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Asthma Treatment in the Emergency Room

A new Canadian study finds children having a moderate-to-severe asthma attack who receive treatment with systemic corticosteroids within the first 75 minutes of triage in the emergency room may be considerably less predisposed to end up a full hospital admission.

Investigators gauged this with a pediatric respiratory assessment measure (PRAM) scale to measure the degree of severity of the respiratory asthma attack and to speedily begin the severity-specific therapy recommended by asthma protocol.

Predominantly, pediatric patients who received corticosteroid therapy during the first 75 minutes were 16% less expected to be admitted to the hospital. Fast treatment also drove down the emergency department stay by nearly 45 minutes for patients who were finally discharged from the emergency department.

“We knew that corticosteroids could help avoid admissions and relapses. However, just how delays between emergency department admission and administration of the treatment impacted outcomes remained unclear,” study author Dr. Sanjit K. Bhogal was quoted saying.

Dr. Francine Ducharme, who led the team that developed the PRAM, add, “Our study demonstrates that to be effective in preventing hospital admission, treatment with corticosteroids should be administered within 75 minutes of triage, regardless of patient age… in fact the earlier the treatment is given within this time frame, the more effective its is.”

Her team has now implemented a teaching module to educate staff to develop severity-specific guidelines. The educational schedule is expected to be accessible on the University of Montreal website by this year’s end. This research emerged in a recent issue of the Annals of Emergency Medicine.