Feasibility and reliability of telemedicine examinations for respiratory distress in children: A pilot study
Related Experiment Video
Updated: Aug 27, 2025
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Todd A Florin1, Douglas Lorenz2, Sriram Ramgopal1
1Division of Emergency Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Insights
Telemedicine is a reliable way to evaluate young children with respiratory issues. This pilot study found that remote examinations using readily available technology showed good agreement with in-person assessments.
Area of Science:
- Pediatric Emergency Medicine
- Digital Health
- Respiratory Medicine
Background:
- Respiratory disorders are a common reason for pediatric emergency department visits.
- Limited data exist on the reliability of telemedicine for evaluating pediatric respiratory conditions.
Purpose of the Study:
- To assess the feasibility and reliability of using telemedicine for evaluating young children with respiratory concerns.
- To compare remote telemedicine evaluations with in-person examinations.
Main Methods:
- A pilot prospective cohort study involving children aged 12-71 months presenting to the ED with lower respiratory tract symptoms.
- Simultaneous examinations: one by a local ED clinician, one by a remote ED clinician via telemedicine, and one by the parent.
- Evaluation of agreement between local clinician and remote clinician, local clinician and parent, and parent and remote clinician.
Main Results:
- Twenty-eight patients were enrolled, with 84 paired examinations.
- Acceptable to excellent agreement was found between raters for most evaluated findings (general appearance, capillary refill time, grunting, nasal flaring, shortness of breath, retractions, impression of respiratory distress, respiratory rate, and temperature), with the exception of heart rate.
- Telemedicine examinations demonstrated feasibility and reliability.
Conclusions:
- Telemedicine is a feasible and reliable method for conducting respiratory examinations in young children.
- Readily available telemedicine platforms and equipment can be effectively utilized in pediatric emergency care settings.
- Further research can build upon these findings to integrate telemedicine more broadly into pediatric respiratory care.
Abstract:
Respiratory disorders are a leading cause of acute care visits by children. Data establishing the reliability of telemedicine in evaluating children with respiratory concerns are limited. The overall objective of this pilot study was to evaluate the use of telemedicine to evaluate children with respiratory concerns. We performed a pilot prospective cohort study of children 12 to 71 months old presenting to the emergency department (ED) with lower respiratory tract signs and symptoms. Three examinations were performed simultaneously-one by the ED clinician with the patient, one by a remote ED clinician using telemedicine, and one by the child's parent. We evaluated measures of agreement between (a) the local and remote clinicians, (b) the local clinician and the parent, and (c) the parent and the remote clinician. Twenty-eight patients were enrolled (84 paired examinations). Except for heart rate, all examination findings evaluated (general appearance, capillary refill time, grunting, nasal flaring, shortness of breath, retractions, impression of respiratory distress, respiratory rate, and temperature) had acceptable or excellent agreement between raters. In this pilot study, we found that telemedicine respiratory examinations of young children are feasible and reliable, using readily available platforms and equipment.
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