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Heterogeneity of emergency treatment practices in wheezing preschool children.

Authors
  • Csonka, Péter1, 2
  • Tapiainen, Terhi3
  • Mäkelä, Mika J4
  • Lehtimäki, Lauri5, 6
  • 1 Centre for Child Health Research, Tampere University and Tampere University Hospital, Tampere, Finland. , (Finland)
  • 2 Terveystalo Healthcare, Tampere, Finland. , (Finland)
  • 3 Department of Pediatrics and Adolescent Medicine, Oulu University Hospital and PEDEGO Research Unit, University of Oulu, Oulu, Finland. , (Finland)
  • 4 Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. , (Finland)
  • 5 Allergy Centre, Tampere University Hospital, Tampere, Finland. , (Finland)
  • 6 Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. , (Finland)
Type
Published Article
Journal
Acta Paediatrica
Publisher
Wiley (Blackwell Publishing)
Publication Date
May 13, 2021
Identifiers
DOI: 10.1111/apa.15915
PMID: 33987866
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Our aim was to survey treatment practices used for preschool children with wheezing in emergency rooms (ER) focussing on inhalation device choice and handling, face mask use, salbutamol dosing and written instructions. We sought to assess whether current protocols are in line with published evidence and guidelines. This is a cross-sectional survey done in paediatric ER units located in Finnish municipalities with more than 10 000 inhabitants. Of the 100 units contacted, 50% responded. More than 50% of the units used nebulisers. Only 13% of the units administered salbutamol in single puffs. More than 30% of the units lacked criteria on face mask use. Poor co-operation had no effect on the dose of salbutamol in 62% of the units. Ensuring tight mask-to-face seal was included in the training in 20% of the units. A written action plan was provided to the caregivers in 28% of the units. ER treatment guidelines for preschool children with wheezing are poorly endorsed. Research is needed to identify approaches to guideline implementation that are specific for primary care. Clinical research should focus on strengthening recommendations that are currently not embraced. ER treatment protocols need to be updated and adherence to guidelines should be re-evaluated. © 2021 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

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