PREHOSPITAL MANAGEMENT OF PEDIATRIC ASTHMA REQUIRING HOSPITALIZATION

Our objective was to evaluate the quality of prehospital assessment an d management in pediatric asthma requiring hospitalization via a retro spective chart review, Charts were obtained from a pediatric emergency department (ED) with 24,000 annual visits. Included in the study were 27 patients less than 18 years of age with asthma requiring hospitali zation, transported to the Boston City Hospital Pediatric ED by Boston Emergency Medicine Services (EMS). We found that 12 patients admitted to the pediatric intensive care unit over an 18-month period, and 15 patients admitted to the ward over a six-month period, received prehos pital care from Boston EMS, Only 63% of cases (17/27) had a physical e xamination marker of asthma severity noted on the EMS record. Twenty-s ix percent of cases (7/27) did not receive O-2 in the field. Thirty pe rcent of cases (8/27) were hypoxic at ED presentation, None of the hyp oxic patients had received albuterol in the field, and one did not rec eive O-2. We conclude that further study of the prehospital assessment and management of pediatric asthma is warranted.