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Ann Emerg Med. 1995 Jan;25(1):36-40.

Contribution of routine pulse oximetry to evaluation and management of patients with respiratory illness in a pediatric emergency department.

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1
Department of Pediatrics, Rainbow Babies and Childrens Hospital, Cleveland, OH.

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 (< or = 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.

PMID:
7802367
[Indexed for MEDLINE]
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