PO-0277 Review Of The Management And Outcome For Patients Treated For Wheeze In A Tertiary Paediatric Emergency Department (ped)

Abstract

Background and aims To review the management of patients who were treated for wheeze in the PED and compare them to those in the British Thoracic Society (BTS) Guidelines. Methods Reviewed PED flimsy of those patients over 2 who were treated for wheeze in PED in March. Results Number of patients 46. 93% received bronchodilators while 7% were given Prednisolone only. 65% were given maximum nebulised bronchodilator therapy (x3 sets). 89% received steroids and 2% received IV medication. 41% received antibiotics in ED and 50% had a chest x-ray performed. Of those discharged (n = 32), 75% were discharged within 4 h. 31% patients were discharged within 1 h of last bronchodilator and a further 41% within 2 h. Of those treated with maximum nebulised bronchodilators (n = 30), 43% were admitted, 23% discharged within 1 h post last bronchodilator and a further 27% within 2 h. 8% re-attended within 48 h -4% due to elevated temperature, 2% were uncertain with inhaler technique and 2% due to increase in symptoms. No patient had documented evidence of written asthma management plan given or to attend primary care for review within next 48 hrs. Conclusions The low re-attendance rate is supportive that those attending received good clinical care and in a timely manner, with 75% of patients being discharged within the 4 h target. However, education is required to ensure patients stay 3–4 h post last bronchodilator and the need for documented discharge advice. Education is also required on the use of chest x-rays and antibiotics.