Asthma exacerbations in the pediatric emergency area: evaluation and
prospects for improvement of pre-hospital care
Abstract
Introduction. - The frequency of emergency department visits
for asthma is a major public health problem in pediatrics. The aim of
this study is to identify the characteristics of children who visit the
pediatric emergency department for asthma exacerbation and to evaluate
their therapeutic management before admission. Methods. - A
prospective study conducted over a 6-month period in the pediatric
emergency departments of 5 hospitals on children aged 1 to 16 years who
were admitted to the department with a clinical diagnosis of asthma
exacerbation. Results. – 143 patients were enrolled in the
study. Asthma episodes were moderate to severe in 69.2% of cases (n =
99). Initial therapeutic treatment before admission to the emergency
department was appropriate in 17.5% of cases (n = 25). Hospitalizations
greater than 24 hours only occurred in 18.2% ( n = 26) . In children
under 3 years of age, the viral context was present in 91.4% (n = 64)
& exacerbations were more severe in younger patients (P = 0.002) and
economically disadvantaged children (P = 0.025). Only 17.4% (n=25) were
found to be positive by an antigen test or PCR test for SARS-CoV-2.
suggesting that the involvement of traditional respiratory viruses in
asthma exacerbation continues even in pandemic times. Regarding the
pre-hospital care, 70.6% (n=101) had received prior treatment, but this
treatment was inappropriate in 53.1 % (n=76). Conclusions. -
This study shows that asthmatic children and their families know little
about the disease and that physicians are not sufficiently aware of
current recommendations for the management of asthmatic children.
Admission to the emergency department for asthma could be partially
avoided by better diagnosis and therapeutic education .