Lucia Dominic, Cain James, Porter Ashlee, Sagar Malvika, Blazovic Sarah, Finley Leland, Mallett Lea
Department of Pediatrics, Baylor Scott & White McLane Children's Medical Center, Temple, Texas.
Proc (Bayl Univ Med Cent). 2020 Aug 21;34(1):40-43. doi: 10.1080/08998280.2020.1801110.
Asthma is one of the leading causes of hospital admission in the pediatric population. Standardization of asthma management guidelines for patients admitted to the emergency department has been suggested to improve care delivery and patient outcomes. Utilizing a multidisciplinary asthma task force at a single academic medical center, we sought to determine if a protocol-driven approach to implementation of care for patients with asthma could improve patient outcomes by reducing wait times for administration of steroids. A prospective cohort study examined the use of a standardized asthma pathway over a 2-year period compared to historical controls. Pathway use significantly decreased time to corticosteroid administration (45 vs. 29 min [year 1] and 20 min [year 2]; < 0.0001). By implementing this standard of care at pediatric emergency departments, time to treatment can be decreased, therefore improving the morbidity and mortality of pediatric patients with asthma nationwide.
哮喘是儿科住院的主要原因之一。有人建议对急诊科收治的患者的哮喘管理指南进行标准化，以改善护理服务和患者预后。我们利用一家学术医疗中心的多学科哮喘特别工作组，试图确定一种以方案为导向的哮喘患者护理实施方法是否可以通过减少类固醇给药的等待时间来改善患者预后。一项前瞻性队列研究对标准化哮喘治疗路径在两年内的使用情况与历史对照进行了比较。使用该治疗路径显著缩短了给予皮质类固醇的时间（第1年为45分钟对29分钟，第2年为20分钟；<0.0001）。通过在儿科急诊科实施这种护理标准，可以缩短治疗时间，从而改善全国哮喘患儿的发病率和死亡率。
