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Childhood asthma, can admissions be avoided?
1Dept of Paediatrics, University College Hospital, Galway.
Insights
Asthma admissions in children were studied, revealing that most attacks were not severe. However, a third of patients received suboptimal prehospital care, highlighting areas for improved asthma management.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Public Health
Background:
- Asthma admissions represent a significant source of morbidity.
- Rising trends in pediatric asthma admissions necessitate further investigation.
Purpose of the Study:
- To prospectively evaluate the severity of asthma exacerbations in admitted children.
- To assess the adequacy of prehospital treatment for pediatric asthma patients.
- To identify factors contributing to hospital admissions for asthma.
Main Methods:
- A prospective study design was employed over a one-year period (January 1 - December 31, 1990).
- Data were collected using a study proforma completed upon patient admission.
- Analysis included patient demographics, asthma history, treatment received, and prehospital care assessment.
Main Results:
- 105 children were admitted; two-thirds were boys, and over half were under 5 years old.
- Most asthma attacks were not severe, with few requiring intravenous medication or continuous oxygen.
- Suboptimal prehospital care, including inappropriate acute management and medication non-compliance, was noted in one-third of patients.
- 16 patients required hospitalization exceeding 48 hours; others were discharged within 2 days.
Conclusions:
- While severe asthma attacks requiring intensive treatment were infrequent, suboptimal prehospital care is a significant issue.
- Improving prehospital management and adherence to treatment schedules can potentially reduce hospitalizations for acute severe asthma.
- Attention to simple treatment protocols may further decrease hospital admissions for pediatric asthma.
Abstract:
Since admissions with asthma continue to increase and account for considerable morbidity, we chose to prospectively study asthma admissions over a one year period to assess the severity of patients' asthma, their need for treatment available only in hospital, and to assess the adequacy of their prehospital treatment. A study proforma was completed soon after the admission of each child. Data gathered between the 1st January and 31st December 1990 are presented. There were 105 children admitted, two-thirds of those were boys and just over half were aged less than 5 years. Eighty-seven children had a previous diagnosis of asthma. Overall the attacks were not severe, only 10 patients were treated with intravenous medication and 18 children required continuous oxygen. Sixteen patients required hospitalisation for more than 48 hours, the remainder were discharged within 2 days. Suboptimal prehospital care was identified in a third of patients, inappropriate management of the acute attack, failure of adequate prophylactic medication and non-compliance with prescribed regimes were common. In our hospital, admissions with acute severe asthma have declined in 1990, attention to simple treatment schedules may further reduce hospitalisation.