Oxygen saturation changes during the pediatric emergency department treatment of wheezing

This study examined the oxygen saturation (OSAT) changes measured by pulse oximetry during emergency department (ED) bronchodilator treatment of wheezing patients. Data were collected prospectively on two cohorts (November 1987 to November 1988, 2,468 patients; and December 1988 to October 1990, 4,913 patients) presenting to a pediatric ED with wheezing-associated respiratory illnesses. Initial, posttreatment, and discharge OSAT was recorded in many of these patients. Improvement in OSAT following ED bronchodilator administration was noted in most patient groups. Initial OSAT was indicative of severity as measured by the need for hospitalization and the number of bronchodilator treatments administered in the ED. Subcutaneous epinephrine and aerosolized albuterol were compared in OSAT improvement and side effects. Aerosolized albuterol was not shown to be superior to epinephrine. Improvements in OSAT following bronchodilator administration documents the presence of relative preexisting hypoxemia which is reversed to some degree with bronchodilators. Pulse oximetry is an objective means of assessing asthma severity.