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In my institution we use a 5-level structured triage system base in clinical
data, vital signs, risk factors and pain level. We do not measure pulse ox
in every patient at triage. We do if clinical data are not sufficient to
make a decision about triage level.

In my opinion every respiratory patient need a pulse ox measure, but not
always at triage. The goal of triage is to determine the level of acuity of
patients and to do this spending the shortest time as possible. If we find
clinical signs of severe respiratory distress, we don't need more
information to assign a high level of urgency. I am sure that this kind of
patients need a pulse ox measurement, but I think it's better to do this at
treatment area, not at triage. Same way, if we see a happy child coughing
but without tachypnea, retractions or other signs of respiratory distress,
we can safely assign a low triage level. 

Maybe pulse ox can be more helpful in children with intermediate signs, in
which we doubt between two triage levels. 

If we decide to measure pulse ox, we must do well. In small infants
sometimes it's a hard work to get a good measurement and in a busy triage we
can think that an infant is hypoxic when he isn't.


José M Quintillá, MD
Emergency Department
Hospital Sant Joan de Déu
University of Barcelone
Spain



-----Mensaje original-----
De: Pediatric Emergency Medicine Discussion List
[mailto:[log in to unmask]] En nombre de Jay Fisher
Enviado el: viernes, 15 de febrero de 2008 2:11
Para: [log in to unmask]
Asunto: triage pulse ox

What criteria are you using to do pulse oximetry on patients in triage? All
patients, all urgent and emergent, based on symptoms? Thanks for your help.


Jay D. Fisher MD FAAP
Director of Pediatric Emergency Services
Emergency Physicians Medical Group
University Medical Center, Las Vegas NV
St. Rose Sienna Hospital, Henderson NV

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