Related Experiment Video
Updated: Sep 28, 2026
Acupoint Catgut Embedding Therapy in Traditional Chinese Medicine for Managing Allergic Rhinitis
Published on: December 20, 2024
Comparability of acute asthma severity assessments by parents and respiratory therapists
Marc H Gorelick1, Molly W Stevens, Theresa R Schultz
1Children's Hospital of Wisconsin, Mail Stop 677, 9000 W Wisconsin Ave, Milwaukee, WI 53226, USA. mgorelic@mail.mcw.edu
Insights
Parents and respiratory therapists (RTs) offer similar assessments of childhood asthma severity after emergency department (ED) visits. Significant differences in evaluating a child's condition are rare, with parents rarely underestimating their child's asthma severity.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Medicine
- Health Outcomes Research
Background:
- Assessing acute asthma severity in children post-emergency department (ED) discharge is crucial for appropriate follow-up care.
- Parental perception of a child's symptoms can influence adherence to treatment and subsequent healthcare utilization.
Purpose of the Study:
- To compare parental and respiratory therapist (RT) assessments of acute asthma severity in children recently discharged from the ED.
- To determine the frequency and clinical significance of discrepancies between parent and RT evaluations.
Main Methods:
- A prospective cohort study involving children aged 2-17 years treated for asthma in an urban children's hospital ED.
- Home care visits were conducted within 24 hours of discharge, including parental interviews and clinical assessments by registered RTs (e.g., pulse oximetry).
Main Results:
- Of 51 children completing the home visit, 48 had complete assessments by both parents and RTs.
- Parents reported improvement in 84% of cases; 6% underestimated wheezing or work of breathing compared to RTs, with only 1 substantial discrepancy.
- RTs found 10% of cases had substantial overestimation of severity by parents.
Conclusions:
- Parental and RT assessments of pediatric asthma severity are comparable within 24 hours post-ED discharge.
- Clinically significant discrepancies between parent and RT evaluations are infrequent.
- Parental underestimation of asthma severity in children is uncommon after ED treatment.
Objective:
To compare the assessments of parents and respiratory therapists (RTs) of acute asthma severity in children discharged after emergency department (ED) treatment.
Design:
Prospective cohort study.
Setting:
Home care visit within 24 hours of discharge from an urban children's hospital ED.
Participants:
Children aged 2 to 17 years discharged to home after treatment in the ED (at least 1 inhaled bronchodilator treatment administered) were randomly selected to have a home care visit.
Main Outcome Measures:
Registered RTs went to the child's home and asked the parent questions about his or her perception of the child's symptoms. The RT performed a clinical assessment including pulse oximetry.
Results:
Ninety children were selected for home care, and 51 patients (57%) successfully completed the home care visit; 48 (53%) underwent a complete assessment by both raters. There were no differences in demographic features or ED clinical variables between those successfully contacted and those not reached. Of those evaluated, 43 parents (84%) reported their child's asthma was improved, and the rest reported no change. Parents underestimated the degree of wheezing or work of breathing relative to the RT in 3 of 48 patients (6%), but only 1 of these was considered substantial (>1 point discrepancy). Findings were overestimated in 14 (29%) of 48 cases, but only 5 (10%) were substantial.
Conclusions:
Parents and RTs provide comparable assessments of acute asthma severity in children within 24 hours of discharge from the ED. Clinically important discrepancies are uncommon, and underestimation of severity by parents is rare.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:13Asthma III: Clinical Manifestations
01:30Asthma-IV: Nursing Management
First, in...
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like asthma or COPD,...
01:28Asthma I: Introduction