MedWire News: Supplying healthcare professionals working in emergency departments (EDs) with pediatric acute asthma management guideline (PAMG) reminder cards significantly improves the care of children who present with asthma attacks, research shows.
"Several Canadian and US studies have described significant regional variations in hospitalization rates for childhood asthma since the 1990s, which are largely influenced by variations in patient characteristics and/or asthma management in EDs," explain Teresa To (The Hospital for Sick Children, Toronto, Ontario, Canada) and team.
To investigate whether PAMG reminder cards can improve the emergency care of children with asthma, the team studied the medical charts of 432 children who visited the ED of The Hospital for Sick Children as a result of the respiratory condition between 2002 and 2004. Of these, 278 children had visited before, and 154 after, the introduction of PAMG reminder cards in January 2003.
PAMG reminder cards were issued to all healthcare providers in the ED, including physicians, nurses, residents, and respiratory therapists, and included guidelines on initial assessment, medications and tests, reassessment and monitoring, disposition, and education and discharge planning.
The researchers found that children with acute asthma who visited after the introduction of PAMG reminder cards were 2.26 times more likely to receive oral corticosteroids and 2.02 times more likely to receive oxygen saturation reassessment before ED discharge than children who visited before 2003.
Children who visited the ED after the introduction of the PAMG reminder cards also received 0.23 more bronchodilator doses in the first hour of ED stay than those who visited before 2003.
However, there were no significant differences in receipt of asthma education, follow-up instructions, or oral corticosteroid prescriptions at ED discharge between children who visited before and after introduction of the PAMG reminder cards.
"This study provides evidence that treatment of acute asthma exacerbations in children in the ED was improved after the implementation of an evidence-based management tool (ie, a guideline reminder card)," To et al conclude in the journal Respiratory Medicine.
They add, however, that "despite the use of an evidence-based guideline protocol, asthma education and discharge planning at our ED remained unchanged."
"Future efforts should focus on promoting and improving evidence-based practice of these components of asthma management in acute care settings," they say.
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