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Asthma exacerbations in the pediatric emergency area: evaluation and prospects for improvement of pre-hospital care
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  • Victor Gonzalez-Uribe,
  • Elsy Navarrete,
  • Fernando Angeles-Tellez,
  • Jose Montiel-Gonzalez,
  • Jorge Colin-Rubio,
  • Clara Fernanda Gonzalez-Chavarria,
  • Zaira Selene Mojica-Gonzalez
Victor Gonzalez-Uribe
Hospital Infantil de Mexico Federico Gomez

Corresponding Author:[email protected]

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Elsy Navarrete
Hospital Infantil de Mexico Federico Gomez
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Fernando Angeles-Tellez
Universidad La Salle Facultad Mexicana de Medicina
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Jose Montiel-Gonzalez
Universidad La Salle Facultad Mexicana de Medicina
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Jorge Colin-Rubio
Universidad La Salle Facultad Mexicana de Medicina
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Clara Fernanda Gonzalez-Chavarria
Universidad La Salle Facultad Mexicana de Medicina
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Zaira Selene Mojica-Gonzalez
Universidad La Salle Facultad Mexicana de Medicina
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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 .