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Abstract
This study examined the changes from the initial peak flows and oxygen saturations
(OSAT) of wheezing children at presentation to the emergency department through their
treatment in the emergency department. Data was collected prospectively on 785 patients
5 to 20 years of age during an 11-month period from November 1, 1990, to September
30, 1991. Both the initial OSAT and peak flows were correlated with the number of
bronchodilator treatments required in the emergency department and with the need for
hospitalization. Both the initial OSAT and the peak flows had a limited ability to
predict the need for hospitalization. Oxygen saturation appears to be a valid measure
of wheezing severity and is more easily obtained in children of all ages. Following
bronchodilator treatment, peak flow results in a larger quantitative improvement than
OSAT; however, this difference does not appear to have any significant advantage.
Aerosolized albuterol and subcutaneous epinephrine resulted in a similar degree of
improvement as measured by peak flow and by oxygen saturation, with clinically similar
changes in heart rate.
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References
- Emergency management of asthma in children.J Pediatr. 1980; 97: 346-350
- An index predicting relapse and need for hospitalization in patients with acute bronchial asthma.N Engl J Med. 1981; 305: 783-789
- A clinical scoring system for diagnosis of respiratory failure.Am J Dis Child. 1972; 123: 227-228
- Early prediction of the need for hospitalization in children with acute asthma.Clin Pediatr. 1984; 23: 81-84
- Pitfalls in the use of clinical asthma scoring.Am J Dis Child. 1988; 142: 183-185
- Evaluation of pulse oximetry.Anesthesiology. 1983; 59: 349-352
- The clinical utility of pulse oxymetry in the pediatric emergency department setting.Pediatr Emerg Care. 1991; 7: 263-266
- Continuous emergency department monitoring of arterial saturation in adult patients with respiratory distress.Ann Emerg Med. 1988; 17: 463-468
- Pulse oximetry to identify a high-risk group of children with wheezing.Am J Emerg Med. 1989; 7: 567-570
- A one-year series of pediatric ED wheezing visits: The Hawaii EMS-C project.Pediatr Emerg Care. 1992; 8: 17-26
- Oxygen saturation as a marker for admission or relapse with acute bronchospasm.Am J Emerg Med. 1987; 5: 196-200
- Predictive value of oxygen saturation in emergency evaluation of asthmatic children.BMJ. 1988; 297: 395-396
- Spirometry, lung volumes and airway resistance in normal children aged 5 to 18 years.Br J Dis Chest. 1970; 64: 15-24
- Oxygen saturation changes during the pediatric emergency department treatment of wheezing.Am J Emerg Med. 1992; 10: 274-284
- Acute asthma: Observations regarding the management of a pediatric emergency room.Pediatrics. 1989; 83: 507-512
- Pediatric predictive index for hospitalization in acute asthma.Ann Emerg Med. 1987; 16: 25-31
- Predicting the need for hospitalization in children with acute asthma.Chest. 1990; 98: 1355-1361
- Clinical scoring does not accurately assess hypoxemia in pediatric asthma patients.Ann Emerg Med. 1984; 13: 1040-1043
- Attempting to predict hospital admission in acute asthma.Am J Dis Child. 1984; 138: 1062-1066
- Clinica-physiologic correlations in acute asthma of childhood.Pediatrics. 1991; 87: 481-486
- Oximetry and peak expiratory flow in assessment of acute childhood asthma.J Pediatr. 1990; 117: 907-909
- Pulse oximetry in acute asthma.Arch Dis Child. 1991; 66: 724-725
- Time course of change in oxygen saturation and peak expiratory flow in children admitted to hospital with acute asthma.Thorax. 1990; 45: 438-441
Article Info
Publication History
Accepted:
June 3,
1992
Received:
April 7,
1992
Footnotes
â?†Supported in part by a grant from Kapiolani Medical Center for Women and Children and a grant from the University of Hawaii.
Identification
Copyright
© 1992 Published by Elsevier Inc.
