Choosing Wisely:

Don’t use continuous pulse oximetry routinely in children with acute respiratory illness unless they are on supplemental oxygen.

Rationale and Comments: The utility of continuous pulse oximetry in pediatric patients with acute respiratory illness is not well established. Use of continuous pulse oximetry has been previously associated with increased admission rates and increase length of stay. The clinical benefit of pulse oximetry is not validated or well documented.
Sponsoring Organizations:
  • Society of Hospital Medicine (Pediatric)
  • Sources:
  • American Academy of Pediatrics guidelines
  • Disciplines:
  • Pediatric
  • Pulmonary medicine
  • References: • American Academy of Pediatrics. Diagnosis and management of bronchiolitis. Pediatrics. 2006;118(4):1774-93.
    • Schroeder AR, et al. Impact of pulse oximetry and oxygen therapy on length of stay in bronchiolitis hospitalizations. Arch Pediatr Adolesc Med. 2004;158(6):527-30.
    • Hunt CE, et al. Longitudinal assessment of hemoglobin oxygen saturation in healthy infants during the first 6 months of life. J Pediatr. 1999;135(5):580-6.
    • Alverson, et al. Multi-center randomized trial of pulse oximetry monitoring strategies for children hospitalized for bronchiolitis. Abstract presented at IDWeek 2012, Oct. 2012, San Diego, Calif.

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