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Comparison of Croup Management Patterns between Pediatricians and Emergency Medicine Physicians: A Single Pediatric

Ho-Young Song1, Jae-Hyun Kwon1, Soo Hyun Park1

  • 1Department of Emergency Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Republic of Korea.

Journal of Clinical Medicine
|October 26, 2024
PubMed

Insights

Emergency medicine physicians more closely followed croup management guidelines than pediatricians. Despite treatment differences, patient outcomes like hospital stay and readmission rates remained similar, highlighting the need for standardized pediatric emergency care.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Practice Guidelines
  • Comparative Effectiveness Research

Background:

  • Pediatric emergency medicine has seen increasing studies comparing treatment patterns between pediatricians and emergency medicine (EM) physicians.
  • Understanding these differences is crucial for enhancing pediatric emergency care and specialist training.

Purpose of the Study:

  • To compare the management patterns of croup (acute laryngotracheobronchitis) between pediatricians and EM physicians.
  • To identify differences in treatment strategies and their adherence to established guidelines.

Main Methods:

  • Retrospective review of 1676 medical records of children diagnosed with croup at a tertiary university-affiliated hospital in South Korea.
  • Analysis of patient characteristics, management patterns, and the impact of physician specialty on emergency care outcomes.

Main Results:

  • EM physicians more frequently used injected dexamethasone monotherapy (30.54% vs. 3.57%).
  • Pediatricians more often used nebulized epinephrine and dexamethasone combination therapy (88.29% vs. 67.71%).
  • EM physicians demonstrated higher appropriate use of nebulized epinephrine based on the Westley Croup Score (77.64% vs. 57.89%), and prescribed oral antibiotics/corticosteroids less frequently than pediatricians.

Conclusions:

  • EM physicians demonstrated closer adherence to current croup management algorithms compared to pediatricians.
  • No significant differences were observed in pediatric emergency department length of stay or 48-hour revisit rates between the groups.
  • Findings emphasize the need for standardized, evidence-based pediatric emergency care and inform training program development.

Keywords:
childcroupemergency medical servicesemergency medicinepediatricians

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