title: A question of time:  systemic corticosteroids in managing acute asthma in children.
abstract: OBJECTIVE
  The aim of this article is to examine the evidence for the effectiveness of systemic corticosteroids in managing acute asthma in children as it relates to the timing of its administration.
  
  
  RESULTS
  Three themes relevant to the timing of systemic corticosteroid administration as it relates to managing acute asthma in children are addressed, namely the evidence for early administration of systemic corticosteroid; factors associated with the administration of systemic corticosteroids and evidence for nurse-initiated administration of systemic corticosteroid.
  
  
  CONCLUSIONS
  There is a clear inverse relationship between time elapsed from the intake of systemic corticosteroids to disposition and the risk of admission. The variable timing of systemic corticosteroid may explain the variable success of clinical care pathways to manage acute asthma. Recent studies have documented a significant reduction hospital admission with early administration of systemic corticosteroid. For acute asthma pathways to succeed in improving hospital admission rates, implementation of such pathways must be linked to barriers to the administration of systemic corticosteroids. Findings from the studies cited provide guidance in the administration of systemic corticosteroids in children with asthma in the real life setting of an emergency department.
authors.affiliation: Child Health Intervention & Longitudinal Development Program, University of New Brunswick, Fredericton, New Brunswick, Canada. sanjit.bhogal@gmail.com
authors.forename: Sanjit K
authors.initials: SK
authors.lastname: Bhogal
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000367:Age Factors; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D006760:Hospitalization; D006801:Humans; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones