Related Experiment Videos
Prehospital management of pediatric asthma requiring hospitalization
1Department of Pediatrics and Emergency Medicine, University of Nevada School of Medicine, University Medical Center of Southern Nevada, Las Vegas, USA.
Insights
Prehospital care for pediatric asthma patients requiring hospitalization showed gaps in assessment and treatment. Many children did not receive timely oxygen or asthma medications in the field, leading to hypoxia upon emergency department arrival.
Area of Science:
- Emergency Medicine
- Pediatric Pulmonology
- Prehospital Care
Background:
- Pediatric asthma exacerbations frequently necessitate hospitalization.
- Effective prehospital assessment and management are crucial for improving outcomes in pediatric asthma.
- Gaps in prehospital care can lead to adverse events and prolonged hospital stays.
Purpose of the Study:
- To evaluate the quality of prehospital assessment and management for pediatric asthma patients requiring hospitalization.
- To identify specific areas for improvement in emergency medical services (EMS) protocols for pediatric asthma.
Main Methods:
- Retrospective chart review of pediatric asthma patients admitted to a pediatric emergency department.
- Inclusion criteria: patients under 18 years old with asthma requiring hospitalization, transported by Boston EMS.
- Data collected on prehospital assessment, oxygen administration, and medication use.
Main Results:
- Of 27 pediatric asthma patients, only 63% had documented physical examination markers of asthma severity.
- 26% of patients did not receive supplemental oxygen in the prehospital setting.
- 30% of patients presented with hypoxia to the emergency department; none received albuterol in the field.
Conclusions:
- Significant deficiencies exist in the prehospital assessment and management of pediatric asthma.
- Further research and protocol refinement are needed to optimize prehospital care for this population.
- Improved prehospital interventions, including oxygen and albuterol, may prevent hypoxia and improve patient outcomes.
Abstract:
Our objective was to evaluate the quality of prehospital assessment and management in pediatric asthma requiring hospitalization via a retrospective chart review. Charts were obtained from a pediatric emergency department (ED) with 24,000 annual visits. Included in the study were 27 patients less than 18 years of age with asthma requiring hospitalization, transported to the Boston City Hospital Pediatric ED by Boston Emergency Medicine Services (EMS). We found that 12 patients admitted to the pediatric intensive care unit over an 18-month period, and 15 patients admitted to the ward over a six-month period, received prehospital care from Boston EMS. Only 63% of cases (17/27) had a physical examination marker of asthma severity noted on the EMS record. Twenty-six percent of cases (7/27) did not receive O2 in the field. Thirty percent of cases (8/27) were hypoxic at ED presentation. None of the hypoxic patients had received albuterol in the field, and one did not receive O2. We conclude that further study of the prehospital assessment and management of pediatric asthma is warranted.