A flaw in a widely used medical device that measures oxygen levels causes critically ill Asians, Blacks and Hispanics to receive less supplemental oxygen to help them breathe than white patients, according to data from a large study published on Monday.

Pulse oximeters clip onto a fingertip and pass red and infrared light through the skin to gauge oxygen levels in the blood. It has been known since the 1970s that skin pigmentation can throw off readings, but the discrepancies were not believed to affect patient care.

Among 3,069 patients treated in a Boston intensive care unit (ICU) between 2008 and 2019, people of color were given significantly less supplemental oxygen than would be considered optimal compared to white people because of inaccuracies in pulse oximeter readings related to their skin pigment, the study found.

"Nurses and doctors make the wrong decisions and end up giving less oxygen to people of color because they are fooled" by incorrect readings from pulse oximeters, said Dr. Leo Anthony Celi of Harvard Medical School and the Massachusetts Institute of Technology, who oversaw the study

For the study published in JAMA Internal Medicine, pulse oximetry readings were checked against direct measurement of blood oxygen levels, which is not practical in the average patient because it requires a painful invasive procedure.

The authors of a separate study involving patients with COVID-19 published recently in the same journal saw "occult hypoxemia" - an oxygen saturation level below 88% despite pulse oximeter readings of 92% to 96% - in 3.7% of blood samples from Asian patients, 3.7% of samples from Black patients, 2.8% of samples from non-Black Hispanic patients versus just 1.7% of samples from white patients. Whites accounted for only 17.2% of all patients with occult hypoxemia.

The authors concluded that racial and ethnic biases in pulse oximetry accuracy have resulted in delayed or withheld treatments among Black and Hispanic patients with COVID-19.

Pulse oximetry can also be affected by obesity, medications used in critically ill patients, and other factors, Celi said.

Imarc Group market research firm forecast the global pulse oximeter market reaching $3.25 billion by 2027, following 2021 sales of $2.14 billion.

"We think it's very reasonable at this point to call upon purchasers and manufacturers to make changes (to the devices), Dr. Eric Ward, coauthor of an editorial published with the study, told Reuters.

Medtronic Plc (MDT.N) executive Frank Chan said in an emailed statement that the company confirms accuracy of its pulse oximeters "by taking synchronized blood samples at each level of blood oxygen content and comparing the pulse ox readings with measurements made from the blood sample."

He added that Medtronic tests its devices on a higher than required number of participants with dark skin pigmentation, "to ensure our technology will perform as intended for all patient populations."

Pulse oximeter maker Phillips Healthcare did not respond to a request for comment.

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A flaw in a widely used medical device that measures oxygen levels causes critically ill Asians, Blacks and Hispanics to receive less supplemental oxygen to help them breathe than white patients, according to data from a large study published on Monday.

A flaw in a widely used medical device that measures oxygen levels causes critically ill Asians, Blacks and Hispanics to receive less supplemental oxygen to help them breathe than white patients, according to data from a large study published on Monday. Pulse oximeters clip onto a fingertip and pass red and infrared light through the skin to gauge oxygen levels in the blood. It has been known since the 1970s that skin pigmentation can throw off readings, but the discrepancies were not believed to affect patient care. Among 3,069 patients treated in a Boston intensive care unit (ICU) between 2008 and 2019, people of color were given significantly less supplemental oxygen than would be considered optimal compared to white people because of inaccuracies in pulse oximeter readings related to their skin pigment, the study found. "Nurses and doctors make the wrong decisions and end up giving less oxygen to people of color because they are fooled" by incorrect readings from pulse oximeters, said Dr. Leo Anthony Celi of Harvard Medical School and the Massachusetts Institute of Technology, who oversaw the study For the study published in JAMA Internal Medicine, pulse oximetry readings were checked against direct measurement of blood oxygen levels, which is not practical in the average patient because it requires a painful invasive procedure. The authors of a separate study involving patients with COVID-19 published recently in the same journal saw "occult hypoxemia" - an oxygen saturation level below 88% despite pulse oximeter readings of 92% to 96% - in 3.7% of blood samples from Asian patients, 3.7% of samples from Black patients, 2.8% of samples from non-Black Hispanic patients versus just 1.7% of samples from white patients. Whites accounted for only 17.2% of all patients with occult hypoxemia. The authors concluded that racial and ethnic biases in pulse oximetry accuracy have resulted in delayed or withheld treatments among Black and Hispanic patients with COVID-19. Pulse oximetry can also be affected by obesity, medications used in critically ill patients, and other factors, Celi said. Imarc Group market research firm forecast the global pulse oximeter market reaching $3.25 billion by 2027, following 2021 sales of $2.14 billion. "We think it's very reasonable at this point to call upon purchasers and manufacturers to make changes (to the devices), Dr. Eric Ward, coauthor of an editorial published with the study, told Reuters. Medtronic Plc (MDT.N) executive Frank Chan said in an emailed statement that the company confirms accuracy of its pulse oximeters "by taking synchronized blood samples at each level of blood oxygen content and comparing the pulse ox readings with measurements made from the blood sample." He added that Medtronic tests its devices on a higher than required number of participants with dark skin pigmentation, "to ensure our technology will perform as intended for all patient populations." Pulse oximeter maker Phillips Healthcare did not respond to a request for comment. You can now write for wionews.com and be a part of the community. Share your stories and opinions with us here. WATCH WION LIVE HERE ×

Non-white ICU patients get less oxygen treatment than needed: study

The UK government has launched an investigation after reports emerged that oximeter—which measure blood oxygen levels and are key to assessing COVID-19 patients—works properly only on people with lighter skin.

Health secretary Sajid Javid said he had commissioned a review of the issue after learning that oximeters give less accurate readings for patients with darker skin.

He claimed that there was a racial bias in some medical instruments, saying, “It’s unintentional but it exists.”

“And the reason is that a lot of these medical devices, even some of the drugs, some of the procedures, some of the textbooks, most of them are put together in majority white countries and I think this is a systemic issue around this,” he added.

Asked whether people may have died of COVID-19 as a result of the error, Javid said, “I think possibly yes. I don’t have the full facts.”\

Also read |<a href="https://www.wionews.com/world/france-stole-millions-of-covid-vaccines-from-uk-in-an-act-of-war-report-418646">&nbsp;France 'stole' millions of Covid vaccines from UK in an 'act of war': Report</a>

Javid assertions come after NHS England and the Medicines and Healthcare products Regulatory Agency (MHRA) said that the pulse oximeters can overestimate the amount of oxygen in the blood.

Britain’s statistics office has found that in the first year of the pandemic, up to March 2021, Black and South Asian people in the UK had higher death rates than their white compatriots, even after factors like occupation and underlying health conditions were taken into account.

Also read |&nbsp;<a href="https://www.wionews.com/world/virus-cases-continue-to-surge-in-britain-428095">Virus cases continue to surge in Britain</a>

But Javid, believes that the issue is not confined to Britain alone, and many similar cases can be discovered in other parts of the world.

"I want to make sure that we do something about it but not just in the UK. This is an international issue so I'm going to work with my counterparts across the world to change this," said Javid.

He said he had already spoken about the issue to his US counterpart, who was as interested in it as he was.

(With inputs from agencies)

The UK government has launched an investigation after reports emerged that oximeter—which measure blood oxygen levels and are key to assessing COVID-19 patients—works properly only on people with lighter skin.

The UK government has launched an investigation after reports emerged that oximeter—which measure blood oxygen levels and are key to assessing COVID-19 patients—works properly only on people with lighter skin. Health secretary Sajid Javid said he had commissioned a review of the issue after learning that oximeters give less accurate readings for patients with darker skin. He claimed that there was a racial bias in some medical instruments, saying, “It’s unintentional but it exists.” “And the reason is that a lot of these medical devices, even some of the drugs, some of the procedures, some of the textbooks, most of them are put together in majority white countries and I think this is a systemic issue around this,” he added. Asked whether people may have died of COVID-19 as a result of the error, Javid said, “I think possibly yes. I don’t have the full facts.”\ Also read | France 'stole' millions of Covid vaccines from UK in an 'act of war': Report Javid assertions come after NHS England and the Medicines and Healthcare products Regulatory Agency (MHRA) said that the pulse oximeters can overestimate the amount of oxygen in the blood. Britain’s statistics office has found that in the first year of the pandemic, up to March 2021, Black and South Asian people in the UK had higher death rates than their white compatriots, even after factors like occupation and underlying health conditions were taken into account. Also read | Virus cases continue to surge in Britain But Javid, believes that the issue is not confined to Britain alone, and many similar cases can be discovered in other parts of the world. "I want to make sure that we do something about it but not just in the UK. This is an international issue so I'm going to work with my counterparts across the world to change this," said Javid. He said he had already spoken about the issue to his US counterpart, who was as interested in it as he was. (With inputs from agencies)

Racial bias in oximeter? UK government launches probe whether device works only on white people

UK Health Secretary Sajid Javid on Sunday, said that he had commissioned a review to ascertain whether Oximeters, used to check blood oxygen levels had an 'inherent bias' as per a research. The research, he said, had indicated that oximeters were less effective on people with darker skin.

He made the announcement in his writeup in Sunday Times.

"One of the founding principles of our NHS is equality, and the possibility that a bias -- even an inadvertent one -- could lead to a poorer health outcome is totally unacceptable," he wrote, referring to Britain's National Health Service.

"We urgently need to know more about the bias in these devices, and what impact it is having on the front line.

"So I have commissioned an independent review, looking at whether systematic bias exists within current devices, and if so, how we can address it."

Javid, the son of Pakistani immigrants and the first person from an ethnic minority to hold the role of UK health secretary, said it would assess all medical devices, and other common biases aside from racial bias, such as gender.

He noted his interest in focusing on this issue came in part from seeing health disparities during the height of the coronavirus crisis last winter.

Then, black, Asian and other minority ethnic groups made up 28 percent of critical-care admissions in England -- about double their representation in the population as a whole.

On international collaboration to tackle the issue, Javid said he had already discussed it with Becerra.

(With inputs from agencies)

UK Health Secretary Sajid Javid on Sunday, said that he had commissioned a review to ascertain whether Oximeters, used to check blood oxygen levels had an 'inherent bias' as per a research.

UK Health Secretary Sajid Javid on Sunday, said that he had commissioned a review to ascertain whether Oximeters, used to check blood oxygen levels had an 'inherent bias' as per a research. The research, he said, had indicated that oximeters were less effective on people with darker skin. He made the announcement in his writeup in Sunday Times. "One of the founding principles of our NHS is equality, and the possibility that a bias -- even an inadvertent one -- could lead to a poorer health outcome is totally unacceptable," he wrote, referring to Britain's National Health Service. "We urgently need to know more about the bias in these devices, and what impact it is having on the front line. "So I have commissioned an independent review, looking at whether systematic bias exists within current devices, and if so, how we can address it." Javid, the son of Pakistani immigrants and the first person from an ethnic minority to hold the role of UK health secretary, said it would assess all medical devices, and other common biases aside from racial bias, such as gender. He noted his interest in focusing on this issue came in part from seeing health disparities during the height of the coronavirus crisis last winter. Then, black, Asian and other minority ethnic groups made up 28 percent of critical-care admissions in England -- about double their representation in the population as a whole. On international collaboration to tackle the issue, Javid said he had already discussed it with Becerra. (With inputs from agencies)

Oximeters reportedly less accurate on dark skin, UK launches review

India is facing the brunt of&nbsp;oxygen&nbsp;shortage with serpentine lines seen outside&nbsp;oxygen&nbsp;manufacturing units as the second wave of COVID-19 has completely overwhelmed health infrastructure of the country.

The world's second-most populous nation is in deep crisis, with its hospitals and morgues overwhelmed as healthcare professionals struggle to cope with streams of patients.

Apart from the megacities, medical&nbsp;oxygen&nbsp;and beds have become scarce in smaller cities, with major hospitals putting up notices saying they have no room for any more patients and asking relatives to arrange for medical&nbsp;oxygen.

Long queues were seen at&nbsp;oxygen&nbsp;plants in several cities of India's most populous Uttar Pradesh state, including its capital Lucknow, with people from private hospitals, isolation centres, and even individuals visiting the plant with their empty cylinders in the hopes of getting some life-saving gas for patients.

Oxygen&nbsp;production and filling facilities in rural India are also overburdened with high-demand. They have shut regular industrial filling of&nbsp;oxygen&nbsp;and are only focused on filling up cylinders for medical&nbsp;oxygen.

Why is&nbsp;medical&nbsp;oxygen&nbsp;vital?&nbsp;

Oxygen&nbsp;therapy is crucial for severe Covid-19 patients with hypoxaemia when&nbsp;oxygen&nbsp;levels in the blood are too low.<iframe allowfullscreen="" autoplay="1" class="includeVideo" frameborder="0" height="350" src="https://www.wionews.com/videos/gravitas-will-india-run-out-of-doctors-to-treat-the-wuhan-virus-381229/embed" style="width:100%;max-width:560px;" width="560"></iframe>

According to&nbsp;community health specialist Rajib Dasgupta,&nbsp;"Some clinical studies&nbsp;show that up to a quarter of hospitalised (Covid-19) patients require&nbsp;oxygen&nbsp;therapy and upwards to two-thirds of those in intensive care units."

"This is why it is imperative&nbsp;to fix&nbsp;oxygen&nbsp;supply systems in hospital settings as this is a disease that affects lungs primarily."

India's toll from the coronavirus surged past 200,000 on Wednesday, the country's deadliest day, as shortages of&nbsp;oxygen, medical supplies and hospital staff compounded a record number of new infections.

What is an oximeter and oxygen concentrator?

Pulse oximetry is a non-invasive and painless test that measures your oxygen saturation level or the oxygen levels in your blood. It can rapidly detect even small changes in how efficiently oxygen is being carried to the extremities furthest from the heart, including the legs and the arms.

During a pulse oximetry reading, a small clamp-like device is placed on a finger, earlobe, or toe. Small beams of light pass through the blood in the finger, measuring the amount of oxygen. It does this by measuring changes in light absorption in oxygenated or deoxygenated blood. This is a painless process.

Meanwhile, in the case of oxygen&nbsp;concentrator, air&nbsp;is filled with various gases such as carbon dioxide, oxygen, hydrogen and nitrogen. So to separate oxygen from these gases Oxygen Concentrator comes into being, it is a medical device that supplies pure oxygen. As per the WHO report published in 2015, this device was developed to help patients admitted to hospital with respiratory illness. Oxygen Concentrator produces oxygen for 24 hours, seven days a week, for up to five years or more. Also, they can supply five to ten litres of oxygen per minute. Unlike the oxygen cylinder, this device doesn't need to get refiled, is portable and can run with the help of an inverter. However, they are quite expensive, compared to oxygen cylinders.

Does India produce enough&nbsp;oxygen?&nbsp;

Yes. Experts say the vast nation of 1.3 billion people is producing enough&nbsp;oxygen, just over 7,000 tonnes a day. Most is for industrial use but can be diverted for&nbsp;medical&nbsp;purposes.

The bottlenecks are in transport and storage.

Liquid&nbsp;oxygen&nbsp;at very low temperatures has to be transported in cryogenic tankers to distributors, which then convert it into gas for filling cylinders.

But India is short of cryogenic tankers.

And such special tankers, when filled, have to be transported by road and not by air for safety reasons.

Most&nbsp;oxygen&nbsp;producers are in India's east, while the soaring demand has been in cities including financial hub Mumbai in the west and the capital Delhi in the north.

According to&nbsp;the head of one of India's biggest&nbsp;medical&nbsp;oxygen&nbsp;suppliers Inox Air Products, Siddharth Jain, "The supply chain has to be tweaked to move&nbsp;medical&nbsp;oxygen&nbsp;from certain regions which have excess supply to regions which need more supply."

Meanwhile, many hospitals do not have on-site&nbsp;oxygen&nbsp;plants, often because of poor infrastructure, a lack of expertise and high costs.

Late last year, India issued tenders for on-site&nbsp;oxygen&nbsp;plants for hospitals. But the plans were never actioned, local media report.

Why the long waits for&nbsp;oxygen&nbsp;in developing nations?&nbsp;

India is only the latest country to confront a lack of&nbsp;medical&nbsp;oxygen&nbsp;supplies. Earlier in the pandemic there were similar scenes of long lines in countries such as Brazil, the Democratic Republic of Congo, Peru and Venezuela.&nbsp;

Unitaid, a global initiative that helps low- and middle-income countries confront public health challenges, puts the lack of supplies of&nbsp;medical&nbsp;oxygen&nbsp;down to its cost, limited infrastructure and logistical difficulties.

Medical&nbsp;oxygen&nbsp;is key to treating people in respiratory distress, whether at home or in hospitals. According to the World Health Organization (WHO), one person in five suffering from Covid-19 needs&nbsp;medical&nbsp;oxygen&nbsp;to ensure that the level of&nbsp;oxygen&nbsp;in their blood is sufficient.

How much is needed in countries facing shortages?&nbsp;

In February, the WHO estimated that half a million people needed 1.2 million&nbsp;oxygen&nbsp;canisters a day.

Unitaid put the price tag of helping the countries facing the greatest need at $1.6 billion this year. &nbsp;

"This is a global emergency that needs a truly global response," said Unitaid's Executive Director, Dr Philippe Duneton, in February.

It has identified some 20 countries facing the greatest difficulties with&nbsp;oxygen&nbsp;supplies, including Malawi, Nigeria and Afghanistan.

How is&nbsp;oxygen&nbsp;made?&nbsp;

Oxygen&nbsp;is made in two ways:

Medical&nbsp;oxygen: is made by separating the&nbsp;oxygen&nbsp;from other gases and impurities found in air by repeated steps of compression, filtration and purification, according to Air Liquide Sante France.

Such&nbsp;medical&nbsp;oxygen&nbsp;reaches more than 99.5 percent purity and is rigorously tested.

It can be highly compressed into a liquid form, but has to be maintained below -182°C, which according to Air Liquide Sante France is the best way to meet variations in demand as one litre of liquid&nbsp;oxygen&nbsp;is the equivalent to around 800 litres when it is in normal gas form.

Canisters that can travel with patients with one litre of compressed litres of&nbsp;oxygen&nbsp;contain about 200 litres of normal&nbsp;oxygen.

- Compressed&nbsp;oxygen: machines that can separate out nitrogen from ambient air can raise&nbsp;oxygen&nbsp;levels to around 93 percent.&nbsp;The machines can be portable or larger to serve a hospital. However, these machines cannot meet surges in demand -- which rose by a factor of five or six in French hospitals as waves of Covid patients peaked. They are require lots of electricity and need to be regularly maintained by a technician.

Who are the main producers?&nbsp;

Outside of China, the three main producers of&nbsp;medical&nbsp;oxygen&nbsp;are the German firm Linde, which is allied with Praxair in the US; the French firm Air Liquide and the US company Air Products.

But there are a large number of local and regional producers of&nbsp;medical&nbsp;oxygen&nbsp;given that it is difficult to shop long distances.

Industrialised countries are better served as production facilities were designed to serve more than just the&nbsp;medical&nbsp;sector, such as the steel and chemicals industries.

What's being done for India?&nbsp;

The Indian military has used its cargo aircraft to transport&nbsp;oxygen&nbsp;tanker trucks where supplies are lacking, and a train called the&nbsp;Oxygen&nbsp;Express was put into service on April 22.

The military has also said it plans to import 23 mobile production units from Germany.

France plans to send eight such units that will be able to produce enough&nbsp;oxygen&nbsp;to serve 10,000 patients a day. It also plans to ship 200 tonnes of liquid&nbsp;oxygen&nbsp;to Indian hospitals.

What's happening on the ground?&nbsp;

Oxygen&nbsp;shortages are still affecting badly hit regions despite the measures to boost supply, transport and storage.

Reports have emerged of hospitals asking patients to arrange for their own&nbsp;cylinders and of people dying even after being admitted due to low&nbsp;oxygen&nbsp;supplies.

Social media platforms have been filled with posts by desperate families hunting for cylinders and refills.

Meanwhile, there is a growing black market for cylinders and concentrators sold far above their usual retail prices.

(With inputs from agencies)

India is facing the brunt of oxygen shortage with serpentine lines seen outside oxygen manufacturing units as the second wave of COVID-19 has completely overwhelmed health infrastructure of the country.

India is facing the brunt of oxygen shortage with serpentine lines seen outside oxygen manufacturing units as the second wave of COVID-19 has completely overwhelmed health infrastructure of the country. The world's second-most populous nation is in deep crisis, with its hospitals and morgues overwhelmed as healthcare professionals struggle to cope with streams of patients. Apart from the megacities, medical oxygen and beds have become scarce in smaller cities, with major hospitals putting up notices saying they have no room for any more patients and asking relatives to arrange for medical oxygen. Long queues were seen at oxygen plants in several cities of India's most populous Uttar Pradesh state, including its capital Lucknow, with people from private hospitals, isolation centres, and even individuals visiting the plant with their empty cylinders in the hopes of getting some life-saving gas for patients. Oxygen production and filling facilities in rural India are also overburdened with high-demand. They have shut regular industrial filling of oxygen and are only focused on filling up cylinders for medical oxygen. Why is medical oxygen vital? Oxygen therapy is crucial for severe Covid-19 patients with hypoxaemia when oxygen levels in the blood are too low. According to community health specialist Rajib Dasgupta, "Some clinical studies show that up to a quarter of hospitalised (Covid-19) patients require oxygen therapy and upwards to two-thirds of those in intensive care units." "This is why it is imperative to fix oxygen supply systems in hospital settings as this is a disease that affects lungs primarily." India's toll from the coronavirus surged past 200,000 on Wednesday, the country's deadliest day, as shortages of oxygen, medical supplies and hospital staff compounded a record number of new infections. What is an oximeter and oxygen concentrator? Pulse oximetry is a non-invasive and painless test that measures your oxygen saturation level or the oxygen levels in your blood. It can rapidly detect even small changes in how efficiently oxygen is being carried to the extremities furthest from the heart, including the legs and the arms. During a pulse oximetry reading, a small clamp-like device is placed on a finger, earlobe, or toe. Small beams of light pass through the blood in the finger, measuring the amount of oxygen. It does this by measuring changes in light absorption in oxygenated or deoxygenated blood. This is a painless process. Meanwhile, in the case of oxygen concentrator, air is filled with various gases such as carbon dioxide, oxygen, hydrogen and nitrogen. So to separate oxygen from these gases Oxygen Concentrator comes into being, it is a medical device that supplies pure oxygen. As per the WHO report published in 2015, this device was developed to help patients admitted to hospital with respiratory illness. Oxygen Concentrator produces oxygen for 24 hours, seven days a week, for up to five years or more. Also, they can supply five to ten litres of oxygen per minute. Unlike the oxygen cylinder, this device doesn't need to get refiled, is portable and can run with the help of an inverter. However, they are quite expensive, compared to oxygen cylinders. Does India produce enough oxygen? Yes. Experts say the vast nation of 1.3 billion people is producing enough oxygen, just over 7,000 tonnes a day. Most is for industrial use but can be diverted for medical purposes. The bottlenecks are in transport and storage. Liquid oxygen at very low temperatures has to be transported in cryogenic tankers to distributors, which then convert it into gas for filling cylinders. But India is short of cryogenic tankers. And such special tankers, when filled, have to be transported by road and not by air for safety reasons. Most oxygen producers are in India's east, while the soaring demand has been in cities including financial hub Mumbai in the west and the capital Delhi in the north. According to the head of one of India's biggest medical oxygen suppliers Inox Air Products, Siddharth Jain, "The supply chain has to be tweaked to move medical oxygen from certain regions which have excess supply to regions which need more supply." Meanwhile, many hospitals do not have on-site oxygen plants, often because of poor infrastructure, a lack of expertise and high costs. Late last year, India issued tenders for on-site oxygen plants for hospitals. But the plans were never actioned, local media report. Why the long waits for oxygen in developing nations? India is only the latest country to confront a lack of medical oxygen supplies. Earlier in the pandemic there were similar scenes of long lines in countries such as Brazil, the Democratic Republic of Congo, Peru and Venezuela. Unitaid, a global initiative that helps low- and middle-income countries confront public health challenges, puts the lack of supplies of medical oxygen down to its cost, limited infrastructure and logistical difficulties. Medical oxygen is key to treating people in respiratory distress, whether at home or in hospitals. According to the World Health Organization (WHO), one person in five suffering from Covid-19 needs medical oxygen to ensure that the level of oxygen in their blood is sufficient. How much is needed in countries facing shortages? In February, the WHO estimated that half a million people needed 1.2 million oxygen canisters a day. Unitaid put the price tag of helping the countries facing the greatest need at $1.6 billion this year. "This is a global emergency that needs a truly global response," said Unitaid's Executive Director, Dr Philippe Duneton, in February. It has identified some 20 countries facing the greatest difficulties with oxygen supplies, including Malawi, Nigeria and Afghanistan. How is oxygen made? Oxygen is made in two ways: Medical oxygen: is made by separating the oxygen from other gases and impurities found in air by repeated steps of compression, filtration and purification, according to Air Liquide Sante France. Such medical oxygen reaches more than 99.5 percent purity and is rigorously tested. It can be highly compressed into a liquid form, but has to be maintained below -182°C, which according to Air Liquide Sante France is the best way to meet variations in demand as one litre of liquid oxygen is the equivalent to around 800 litres when it is in normal gas form. Canisters that can travel with patients with one litre of compressed litres of oxygen contain about 200 litres of normal oxygen. - Compressed oxygen: machines that can separate out nitrogen from ambient air can raise oxygen levels to around 93 percent. The machines can be portable or larger to serve a hospital. However, these machines cannot meet surges in demand -- which rose by a factor of five or six in French hospitals as waves of Covid patients peaked. They are require lots of electricity and need to be regularly maintained by a technician. Who are the main producers? Outside of China, the three main producers of medical oxygen are the German firm Linde, which is allied with Praxair in the US; the French firm Air Liquide and the US company Air Products. But there are a large number of local and regional producers of medical oxygen given that it is difficult to shop long distances. Industrialised countries are better served as production facilities were designed to serve more than just the medical sector, such as the steel and chemicals industries. What's being done for India? The Indian military has used its cargo aircraft to transport oxygen tanker trucks where supplies are lacking, and a train called the Oxygen Express was put into service on April 22. The military has also said it plans to import 23 mobile production units from Germany. France plans to send eight such units that will be able to produce enough oxygen to serve 10,000 patients a day. It also plans to ship 200 tonnes of liquid oxygen to Indian hospitals. What's happening on the ground? Oxygen shortages are still affecting badly hit regions despite the measures to boost supply, transport and storage. Reports have emerged of hospitals asking patients to arrange for their own cylinders and of people dying even after being admitted due to low oxygen supplies. Social media platforms have been filled with posts by desperate families hunting for cylinders and refills. Meanwhile, there is a growing black market for cylinders and concentrators sold far above their usual retail prices. (With inputs from agencies)

Medical oxygen: Why is it vital and does India produce enough?

US Food and Drug Administration (USFDA) has warned that Oximeters may not always give accurate measurement of oxygen levels in blood if used for patient with 'skin pigmentation'. This almost entirely translates to Oximeters not providing accurate results 100 per cent of the time for patients with dark skin. USFDA has issued a warning in this regard. It uses a study published in The New England Journal of Medicine. The study has been carried out by researchers from University of Michigan Medical School.

Oximeters are devices that are typically attached to fingertips of patients. Oximeters are non-invasive in their measurement of blood oxygen levels. In times of coronavirus pandemic, use of Oximeters has increased many times around the world. Drop in blood Oxygen levels may indicate that a person may be infected by COVID-19 virus.

The study carried out by researchers from University of Michigan compared Oxygen readings from Oximeters to those obtained by a more accurate method called Arterial blood gas. These 'pairs' of readings, taken from 10,001 patients were analysed. The patients had White as well as Black patients. It was found that occurrence of wrong reading of blood oxygen levels was three times more in Black patients than it was in White patients. In these patients, Oximeters gave a wrong reading about blood Oxygen levels being normal whereas it was not so.

Based on this study, USFDA has issued a warning that "pulse oximeters have limitations". It has then advised health care providers to supplement their readings with data from other tests and other information that may forthcoming during the examination of the patient.

US Food and Drug Administration (USFDA) has warned that Oximeters may not always give accurate measurement of oxygen levels in blood if used for patient with 'skin pigmentation'.

US Food and Drug Administration (USFDA) has warned that Oximeters may not always give accurate measurement of oxygen levels in blood if used for patient with 'skin pigmentation'. This almost entirely translates to Oximeters not providing accurate results 100 per cent of the time for patients with dark skin. USFDA has issued a warning in this regard. It uses a study published in The New England Journal of Medicine. The study has been carried out by researchers from University of Michigan Medical School. Oximeters are devices that are typically attached to fingertips of patients. Oximeters are non-invasive in their measurement of blood oxygen levels. In times of coronavirus pandemic, use of Oximeters has increased many times around the world. Drop in blood Oxygen levels may indicate that a person may be infected by COVID-19 virus. The study carried out by researchers from University of Michigan compared Oxygen readings from Oximeters to those obtained by a more accurate method called Arterial blood gas. These 'pairs' of readings, taken from 10,001 patients were analysed. The patients had White as well as Black patients. It was found that occurrence of wrong reading of blood oxygen levels was three times more in Black patients than it was in White patients. In these patients, Oximeters gave a wrong reading about blood Oxygen levels being normal whereas it was not so. Based on this study, USFDA has issued a warning that "pulse oximeters have limitations". It has then advised health care providers to supplement their readings with data from other tests and other information that may forthcoming during the examination of the patient.

Oximeters may not always give accurate reading on dark skin: Study

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