Pulse oximetry to identify a high-risk group of children with wheezing.

To investigate the value of pulse oximetry in children with wheezing presenting for emergency medical treatment, initial oxygen saturations (OSAT) were measured in 1,101 of 1,235 patients presenting to a pediatric ED over a 5-month period with wheezing-associated respiratory illnesses. The mean OSATs were 95.4% for wheezing children and 98.7% for controls. An initial OSAT of 95% or more indicated a low need for hospitalization. An initial OSAT less than 85% indicated a high need for hospitalization (positive predictive value, 90%). Pulse oximetry may be useful in identifying children with wheezing who are at high risk, as demonstrated by the need for hospitalization, during the early phase of an ED encounter, at which time more aggressive therapeutic interventions may be considered.