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The prehospital management of children with acute asthma
K P Dawson1, E Jandera, A C Penna
1Department of Paediatrics, Westmead Hospital, New South Wales, Australia.
Insights
Many parents of children with acute asthma have action plans, but prehospital treatment is often inadequate. This highlights a gap in asthma management despite national campaigns, impacting emergency care outcomes.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Public Health
Background:
- Acute asthma in children necessitates effective prehospital management.
- Asthma action plans are crucial for guiding home care and reducing hospitalizations.
- Suboptimal prehospital treatment can lead to severe exacerbations and emergency room visits.
Purpose of the Study:
- To assess the utilization of asthma action plans among parents of children hospitalized with acute asthma.
- To evaluate the intensity and adequacy of prehospital treatments administered before hospital admission.
- To identify potential gaps in asthma care management in the prehospital setting.
Main Methods:
- A sequential sample of 100 parents whose children were admitted for acute asthma was interviewed.
- Data collected included possession and use of asthma action plans and details of prehospital interventions.
- Analysis focused on the frequency of action plan use and types of treatments provided.
Main Results:
- 51% of parents reported having an asthma action plan, with 84% of those using it before admission.
- Children with a history of frequent hospital admissions (>2) were more likely to have an action plan (79%).
- Bronchodilator use was common, but often infrequent; steroid use was inadequate, indicating suboptimal prehospital management.
Conclusions:
- While asthma action plans are available to many parents, their consistent and effective use in prehospital settings requires improvement.
- Prehospital management of acute pediatric asthma, including bronchodilator and steroid administration, is frequently suboptimal.
- Further interventions are needed to enhance prehospital asthma care, even with concurrent national asthma campaigns.
Abstract:
Parents of 100 children admitted sequentially to hospital with acute asthma were interviewed in order to determine the frequency of the use of asthma action plans and the intensity of prehospital treatment. The results revealed that 51% of the parents possessed some form of action plan and 84% of this group used their plan prior to the child's admission to hospital. However 79% of those children with more than two prior hospital admissions for asthma had an action plan. Bronchodilator therapy was widely used, with widespread possession of nebulizer units, but tended to be given infrequently prior to hospital admission. Steroid use in the acute attack was inadequate. Despite a concurrent national asthma campaign prehospital management was considered to be suboptimal.