[Characteristics of admissions to pediatric emergency departments for exacerbations of asthma. Assessment and prospects for improving prehospital care].
BACKGROUND
The frequency of emergency department visits for asthma is a major public health problem in pediatrics. The aim of this study is to establish the characteristics of children visiting pediatric emergency departments for acute asthma and to assess their therapeutic management prior to admission.


METHODS
A prospective clinical study performed during 3 months at the pediatric emergency department of the university teaching hospital of Clermont-Ferrand, of children aged 1 to 16 years admitted to the department with a clinical diagnosis of asthma exacerbation.


RESULTS
One hundred and forty-three patients were included in the study. Asthma crises were moderate to severe in 69.2% of cases (n=99). Initial therapeutic management prior to the admission to the emergency department was appropriate in 17.5% of cases (n=25). Most of the known asthmatic patients had not been followed up by a pediatric pulmonologist (n=56). A crisis protocol had been set up in 16.5% of cases (n=20). Exacerbations were more severe among younger patients (P=0.002) and economically disadvantaged children (P=0.025).


CONCLUSIONS
This study uncovers poor knowledge of the disease among asthmatic children and their families, and an insufficient awareness among health practitioners of current recommendations for the treatment of asthmatic children. Admissions to the emergency department for asthma could be partly avoided by improving diagnosis and therapeutic education.
Service des urgences pédiatriques, université d'Auvergne-Clermont I, CHU-Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France. Electronic address: vjulian@chu-clermontferrand.fr.
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V
Julian
Direction de la recherche clinique, unité de biostatistique, université d'Auvergne-Clermont I, CHU Gabriel-Montpied, Clermont-Ferrand, France.
B
B
Pereira
Service des urgences pédiatriques, université d'Auvergne-Clermont I, CHU-Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France.
A
A
Labbé
Service des urgences pédiatriques, université d'Auvergne-Clermont I, CHU-Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France.
F
F
Amat
D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006699:Home Care Services / Q000592:standards* / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D058996:Quality Improvement
Asthmatic crisis; Asthme infantile; Education of patient; Emergency; Epidemiology; Pediatrics; Prospective studies; Urgences pédiatriques; Éducation du patient; Épidémiologie; Étude prospective