|Title:||Dexamethasone for acute asthma and viral induced wheeze: Quality Improvement in a Paediatric Emergency Department|
|Author(s):||Ruddell, J. Trouton, M. Davison, G. McDonald, R. O'Neill, V. McCann, J. Kennedy, B. Mullen, S.|
|Institution:||Royal Belfast Hospital for Sick Children|
|Poster:||Click to view poster|
|Category:||Asthma and COPD|
|Abstract:||Oral corticosteroids (OCS) are effective for managing acute wheeze, but the financial burden on the NHS is considerable. National guidelines (NICE and SIGN) recommend treatment with prednisolone. This quality improvement project aims to determine if dexamethasone is a suitable, better tolerated, cost-saving alternative.|
Clinical records were reviewed for patients receiving OCS for exacerbation of asthma, viral induced wheeze, and lower respiratory tract infections in a Paediatric Emergency Department (PED) between 2016 and 2018. Data was retrospectively collected from departmental and regional clinical record systems for 100 patients (aged 2-14) per year presenting in October, November, or December. The OCS protocol differed each year: 2016 – 1-2mg/kg prednisolone; 2017 – 600mcg/kg dexamethasone; 2018 – 300mcg/kg dexamethasone. Statistical analysis was performed using IBM SPSS version 26. The price of each OCS was used to determine departmental savings associated with using dexamethasone.
There was no statistically significant difference in re-attendance rates, OCS tolerability, length of stay, or admission rates by year or drug (type and dose). Using dexamethasone as an alternative OCS saved the department £19,501.28 between October-December 2017, and £21,978.87 for the same period in 2018.
Dexamethasone is cost-saving alternative to prednisolone for treating acute wheeze, which is equally efficacious and tolerable