OBJECTIVE: The aim of this study was to evaluate the relationship between time of corticosteroid administration to children with asthma exacerbations in the Emergency Department (ED) and length of stay (LOS). We hypothesized administration within 60 minutes would be associated with a 10- minute or greater decrease in mean LOS. METHODS: A retrospective chart review of 882 patients was conducted. Children between the ages of 2 and 18 years presented to the Connecticut Children's Medical Center's (CCMC's) ED with an acute asthma exacerbation were included. Children were excluded if they did not receive oral corticosteroids in the ED, had significant co-morbidities, were currently taking corticosteroids, or had taken them within the past 7 days. Children receiving corticosteroids within 60 minutes of triage were compared with children receiving corticosteroids for 61 minutes or later. The primary outcome was mean LOS. RESULTS: Children treated with corticosteroids within 60 and 61 minutes or later had similar age, gender, insurance, and disposition. Children treated with corticosteroids within 60 minutes had a 25-minute decrease in LOS compared with children treated for 61-minute or later (95% CI: 15-35), p < .0001. CONCLUSIONS: Administering corticosteroids to pediatric asthma patients in the ED within an hour of triage is associated with a 25-minute mean decrease in LOS. With large numbers of asthma visits, a 25-minute decrease in LOS for each child could have a significant impact on patient throughput in the ED.
OBJECTIVE: The aim of this study was to evaluate the relationship between time of corticosteroid administration to children with asthma exacerbations in the Emergency Department (ED) and length of stay (LOS). We hypothesized administration within 60 minutes would be associated with a 10- minute or greater decrease in mean LOS. METHODS: A retrospective chart review of 882 patients was conducted. Children between the ages of 2 and 18 years presented to the Connecticut Children's Medical Center's (CCMC's) ED with an acute asthma exacerbation were included. Children were excluded if they did not receive oral corticosteroids in the ED, had significant co-morbidities, were currently taking corticosteroids, or had taken them within the past 7 days. Children receiving corticosteroids within 60 minutes of triage were compared with children receiving corticosteroids for 61 minutes or later. The primary outcome was mean LOS. RESULTS:Children treated with corticosteroids within 60 and 61 minutes or later had similar age, gender, insurance, and disposition. Children treated with corticosteroids within 60 minutes had a 25-minute decrease in LOS compared with children treated for 61-minute or later (95% CI: 15-35), p < .0001. CONCLUSIONS: Administering corticosteroids to pediatric asthmapatients in the ED within an hour of triage is associated with a 25-minute mean decrease in LOS. With large numbers of asthma visits, a 25-minute decrease in LOS for each child could have a significant impact on patient throughput in the ED.
Authors: Jennifer N Fishe; Eugene Palmer; Erik Finlay; Carmen Smotherman; Shiva Gautam; Phyllis Hendry; Leslie Hendeles Journal: Pediatr Emerg Care Date: 2019-02-14 Impact factor: 1.454
Authors: Jennifer N Fishe; Phyllis Hendry; Jennifer Brailsford; Ramzi G Salloum; Bruce Vogel; Erik Finlay; Sam Palmer; Susmita Datta; Leslie Hendeles; Kathryn Blake Journal: Contemp Clin Trials Date: 2020-09-12 Impact factor: 2.226
Authors: Jeffrey M Simmons; Jocelyn M Biagini Myers; Lisa J Martin; Carolyn M Kercsmar; Christine L Schuler; Valentina V Pilipenko; John W Kroner; Hua He; Stephen R Austin; Huyen-Tran Nguyen; Kristie R Ross; Karen S McCoy; Sherman J Alter; Samantha M Gunkelman; Pierre A Vauthy; Gurjit K Khurana Hershey Journal: Hosp Pediatr Date: 2018-05-15