Related Experiment Video
Updated: May 2, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
The compliance to acute asthma management protocols in paediatric emergency department
F Yasin1, C Martin2, T Bolger2
1Department of Paediatric Emergency Medicine, AMNCH, Tallaght, Dublin 24. mkmb_12@yahoo.com
Insights
Adherence to asthma guidelines is crucial for consistent patient outcomes. This study found significant inconsistencies in clinical documentation and treatment delays in pediatric acute asthma cases, highlighting the need for better protocol compliance.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Medicine
- Clinical Quality Improvement
Background:
- Asthma guidelines aim to standardize care and improve outcomes for acute exacerbations.
- Compliance with established protocols is essential for consistent and effective management.
Purpose of the Study:
- To assess adherence to local acute asthma protocols in a pediatric emergency department.
- To identify areas of non-compliance in clinical assessment, management, and follow-up.
Main Methods:
- Retrospective review of medical records for children presenting with acute asthma.
- Evaluation of documentation for clinical signs, time to nebulization, and discharge planning.
- Comparison of patient management against local acute asthma protocols.
Main Results:
- Inconsistent documentation of clinical signs (respiratory effort, mental status, speech) across severity groups.
- Delayed bronchodilator therapy in 50% of life-threatening and 90% of severe asthma exacerbations.
- Inadequate discharge advice and absence of written asthma action plans for most patients.
Conclusions:
- Significant gaps exist in protocol adherence for pediatric acute asthma care.
- Improved compliance with clinical assessment, management, and follow-up protocols is necessary.
- Standardized documentation and timely interventions are critical for optimizing asthma care.
Abstract:
Asthma guidelines should be followed closely to ensure improvement and consistency of outcome. In order to measure compliance with local acute asthma protocols, we reviewed notes of children presenting to our ED with acute asthma. We noted clinical assessment of severity of asthma exacerbation, compared management of cases with local protocols, noted time to first nebulisation, discharge advice and follow up plans. Retrospectively, 6 patients had life-threatening, 70 had severe and 64 had mild-to-moderate exacerbation. We observed inconsistent documentation of clinical signs including, respiratory effort 6 (100%), 62 (89%), 39 (61%), mental status 3 (50%), 46 (65%), 47 (73%) and speech 1 (16.7%), 19 (27%), 7 (11%) in life threatening, severe and mild-to-moderate groups respectively. Bronchodilator therapy was delayed in life-threatening 3 (50%) and severe cases 63 (90%). While discharge advice was documented in 54% patients, no written asthma action plans were given. This study demonstrated necessity of protocol-adherence in areas of clinical assessment, management and follow up.
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:
01:30Asthma-IV: Nursing Management
First, in...
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:13Asthma III: Clinical Manifestations