Correlations between pulse oximetry and peak expiratory flow in acute asthma

Andrade, Cláudia Ribeiro de; Duarte, Marta Cristina Teixeira; Camargos, Paulo Augusto Moreira

doi:10.1590/s0100-879x2007000400006

Cited by 8 publications

(2 citation statements)

References 16 publications

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“…There was significant correlation between % of expected PEFR and oxygen saturation (p value <0.0001). 8 Global initiative for asthma 2018 and British Thoracic Society 2019 guidelines recommend chest X-ray in acute exacerbations of asthma only when there is inadequate response to treatment, focal chest signs, suspicion of complications like pneumothorax, lobar collapse or consolidation, suspicion of foreign body aspiration or subcutaneous emphysema. 1,5 In this study, chest X-rays were done as indicated by these standard guidelines in 12 (24%) children on admission.…”

Section: Discussionmentioning

confidence: 99%

Role of peak expiratory flow rate and chest radiography in children above 5 years of age with acute asthma

Shankarnarayana

Devdas

John

et al. 2020

Int J Contemp Pediatr

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Background: Asthma is a heterogeneous disease characterized by cough, wheeze and shortness of breath that vary in intensity and time with variable expiratory airflow limitation, associated with chronic airway inflammation. Aim of the study was to assess the usefulness of Peak Expiratory Flow Rate [PEFR] and oxygen saturation in determining severity of acute asthma, to measure objective change in PEFR and oxygen saturation following bronchodilator therapy and the role of chest X-rays in acute asthma.Methods: A prospective study of 50 children above 5 years with acute asthma who presented to the emergency department in a tertiary care hospital were included. PEFR and oxygen saturation before and after bronchodilator therapy was measured. Indication for chest X-rays, its clinical correlation and change in standard treatment of acute asthma based on X-ray reports was noted.Results: The mean PEFR and PEFR % of expected was lower in severe asthma when compared to moderate asthma and was statistically significant (p<0.001). The % of expected PEFR before salbutamol therapy was 48.78±14.36, which improved significantly to 67.13±14.22 after treatment (p<0.001). Oxygen saturation before and after salbutamol therapy was 94.96 ± 4.11 and 96.96±2.87 respectively with the change being significant (p value <0.001). Chest X-rays were performed in 12 (24%) children as per standard guidelines, of which 1(9%) was abnormal showing right basal consolidation. Chest X-ray correlated with clinical findings in 1 child and the findings on chest X-ray altered the ongoing treatment by addition of antibiotic.Conclusions: PEFR and oxygen saturation is useful in the emergency department to objectively assess the severity of acute asthma and the response to initial bronchodilator therapy. Chest X-rays are not routinely indicated in the standard treatment of acute asthma.

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Section: Discussionmentioning

confidence: 99%

Role of peak expiratory flow rate and chest radiography in children above 5 years of age with acute asthma

Shankarnarayana

Devdas

John

et al. 2020

Int J Contemp Pediatr

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“…Guideline recommendations include performing peak expiratory flow rate (PEFR) and pulse oximetry measurements which provide important objective assessments of asthma severity[9,10] and help to determine treatments used and need for hospitalisation[11,12]. Nebulised or inhaled beta-agonists (most commonly salbutamol) and oxygen are the main treatments advocated [6,7].…”

Section: Introductionmentioning

confidence: 99%

Identifying barriers and facilitators to ambulance service assessment and treatment of acute asthma: a focus group study

Shaw

Siriwardena

2014

BMC Emerg Med

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BackgroundAcute asthma is a common reason for patients to seek care from ambulance services. Although better care of acute asthma can prevent avoidable morbidity and deaths, there has been little research into ambulance clinicians’ adherence to national guidelines for asthma assessment and management and how this might be improved. Our research aim was to explore paramedics’ attitudes, perceptions and beliefs about prehospital management of asthma, to identify barriers and facilitators to guideline adherence.MethodsWe conducted three focus group interviews of paramedics in a regional UK ambulance trust. We used framework analysis supported by NVivo 8 to code and analyse the data.ResultsSeventeen participants, including paramedics, advanced paramedics or paramedic operational managers at three geographical sites, contributed to the interviews. Analysis led to five themes: (1) guidelines should be made more relevant to ambulance service care; (2) there were barriers to assessment; (3) the approach needed to address conflicts between clinicians’ and patients’ expectations; (4) the complexity of ambulance service processes and equipment needed to be taken into account; (5) and finally there were opportunities for improved prehospital education, information, communication, support and care pathways for asthma.ConclusionsThis qualitative study provides insight into paramedics’ perceptions of the assessment and management of asthma, including why paramedics may not always follow guidelines for assessment or management of asthma. These findings provide opportunities to strengthen clinical support, patient communication, information transfer between professionals and pathways for prehospital care of patients with asthma.

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