Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-27T20:52:08.331Z Has data issue: false hasContentIssue false
  • English
  • Français

Occult Hypoxemia During Aeromedical Transport: Detection by Pulse Oximetry

Published online by Cambridge University Press:  28 June 2012

James D. Melton III ,
Michael B. Heller ,
Richard Kaplan  and
Karen Mohan-Klein
James D. Melton III
Affiliation:
University of Pittsburgh Affiliated Residency in Emergency Medicine
Michael B. Heller
Affiliation:
Associate Professor of Medicine, Division Emergency Medicine, Department of Medicine,University of Pittsburgh, School of Medicine
Richard Kaplan
Affiliation:
Research Coordinator, Center for Emergency Medicine of Western Pennsylvania
Karen Mohan-Klein
Affiliation:
Coordinator, Specialized Treatment and Transport Team, Specialized Treatment and Transport System, Center for Emergency Medicine of Western Pennsylvania
Get access Rights & Permissions [Opens in a new window]

Abstract

The use of pulse oximetry as an adjunct to clinical evaluation of oxygenation during aeromedical transport by helicopter and fixed-wing aircraft was evaluated. As evidenced by an oxygen saturation of 90% or less, 29 of 150 patients (29%) were hypoxemic in the presence of the flight team. Airway interventions were carried out by the flight team in 17 of these 29 hypoxemic patients. In 11 of these 17 instances, desaturation noted by pulse oximeter was the first evidence that airway interventions were indicated. In the other 12 cases of hypoxemia, no new airway interventions were carried out despite oximeter evidence of desaturation. Three of these patients subsequently required aggressive airway interventions following their arrival at the receiving emergency department. Of the 32 patients transported by fixed-wing aircraft, 27% had evidence of unsuspected hypoxemia detected only by the pulse oximeter. The hypoxemia seemed related to increasing altitude in eight of this latter group. Pulse oximetry is a valuable and feasible technique for monitoring patients during aeromedical transport. Its use may allow detection of physiologic hypoxemia before such becomes apparent clinically.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 4 , Issue 2 , December 1989 , pp. 115 - 120
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Yelderman, M, New, W: Evaluation of pulse oximetry. Anesthesiology, 1983; 59:349–352.CrossRefGoogle ScholarPubMed
2. Mihm, FG, Halperin, BD: Noninvasive detection of profound arterial desaturations using a pulse oximetry device. Anesthesiology 1985; 62:85–87.CrossRefGoogle ScholarPubMed
3. Fanconi, Doherty P, Edwards, JF, et al: Pulse oximetry in pediatric intensive care: Comparison with measured saturations and transcutaneous oxygen tension. J Pediatr 1985; 107:362–366.CrossRefGoogle ScholarPubMed
4. Tytler, JA, Seely, HF: The Nellcor N-101 pulse oximeter. Anesthesiology, 1986; 41:302–305.Google ScholarPubMed
5. Nickerson, BG, Sarkisian, C, Tremper, K: Bias and precision of pulse oximeters and arterial oximeters. Chest 1988; 93:515–517.CrossRefGoogle ScholarPubMed
6. Jones, J, Heiselman, D, Cannon, L, et al: Continuous monitoring of arterial saturation in adult patients with respiratory distress, Ann Emerg Med 1988; 17:463–468.CrossRefGoogle ScholarPubMed
7. Tyler, IL, Tantisira, B, Winter, PM: Continuous monitoring of arterial oxygen saturation with pulse oximetry during transport to the recovery room. Anesth Analg 1985; 24:1108–1112.Google Scholar
8. Sendak, MJ, Harris, AP, Donham, RT: Use of pulse oximetry during newborn resuscitation. Crit Care Med 1986; 24:739–740.CrossRefGoogle Scholar
9. Melton, JD: Noninvasive Monitoring techniques. Emerg Care Quart 1987; 3:63–76.Google Scholar
10. Miller, JD, Becker, DP, Ward, JD, et al: Significance of intracranial hypertension in severe head injury. J Neurosurg 1977; 47:503–516.CrossRefGoogle ScholarPubMed
11. McQuire, TJ, pointer, JE: Evaluation of a pulse oximeter in the prehospital setting. Ann Emerg Med, 1988; 17:1058–1062.CrossRefGoogle Scholar
12. Gudgell, S, Vukow, LF, Farnell, MB: Pulse oximetry in rotor-wing transport. Aeromedical Journal, 1987; 2:21.(abst)CrossRefGoogle Scholar
13. Galdun, J, Dunmire, S, Kaplan, RM, et al: Accuracy of transcutaneous, transconjunctival and pulse oximetry during air and ground transport with induced hypoxia and hyperoxia. Ann Emerg Med 1988; 17:425.Google Scholar
14. Yoshiva, I, Shimada, Y, Tanaka, K: Spectrophotometric monitoring of arterial oxygen saturation in the fingertip. Med Biol Eng Comp 1980; 18:27–32.CrossRefGoogle Scholar
15. Barker, SJ, Tremper, KK: The effect of carbon monoxide inhalation on pulse oximetry and transcutaneous PO2. Anesth 1987; 66:677–679.CrossRefGoogle ScholarPubMed
16 Shufflebarger, C, Jehle, D, Cottington, , et al: Transconjunctival oxygen monitoring during helicopter transport. Ann Emerg Med 1985; 14:518 (abst).CrossRefGoogle Scholar