Isolated pulse oximetry readings are unreliable

BMJ 1995;310:1065 (22 April)

Letters

Isolated pulse oximetry readings are unreliable

EDITOR,--We are concerned at David Isaac's recommendation thatgeneral practitioners should routinely carry pulse oximetersto aid their assessment of children with bronchiolitis.¹ Insupport of this he cites two studies.² ³ Both conclude thatpulse oximetry gives the best single initial measurement ofthe severity of illness in bronchiolitis in the emergency department.They do not, however, support the view that general practitionersshould assess acute respiratory disease in children in the communityby using pulse oximetry.

An isolated measurement of oxygen saturation obtained by thegeneral practitioner in the community is of only limited value.Oxygen saturation must be considered in the context of the child'soverall clinical condition and the results of blood gas analysis.We therefore urge caution in the use of pulse oximetry; a normalvalue may give a false sense of security and might lead to adelay in referral to hospital with potentially fatal results.

Registrar in anaesthesia Consultant in anaesthesia and paediatricintensive care Consultant in anaesthesia and paediatric intensivecare Consultant in anaesthesia and paediatric intensive careDepartment of Anaesthesia, Royal Manchester Children's Hospital,Manchester M27 4HA

Ian Waite, Robert W M Walker, Andrew Sharples, Oliver Dearlove