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Failure of Outpatient Management With Different Observation Times After Racemic Epinephrine for Croup
Nadine Smith1, Kathryn Giordano1, Amy Thompson1
11 Division of Emergency Medicine, Nemours/AI duPont Hospital for Children, Wilmington, DE, USA.
Background:
Observation is necessary following racemic epinephrine (RE) for patients with croup. The ideal length of this observation period is unclear.
Objective:
To compare the rate of failed outpatient management utilizing different observation times after RE administration for croup.
Methods:
We performed a retrospective chart review of children with croup who required RE. Failure of treatment was defined as requiring a second RE treatment and/or returning to the pediatric emergency department for croup symptoms within 24 hours of discharge.
Results:
The primary analysis considered patients observed between 2.1 and 3 hours compared with those observed for 3.1 to 4 hours. The patients in the 2.1- to 3-hour group had a higher rate of treatment failure (16.7% vs 7.1%, OR = 2.44, P < .01).
Conclusions:
Patients requiring RE for croup are more likely to have treatment failure if observed for between 2.1 and 3 hours as opposed to 3.1 to 4 hours.
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