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Pediatric asthma pathway in the emergency room

Dominic Lucia1, James Cain1, Ashlee Porter1

  • 1Department of Pediatrics, Baylor Scott & White McLane Children's Medical Center, Temple, Texas.

Proceedings (Baylor University. Medical Center)
|January 18, 2021
PubMed

Insights

Implementing a standardized asthma care pathway in pediatric emergency departments significantly reduced steroid administration times. This improves outcomes for children with asthma, decreasing hospital admissions and mortality.

Area of Science:

  • Pediatric Emergency Medicine
  • Respiratory Medicine
  • Healthcare Quality Improvement

Background:

  • Pediatric asthma is a major cause of emergency department visits and hospital admissions.
  • Standardized management guidelines are needed to improve care delivery and patient outcomes.
  • Timely corticosteroid administration is crucial for effective asthma exacerbation management.

Purpose of the Study:

  • To evaluate the impact of a protocol-driven, standardized asthma care pathway on emergency department wait times for steroid administration.
  • To assess if this standardized approach improves patient outcomes in pediatric asthma management.

Main Methods:

  • A prospective cohort study was conducted at a single academic medical center.
  • A multidisciplinary asthma task force developed and implemented a standardized asthma pathway.
  • The study compared outcomes (time to corticosteroid administration) against historical controls over a 2-year period.

Main Results:

  • Implementation of the standardized asthma pathway significantly decreased the time to corticosteroid administration.
  • Time to steroids reduced from 45 minutes (historical control) to 29 minutes (year 1) and 20 minutes (year 2) post-implementation (P < 0.0001).
  • The protocol demonstrated a consistent and significant reduction in treatment delays.

Conclusions:

  • A standardized asthma care pathway effectively reduces critical treatment delays in pediatric emergency departments.
  • Implementing such protocols can decrease morbidity and mortality associated with pediatric asthma exacerbations nationwide.
  • Standardization of care is a key strategy for improving the management of pediatric asthma.

Keywords:
Asthmaasthma pathwaycorticosteroidsemergency department

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