Pulse oximetry in the accident and emergency department.

Abstract

SUMMARYThe early detection and treatment of hypoxia is important to reduce patient morbidity in the accident and emergency department. At present, the commonly used methods all have practical difficulties in the urgent situations that prevail in the department. Pulse oximetry has recently become a method of choice in many anaesthetic and intensive care units for the continuous monitoring of oxygenation and the early detection of hypoxia.As similar conditions prevail in the accident and emergency departnent, we have attempted to evaluate its ease of use and the quality of information obtained in our department.Patients presenting with chest pain to an accident and emergency department have their oxygen saturation measured by the pulse oximeter finger probe prior to the commencement of oxygen therapy. After 5 min of oxygen therapy, the measurement was repeated. Our result showed that although no patients could be judged as hypoxic on clinical grounds the pulse oximeter showed, within 30 s of admission, that a number had an abnormal oxygen saturation. Continuous monitoring with the probe after the application of low flow oxygen therapy also aided in monitoring their treatment and this improvement was again easily and quickly recorded.Our experience shows that the pulse oximeter may be a useful tool for evaluating hypoxia and oxygen therapy in the accident and emergency department and we feel that we should be one of the groups who should reply in the positive to Zorab's question, 'Who needs pulse oximetry?' (Zorab, 1988).

Vital signs

“…Pulse oximetry has been recommended during the insertion of invasive lines in pre‐medicated cardiac surgical patients and for postoperative patients as one study demonstrated that hypoxaemia can occur during the transfer from theatre to the recovery unit 14,15 . Studies evaluating the use of pulse oximetry in the emergency department found that it significantly changed medical treatment and has been recommended for all acutely ill patients presenting at the emergency department 16–18 . One study found that the introduction of pulse oximetry in the emergency department resulted in a 37% reduction in the number of arterial blood gas analyses and a 56% reduction in the number of cases involving three or more arterial blood gas analyses, without any increase in the number of adverse events 19 .…”