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PubMed · 16801841

Decrease in emergency department length of stay as a result of triage pulse oximetry.

James Choi·Ilene Claudius
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Abstract

OBJECTIVES: Many emergency departments do not perform pulse oximetry in triage, in spite of its potential for altering management decisions. We attempted to quantify the decrease in patient throughput time in a pediatric emergency department following the introduction of triage pulse oximetry. METHODS: One hundred fifty-nine bronchiolitis patients from 2004 served as the preintervention group, and were evaluated against 89 severity-matched postintervention bronchiolitis patients from 2005. Their mean lengths of ED stay were compared by a t test. RESULTS: The preintervention group had a mean length of stay of 4 hours and 59 minutes, and the postintervention group had a mean length of stay of 4 hours and 9 minutes, which was significantly different (P = 0.03). The sensitivity of respiratory distress on the triage exam for predicting hypoxia was fair (74%). CONCLUSIONS: Institution of triage pulse oximetry significantly decreases ED throughput times. Clinical exam alone is not a replacement for measurement of oxygen saturation.

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BronchiolitisEmergency Service, HospitalHumansInfantLength of StayOximetryTriageJournal Article

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James Choi, Ilene Claudius. 2006. Decrease in emergency department length of stay as a result of triage pulse oximetry.. https://doi.org/10.1097/01.pec.0000221340.26873.2f

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Chest radiography in children aged 2-59 months diagnosed with non-severe pneumonia as defined by World Health Organization: descriptive multicentre study in Pakistan.

OBJECTIVES: To evaluate the chest radiographs of children diagnosed with non-severe pneumonia on the basis of the current World Health Organization guidelines (fast breathing alone) for radiological evidence of pneumonia. DESIGN: Descriptive analysis. SETTING: Outpatient departments of six hospitals in four cities in Pakistan. PARTICIPANTS: 2000 children with non-severe pneumonia were enrolled; 1932 children were selected for chest radiography. INTERVENTIONS: Two consultant radiologists used standardised WHO definitions to evaluate chest radiographs; no clinical information was made available to them. If they disagreed, the radiographs were read by a third radiologist; the final classification was based on agreement between two of the three radiologists. MAIN OUTCOME MEASURES: Presence or absence of pneumonia on radiographs. RESULTS: Chest radiographs were reported normal in 1519 children (82%). Radiological evidence of pneumonia was reported in only 263 (14%) children, most of whom had interstitial pneumonitis. Lobar consolidation was present in only 26 children. The duration of illness did not correlate significantly with the presence of radiological changes (relative risk 1.17, 95% confidence interval 0.91 to 1.49). CONCLUSION: Most children diagnosed with non-severe pneumonia on the basis of the current WHO definition had normal chest radiographs.

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