Cunningham Steve, McMurray Ann
Department of Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF, Scotland, UK.
Prim Care Respir J. 2006 Apr;15(2):98-101. doi: 10.1016/j.pcrj.2006.01.005. Epub 2006 Feb 28.
The BTS/SIGN guideline recommends oxygen saturation (SaO2) monitoring as an objective measure of acute asthma severity, particularly in children, in both primary and secondary care. We assessed the availability and use of SaO2 monitoring for acute asthma assessment in primary care.
Fax and telephone questionnaire of Primary Care services in the Edinburgh region to assess use of SaO2 monitoring in the past 24 months, in association with a 24-month retrospective assessment of A&E attendances with acute wheeze. Children over 12 months of age registered with eligible general practices attending A&E with wheeze and/or asthma were included.
There were replies from 103 general practices (100%) and eight Out-of-hours cooperatives (100%). Oxygen saturation monitoring was available in four general practices (3.9%) and three Out-of-hours cooperatives (37.5%). 1408 children attended A&E with wheeze/asthma, 721 referred by primary care. Oxygen saturation monitoring was available to 7.9% of A&E attendees from primary care, but documented in only 1.8% of primary care referrals.
SaO2 monitoring is not widely available in primary care and is infrequently used for the assessment of acute asthma. SaO2 measurement as an adjunct to clinical assessment of asthma in primary care needs encouragement.
英国胸科学会/苏格兰校际指南网络(BTS/SIGN)指南建议,将血氧饱和度(SaO2)监测作为评估急性哮喘严重程度的客观指标,尤其适用于儿童,无论是在初级医疗还是二级医疗中。我们评估了初级医疗中用于急性哮喘评估的SaO2监测的可用性和使用情况。
对爱丁堡地区的初级医疗服务机构进行传真和电话问卷调查,以评估过去24个月内SaO2监测的使用情况,并对因急性喘息而到急诊就诊的情况进行为期24个月的回顾性评估。纳入12个月以上、在符合条件的全科诊所注册、因喘息和/或哮喘到急诊就诊的儿童。
收到了103家全科诊所(100%)和8家非工作时间合作机构(100%)的回复。4家全科诊所(3.9%)和3家非工作时间合作机构(37.5%)具备血氧饱和度监测设备。1408名儿童因喘息/哮喘到急诊就诊,其中721名由初级医疗机构转诊。在初级医疗机构转诊至急诊的患者中,7.9%的患者能够进行血氧饱和度监测,但仅有1.8%的初级医疗转诊记录了该监测结果。
在初级医疗中,SaO2监测设备并不普遍,且很少用于急性哮喘的评估。需要鼓励在初级医疗中将SaO2测量作为哮喘临床评估的辅助手段。