I think a pulse ox would be just as helpful as the other "vital signs" assessed
for at triage. Not always abnormal, not always going to be the sole indicator
for disease, but together they add to the assessment. There are numerous
times a child is wheezing on your exam and it wasn't picked up in triage. So
the child waits in the waiting room until you call the child in, rather than
having his/her care expedited to the respiratory area. You perform a pulse ox
afterwards and it's 95%. Happens all the time. I know this is anectdotal.
However, a paper from PEC in 2006 attempted to quantify how helpful adding a
pulse ox reading to the triage vitals would be in children eventually diagnosed
Choi J, Claudius I. Decrease in emergency department length of stay as a
result of triage pulse oximetry. Pediatr Emerg Care. 2006 Jun;22(6):412-4.
OBJECTIVES: Many emergency departments do not perform pulse oximetry in
triage, in spite of its potential for altering management decisions. We
attempted to quantify the decrease in patient throughput time in a pediatric
emergency department following the introduction of triage pulse oximetry.
METHODS: One hundred fifty-nine bronchiolitis patients from 2004 served as
the preintervention group, and were evaluated against 89 severity-matched
postintervention bronchiolitis patients from 2005. Their mean lengths of ED
stay were compared by a t test. RESULTS: The preintervention group had a
mean length of stay of 4 hours and 59 minutes, and the postintervention group
had a mean length of stay of 4 hours and 9 minutes, which was significantly
different (P = 0.03). The sensitivity of respiratory distress on the triage exam
for predicting hypoxia was fair (74%). CONCLUSIONS: Institution of triage
pulse oximetry significantly decreases ED throughput times. Clinical exam alone
is not a replacement for measurement of oxygen saturation.
PMID: 16801841 [PubMed - indexed for MEDLINE]
James Meltzer, MD
Jacobi PEM Fellow
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is: