Contribution of Routine Pulse Oximetry to Evaluation and Management of Patients With Respiratory Illness in a Pediatric Emergency Department

Amy J. Maneker, Emory M. Petrack, Steven E. Krug

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Study objective: To determine whether routine pulse oximetry in a pediatric emergency department can be used to identify patients with a low oxygen saturation (SaO2) that is unexpected on the basis of clinical evaluation. Design: Prospective comparison of blinded, clinical evaluation by physicians with subsequent pulse oximetry readings. Setting:Pediatric ED in an urban,university medical center. Participants: A convenience sample of 368 patients presenting to the pediatric ED with respiratory illnesses. Methods: The history, physical examination, pediatric ED management, and therapy were recorded. Based on clinical assessment, the physician was asked whether the patient had a low SaO2(≤92%). Room-air pulse oximetry was then obtained, with subsequent treatment and management plans recorded. Results: Clinical assessment had a sensitivity of 33%, specificity of 86%, negative predictive value of 85%, and positive predictive value of 35% for detecting children with low SaO2. Unexpected low SaO2 usually led to a change in patient management or disposition. Conclusion: Clinical evaluation in a pediatric ED does not screen adequately for the detection of hypoxemia and should be supplemented by routine pulse oximetry in all patients with respiratory findings. [Maneker AJ, Petrack EM, Krug SE: Contribution of routine pulse oximetry to evaluation and management of patients with respiratory illness in a pediatric emergency department. Ann Emerg Med January 1995;25:36-40.].

Original languageEnglish (US)
Pages (from-to)36-40
Number of pages5
JournalAnnals of Emergency Medicine
Volume25
Issue number1
DOIs
StatePublished - Jan 1995

ASJC Scopus subject areas

  • Emergency Medicine

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