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[Asthma attacks in children over two years old in a pediatric hospital in Nice]
Insights
Pediatric asthma attacks are common emergencies. This study highlights delayed treatment and the critical role of pediatric emergency departments in managing childhood asthma effectively.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Medicine
- Epidemiology
Context:
- Asthma is a prevalent condition in children, frequently leading to emergency department visits.
- Understanding the patterns of pediatric asthma attacks is crucial for optimizing care.
- This study investigated asthma exacerbations in children presenting to a pediatric emergency department over a 12-month period.
Purpose:
- To prospectively analyze asthma attacks in children aged over 2 years.
- To evaluate treatment protocols and hospitalization decisions in pediatric asthma emergencies.
- To assess the role of pediatric emergency wards in managing and understanding childhood asthma.
Summary:
- A prospective study observed 137 asthma attacks in 122 children (mean age 6.9 years).
- Most children had a known asthma diagnosis and experienced delays in seeking medical attention, often after self-treatment.
- Inhaled beta-2 agonists were the primary treatment, with hospitalization decisions made after initial response; one death occurred before admission.
Impact:
- The findings underscore the need for timely intervention and effective management strategies in pediatric asthma emergencies.
- Pediatric emergency departments play a vital role in immediate care and initiating long-term asthma surveillance.
- This research contributes to the epidemiological understanding of childhood asthma and its management in emergency settings.
Abstract:
Asthma is a common pediatric emergency. We report the results of a prospective investigation concerning asthma attacks observed in children aged more than 2 years at Lenval hospital (Nice) during a 12-month period, from September 1993 to September 1994. One hundred and thirty seven asthma attacks were observed in 122 children aged 6.9 +/- 3.4 years, representing 5.2% of children ranged from 2 to 6 years medical emergencies, and 10.3% of children greater than 6 years medical emergencies. In most cases (82.4%) the diagnosis of asthma was already known. The children were first seen, on the average, between 32.3 +/- 38.6 hours after the beginning of the attack, previously self-treated at home in one out of every two cases. Treatment was set in each case on the isolated administration of inhaled beta 2-adrenergic agonist. The decision whether or not to hospitalize was made, at the latest, one half hour after the second administration of the beta 2-agonist. One death occurred before hospital admission. Hospitalization was decided in 38.6% of the cases, two of which were immediately directed for reanimation. A majority of the children (60.7%) were able to return home after metered dose inhalation for 5 of them, after 1 nebulization of beta 2-agonist in 66 cases, after 2 nebulizations in 12 cases. The prevalence of asthma is increasing and can be estimated at approximately 10% in France. The pediatrics emergency wards have an important role to play in the evolution of this illness. They must guarantee the most favorable management of the attack. They must then participate decisively in the initiation of the necessary surveillance to be continued. They play a great part in the knowledge of the epidemiology.