Contribution of Routine Pulse Oximetry to Evaluation and Management of Patients With Respiratory Illness in a Pediatric Emergency Department
Study objective: To determine whether routine pulse oximetry in a pediatric emergency department can be used to identify patients with a low oxygen saturation (SaO 2) that is unexpected on the basis of clinical evaluation. Design: Prospective comparison of blinded, clinical evaluation by physicians...
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Veröffentlicht in: | Annals of emergency medicine 1995, Vol.25 (1), p.36-40 |
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Zusammenfassung: | Study objective: To determine whether routine pulse oximetry in a pediatric emergency department can be used to identify patients with a low oxygen saturation (SaO
2) 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 SaO
2(≤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 SaO
2. Unexpected low SaO
2 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.] |
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ISSN: | 0196-0644 1097-6760 |
DOI: | 10.1016/S0196-0644(95)70352-7 |