Asthma in emergency departments: Combined adult and paediatric versus paediatric only centres

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Powell, Colin, Kelly, Anne-Maree, Kerr, Debra, Raftos, J and Rosengarten, P (2004) Asthma in emergency departments: Combined adult and paediatric versus paediatric only centres. Journal of Paediatrics and Child Health, 40 (8). pp. 433-437. ISSN 1034-4810


Objective: To compare the management of paediatric patients with mild or moderate asthma in paediatric-only emergency departments (POEDs) to treatment in a mixed adult-child emergency departments (mixed EDs). Methods: Prospective, observational study conducted in 36 Australian emergency departments (EDs) for 2 weeks in 2001. Children aged 1–15 years with acute asthma classified as mild or moderate severity. Details of demography, severity assessment, and type of treatment facility, treatment and disposition were collected. Analysis used descriptive statistics, comparison of proportions by χ2, and multiple logistic regression. Results:Two-hundred and nine children were treated at POEDs and 257 at mixed EDs. The groups had similar severity. Spacers to deliver beta-agonists were used more frequently in POEDs (67.5% vs 24.2%; P < 0.01). Children treated at POEDs with a mild attack were more likely to be admitted (20.6% vs 9.5%; P < 0.02) and given salbutamol (82.8% vs 71.9%; P = 0.03). For children with moderate asthma, oral steroid prescription on hospital discharge was more common for those treated in a mixed ED (81.0% v 95.7%; P= 0.01). Ipratropium bromide (IB) was widely used at both types of ED but more commonly used in mixed EDs (41.7% vs 54.9%; P < 0.01). There were no differences in length-of-stay, representation rate within one month and oral steroid use for attack. Less than 2/3 of children with mild asthma attacks received steroid treatment in the ED. Conclusion: Treatment was similar between the two types of ED. IB was overused in mild asthma and oral steroids were underused in moderate asthma, by both ED types. Spacers were under-utilized in mixed EDs.

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Item type Article
DOI 10.1111/j.1440-1754.2004.00424.x
Official URL
Subjects Historical > FOR Classification > 1103 Clinical Sciences
Historical > FOR Classification > 1117 Public Health and Health Services
Historical > Faculty/School/Research Centre/Department > School of Nursing and Midwifery
Keywords ResPubID19035, asthma, emergency presentation, paediatric, outcome, treatment
Citations in Scopus 8 - View on Scopus
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