Written by Kimiko Dunbar
Spoon Feed
Many families are utilizing consumer-grade pulse oximeters for their kids, often without appropriate education about oxygen saturation thresholds and device accuracy.
Knowledge is… power?
This study evaluated the use of consumer-grade pulse oximeters among families with children attending pediatric subspecialty clinics, comparing those who attended pulmonary or cardiac clinics (i.e. those with underlying cardiopulmonary disease) to those who attended GI clinics (a proxy for the general population). There was no significant difference in consumer grade oximeter use between the groups. Using a cross-sectional survey of 200 families, 26.5% owned oximeters, with 83.7% being fingertip devices. Most families used oximeters only when the child was ill (83.7%). The mean SpO2 families considered to be normal was 97.4%, but knowledge around SpO2 thresholds was variable. Some guardians did not know what a normal oxygen saturation value was; 17.9% indicated they would be concerned if the SpO2 was 95% or higher. The average oxygen saturation threshold for emergency care was 88.1%, and 37.2% reported going to the ED at least once for concern about their child’s SpO2. All but one family felt that their oximeter device was either somewhat or very accurate. This study was limited by small sample size, an unvalidated questionnaire, and use of the GI clinic as the “control” population, given that that population is likely not representative of the general pediatric population.
How will this change my practice?
Hypoxia on home devices comes up a lot, especially during peak respiratory season. Generally, we don’t recommend home pulse oximetry, which admittedly feels a little strange when we are admitting a child for bronchiolitis after presentation to the ED for identification of hypoxia on a home device. Patients seem to have an inappropriate trust in their accuracy. It’s clear that these devices are available and readily used, and equally clear that there’s a huge gap in education. I’ll be spending more time talking with families about the use of home pulse oximetry, probably focusing on education rather than dissuading use, even if it wouldn’t be something I would recommend or prescribe.
Source
Families’ perceptions of consumer-grade, inexpensive oxygen saturation monitors. Pediatr Pulmonol. 2024 Dec;59(12):3349-3354. doi: 10.1002/ppul.27203. Epub 2024 Aug 7. PMID: 39109914
