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Pulse oximetry in discharge decision-making: a survey of emergency physicians

Lance Brown1, Bernard Dannenberg

  • 1Loma Linda University Medical Center and Children's Hospital, Loma Linda, California, USA.

CJEM
|July 20, 2007
PubMed

Insights

Emergency physicians show variability in pulse oximetry discharge thresholds for children with pneumonia and bronchiolitis. A safe, clinically validated threshold is still needed for these common pediatric conditions.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Practice Guidelines
  • Respiratory Illnesses

Background:

  • Bronchiolitis and pneumonia are common pediatric respiratory infections.
  • Pulse oximetry is frequently used to assess oxygenation in these children.
  • Establishing safe discharge criteria is crucial for patient management.

Purpose of the Study:

  • To describe pulse oximetry discharge thresholds used by emergency physicians for children with bronchiolitis and pneumonia.
  • To assess practice variability in these thresholds among general and pediatric emergency physicians.

Main Methods:

  • A mail-in survey was sent to 281 members of the Pediatric Emergency Medicine Section of the American College of Emergency Physicians.
  • Physicians responded to case scenarios involving a child with pneumonia and a child with bronchiolitis.
  • Survey questions included reported pulse oximetry discharge thresholds and practice characteristics.

Main Results:

  • 182 physicians completed the survey.
  • Median pulse oximetry discharge thresholds were 93% for pneumonia and 94% for bronchiolitis.
  • Subgroup analysis revealed minimal variation, except for physicians practicing at high altitudes.

Conclusions:

  • No universally safe and clinically validated pulse oximetry discharge threshold currently exists.
  • Emergency physicians exhibit moderate variability in self-reported pulse oximetry discharge thresholds.
  • This data allows physicians to compare their practice with the study's findings.
Abstract

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