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Emergency Medicine Journal 2004;21:59-60; doi:10.1136/emj.2003.004887
© 2004 BMJ Publishing Group Ltd and the College of Emergency Medicine.

ORIGINAL ARTICLE

Wavelet analysis of pulse oximeter waveform permits identification of unwell children

P Leonard1, T F Beattie1, P S Addison2 and J N Watson3

1 Department of Accident and Emergency Medicine, The Royal Hospital for Sick Children, Edinburgh, Scotland
2 Faculty of Engineering and Computing, Napier University, Merchiston Campus, Edinburgh, Scotland
3 Cardiodigital Ltd, Edinburgh, Scotland

Correspondence to:
Correspondence to:
Dr P A Leonard
Department of Accident and Emergency Medicine, The Royal Hospital for Sick Children, Edinburgh, Scotland; paul\|[lowbar]\|leonard{at}blueyonder.co.uk

Background: Children who are unwell often display signs of circulatory compromise. It has been observed that pronounced changes occur in the appearance of the photoplethysmogram (pulse oximeter tracing) in these children. The aim of the study was to discover if wavelet transforms can identify more subtle changes in the photoplethysmogram of children who are unwell.

Methods: Photoplethysmograms were obtained from children attending a paediatric accident and emergency department with clinical features suggestive of significant bacterial illness or circulatory compromise. Photoplethysmograms were also obtained from a control group of well children. Wavelet transforms were applied to the traces in an attempt to separate the two groups.

Results: 20 traces were obtained from unwell children and 12 from controls. Analysis of the entropy of the wavelet transform of the photoplethysmogram allows the differentiation of unwell children from controls (p = 0.00002).

Conclusions: Wavelet transform of the photoplethysmogram offers the possibility of a rapid non-invasive method of screening children for significant illness.

Keywords: children; photopletyhysmogram; wavelet


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