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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
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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

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