A Statewide Study of the Epidemiology of Emergency Medical Services' Management of Pediatric Asthma
| Autor: | Erik Finlay, Jennifer N. Fishe, Phyllis L. Hendry, Leslie Hendeles, Eugene Palmer, Shiva Gautam, Carmen Smotherman |
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| Rok vydání: | 2019 |
| Předmět: |
Emergency Medical Services
medicine.medical_specialty Adolescent Ipratropium bromide Logistic regression Article Magnesium Sulfate 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Epidemiology Emergency medical services medicine Humans Albuterol Child Respiratory distress business.industry Ipratropium 030208 emergency & critical care medicine Retrospective cohort study General Medicine Odds ratio Asthma Confidence interval Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Emergency Medicine business medicine.drug |
| Zdroj: | Pediatr Emerg Care |
| ISSN: | 0749-5161 |
| DOI: | 10.1097/pec.0000000000001743 |
| Popis: | Objectives Little is known about emergency medical services' (EMS') management of pediatric asthma. This study's objective was to describe the demographic, clinical, and geographic characteristics of current EMS' management of pediatric asthma in the state with the fourth-largest pediatric population. Methods This was a retrospective observational study of EMS patients ages 2 to 18 years with an asthma exacerbation from 2011 to 2016. Patients from Florida's EMS Tracking and Reporting System were included if their EMS chief complaint indicated respiratory distress, if they received at least 1 albuterol treatment, and if they were transported to a hospital. Results A total of 11,226 patients met the inclusion criteria. The median age was 9 years, and 49% were African-American. Geospatial analysis revealed 4 rural counties with disproportionate numbers of African-American patients. In addition to albuterol, 37% of patients received ipratropium bromide and 9% received systemic corticosteroids. Adjusted logistic regression revealed that the strongest predictors of receiving systemic corticosteroids from EMS were intravenous access (odds ratio, 33.4; 95% confidence interval, 24.4-45.6) and intravenous magnesium sulfate administration (odds ratio, 5.0; 95% confidence interval, 3.4-7.3), indicating a more severe presentation. Conclusions This statewide study demonstrated low rates of EMS administration of ipratropium bromide and systemic corticosteroids, both evidence-based treatments for asthma exacerbations. Targeted EMS education should attempt to increase utilization of both those medications. In addition, the feasibility and efficacy of EMS administration of oral systemic corticosteroids for children should be explored. |
| Databáze: | OpenAIRE |
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