to assess the benefits of increasing community health care worker training and direct and indirect investment in pulse oximetry.…”