University of Oulu

Csonka, P, Tapiainen, T, Mäkelä, MJ, Lehtimäki, L. Heterogeneity of emergency treatment practices in wheezing preschool children. Acta Paediatr. 2021; 110: 2448– 2454.

Heterogeneity of emergency treatment practices in wheezing preschool children

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Author: Csonka, Péter1,2; Tapiainen, Terhi3; Mäkelä, Mika J.4;
Organizations: 1Centre for Child Health Research, Tampere University and Tampere University Hospital, Tampere, Finland
2Terveystalo Healthcare, Tampere, Finland
3Department of Pediatrics and Adolescent Medicine, Oulu University Hospital and PEDEGO Research Unit, University of Oulu, Oulu, Finland
4Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
5Allergy Centre, Tampere University Hospital, Tampere, Finland
6Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-10-05


Aim: Our aim was to survey treatment practices used for preschool children with wheezing in emergency rooms (ER) focussing on inhalation device choice and handling, face mask use, salbutamol dosing and written instructions. We sought to assess whether current protocols are in line with published evidence and guidelines.

Methods: This is a cross-sectional survey done in paediatric ER units located in Finnish municipalities with more than 10 000 inhabitants.

Results: Of the 100 units contacted, 50% responded. More than 50% of the units used nebulisers. Only 13% of the units administered salbutamol in single puffs. More than 30% of the units lacked criteria on face mask use. Poor co-operation had no effect on the dose of salbutamol in 62% of the units. Ensuring tight mask-to-face seal was included in the training in 20% of the units. A written action plan was provided to the caregivers in 28% of the units.

Conclusion: ER treatment guidelines for preschool children with wheezing are poorly endorsed. Research is needed to identify approaches to guideline implementation that are specific for primary care. Clinical research should focus on strengthening recommendations that are currently not embraced. ER treatment protocols need to be updated and adherence to guidelines should be re-evaluated.

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Series: Acta pædiatrica
ISSN: 0803-5253
ISSN-E: 1651-2227
ISSN-L: 0803-5253
Volume: 110
Issue: 8
Pages: 2448 - 2454
DOI: 10.1111/apa.15915
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: This study was supported by the Tampere Tuberculosis Foundation and the Research Foundation of the Pulmonary Disease.
Copyright information: © 2021 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.