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.
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.
Authors: Craig Newgard; Susan Malveau; Kristan Staudenmayer; N Ewen Wang; Renee Y Hsia; N Clay Mann; James F Holmes; Nathan Kuppermann; Jason S Haukoos; Eileen M Bulger; Mengtao Dai; Lawrence J Cook Journal: Acad Emerg Med Date: 2012-04 Impact factor: 3.451
Authors: Anriada Nassif; Daniel G Ostermayer; Kim B Hoang; Mary K Claiborne; Elizabeth A Camp; Manish I Shah Journal: Prehosp Emerg Care Date: 2018-01-19 Impact factor: 3.077
Authors: Chu-Lin Tsai; Ashley F Sullivan; James A Gordon; Rainu Kaushal; David J Magid; David Blumenthal; Carlos A Camargo Journal: J Allergy Clin Immunol Date: 2008-12-13 Impact factor: 10.793
Authors: Manish N Shah; Jeremy T Cushman; Colleen O Davis; Jeffrey J Bazarian; Peggy Auinger; Bruce Friedman Journal: Prehosp Emerg Care Date: 2008 Jul-Sep Impact factor: 3.077
Authors: Amy Knowlton; Brian W Weir; Brenna S Hughes; R J Hunter Southerland; Cody W Schultz; Ravi Sarpatwari; Lawrence Wissow; Jonathan Links; Julie Fields; Junette McWilliams; Wade Gaasch Journal: Acad Emerg Med Date: 2013-11 Impact factor: 3.451
Authors: Marianne Gausche-Hill; Marc Eckstein; Timothy Horeczko; Nancy McGrath; Aileen Kurobe; Linda Ullum; Amy H Kaji; Roger J Lewis Journal: Prehosp Emerg Care Date: 2014-05-15 Impact factor: 3.077
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: Alexandra L Cheetham; Nidhya Navanandan; Jan Leonard; Kelsey Spaur; Geoffrey Markowitz; Kathleen M Adelgais Journal: J Asthma Date: 2021-02-13