Bronchodilator and steroid use for the management of bronchiolitis in Canadian pediatric emergency departments

CJEM
Amy PlintDavid Johnson

Abstract

Given the recent publication of several large trials and systematic reviews, we undertook a study of the current management of bronchiolitis in Canadian pediatric emergency departments (EDs) and explored physicians' rationale for their treatment decisions. The overarching purpose of this study was to assist in planning a future trial of combined epinephrine and dexamethasone for bronchiolitis. Physicians in the Pediatric Emergency Research Canada (PERC) database received an 18-item electronic survey. A modified Dillman method was used. Of the 271 physicians surveyed, 191 (70.1%) responded. The majority (120 of 271; 66.5%) reported ''typically'' giving a bronchodilator trial in the ED, with respondents almost evenly divided between treatment with salbutamol (n=62) and treatment with epinephrine (n=61). Of those who use salbutamol, 77.4% indicated that they prefer it because it can be prescribed for home use. Of those who use epinephrine, 80.3% indicated that they believe the medical literature supports its benefit over salbutamol. Few participants (2.6%) reported ''always'' using steroids, whereas the majority (62.8%) reported ''sometimes'' using them. The most common factor reported to influence steroid use was illness severity...Continue Reading

Citations

Feb 24, 2016·Expert Review of Respiratory Medicine·Silvia VandiniMarcello Lanari
Aug 24, 2016·Lancet·Todd A FlorinJoseph J Zorc
Jun 18, 2017·Hospital Pediatrics·Steven L SheinBenjamin Gaston
Sep 20, 2018·Emergency Medicine Australasia : EMA·Matthew OliverDane Chalkley
Aug 27, 2019·Pediatric Emergency Care·Larry B Mellick, Juan Gonzalez
Dec 15, 2018·Pediatric Pulmonology·Patricia O'ConnellSteven L Shein

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