Need for Improvement in Prehospital Management of Pediatric Asthma

emergency medical services, ambulance, emt
emergency medical services, ambulance, emt
Steroid usage is low in pediatric asthma emergency medical services transports, indicating an area of improvement for prehospital management of pediatric asthma.

Approximately 6% of pediatric emergency medical services transports are for asthma, but steroid usage is low, indicating an area of improvement for prehospital management of pediatric asthma, according to study results published in Pediatric Pulmonology.

Despite the major health burden of asthma, data are lacking regarding the management of asthma in the prehospital setting. Thus, researchers retrospectively reviewed electronic medical records from 24 emergency medical services agencies in Southwestern Pennsylvania between 2014 and 2017.

They found that of the 19,246 pediatric transports, 1078 (5.6%) patients had wheezing, and of these, 532 (49.4%) met criteria for severe asthma. These patients were more likely to be adolescents compared with those with nonsevere asthma. However, overall use of steroids was low (7.5%), with 12.8% of patients with severe asthma having received intravenous methylprednisolone compared with 2.4% of patients with nonsevere asthma (P <.01). Other therapies administered included albuterol (64.8%), ipratropium bromide (25.1%), oxygen (26.0%), a peripheral intravenous line (16.7%), and continuous positive airway pressure (0.4%).

Although the majority of patients were given bronchodilator therapy, only a minority were provided steroids, even among those with severe asthma. In addition, the researchers found that a larger proportion of patients with severe asthma did not have home access to bronchodilator therapy.

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The researchers concluded that, “These findings provide descriptive data on the management of pediatric asthma in the prehospital setting to facilitate future efforts in quality improvement, research, and protocol development.”


Ramgopal S, Mazzarini A, Martin‐Gill C, Owusu‐Ansah S. Prehospital management of pediatric asthma patients in a large emergency medical services system [published online October 18, 2019]. Pediatr Pulmonol. doi:10.1002/ppul.24542