Department of Emergency Medicine, Marshfield Medical Center, Marshfield, Wisconsin,
Department of Emergency Medicine, Marshfield Medical Center, Marshfield, Wisconsin.
WMJ. 2022 Apr;121(1):26-29.
To determine if the length of observation (< 2 hours vs ≥ 2 hours) following treatment of croup with inhaled racemic epinephrine in the emergency department (ED) is associated with return rates (within 48 hours after treatment) in pediatric patients.
We conducted a retrospective review of patients' medical records from February 2010 through June 2018 for pediatric patients (male and female, ≤ 12 years of age) diagnosed with croup in the ED, treated with racemic epinephrine, and discharged from the ED.
We evaluated patients observed for less than 1 hour, 1 to 2 hours, and greater than 2 hours to determine difference in return rates within 48 hours. For patients with mild croup symptoms, 2% observed for less than 1 hour returned; 5% observed for 1 to 2 hours returned, and 3% observed for greater than 2 hours returned. Of the patients with moderate croup symptoms, 29% observed for less than 1 hour returned, 20% observed for 1 to 2 hours returned, and 20% observed for greater than 2 hours returned. A majority who returned for follow-up were not retreated with racemic epinephrine.
Based on our study results, we can conclude that observing patients following treatment of croup with inhaled racemic epinephrine in the ED for less than 2 hours did not increase their risk of deterioration or need to return. Our data did not show that a longer observation time resulted in lower return rates within 48 hours.
确定在急诊科（ED）使用吸入性消旋肾上腺素治疗喘鸣后观察时间（<2 小时与≥2 小时）是否与儿科患者的复诊率（治疗后 48 小时内）相关。
我们对 2010 年 2 月至 2018 年 6 月期间在 ED 被诊断为喘鸣、接受消旋肾上腺素治疗并从 ED 出院的儿科患者（男、女，≤12 岁）的病历进行了回顾性分析。
我们评估了观察时间少于 1 小时、1 至 2 小时和超过 2 小时的患者，以确定 48 小时内复诊率的差异。对于轻度喘鸣症状的患者，2%观察时间少于 1 小时的患者返回；5%观察时间为 1 至 2 小时的患者返回，3%观察时间超过 2 小时的患者返回。对于中度喘鸣症状的患者，29%观察时间少于 1 小时的患者返回，20%观察时间为 1 至 2 小时的患者返回，20%观察时间超过 2 小时的患者返回。大多数需要复诊的患者没有重新接受消旋肾上腺素治疗。
根据我们的研究结果，我们可以得出结论，在 ED 观察接受吸入性消旋肾上腺素治疗的喘鸣患者不到 2 小时不会增加其恶化或需要返回的风险。我们的数据没有表明较长的观察时间会导致 48 小时内复诊率降低。
