PS-365 Validation Of A Clinical Scale In Acute Bronchiolitis

Abstract

pilot was carried out from 8 am-8 pm Monday to Friday. Data collected included time of arrival and assessment, admission rates, parental and staff satisfaction. Results During Jan 2013 and April 2013 between 8 am-8 pm there was a total of 785 admissions. A retrospective analysis was carried out on 80 randomly selected charts. Ages ranged from 3 weeks to 13 years 9 months, with a median age of 3 years 5 months. 97% of patients were seen within 4 h of nursing triage with only 59% being reviewed by a senior doctor within the following 4 h of their initial medical review.There were 100 APAU admissions during May 2013. Only 87 charts were available and audited. Ages ranged from 2 days to 14 years with a median age of 1 year 7 months. Common diagnoses included gastroenteritis and respiratory tract infections. 100% of patients were medically assessed within 4 h of nursing triage with 85% of patients being reviewed by a senior doctor within the following 4 h (p value 0.01).Admission rates fell from 95% to 44% during the hours of 8 am-8 pm (p value < 0.0001). Staff impression of our facilities for managing direct admissions as good or excellent improved from 25% to 95%. Patient and parent feedback was excellent. Conclusion We have shown that developing a model of acute paediatric assessment in a DGH setting can both reduce admissions and improve quality outcomes. Both physical infrastructure and funding remain issues for sustainability however we believe that this project demonstrates the value in investing in acute paediatric care.Primary Care: Infections Background and aims The smoking parent is considered a risk factor of severity for acute bronchiolitis (AB). We aimend to evaluate the relationship between parental history of smoking and length of stay of infants hospitalised for AB. Methods Prospective descriptive study including all infants admitted for moderately bronchiolitis, between 2011 and 2013. They were grouped in smoking parent or not. Severe bronchiolitis and patients with serious risk factors were excluded. The primary outcome was length of stay (LOS). The following variables were recorded: age, sex, atopic dermatitis, parental atopy, number of siblings, breastfeeding, RSV, treatment received, need for PICU, mortality and clinical score at admission. Results Among the 137 enrolled infants, 56.2% had no smoking parent. There were no statistically significant differences (p > 0.05) between the two groups in the following variables: median age (40 vs 59 days), male gender (48% vs 53%), atopic dermatitis (6.7% vs 15.6%), breastfeeding (59.7% vs 53.3%), number of siblings (0.66 vs. 0.63) day care attendance (16.9% vs. 6.7%), severity score (5.35 vs 5.28), percentage of positive RSV (67% vs 65%) and PICU admission (7.8% vs 5%). There were statistically significant differences in parental atopy (p =

The impact of viral bronchiolitis phenotyping: Is it time to consider phenotype-specific responses to individualize pharmacological management?

“…In addition, the AAP 2014 bronchiolitis guideline's assertion that clinicians are unable to adequately observe clinically relevant responses to bronchodilator is not congruent with the evidence [27]. A systematic review of all available instruments to evaluate severity of bronchiolitis identified a total of 32 tools, some of them considered to have adequate "responsiveness" [28,29], defined as the ability of a score to detect clinically important changes over time in response to interventions such as bronchodilators [27].…”

Bronchodilators should be considered for all patients with acute bronchiolitis, but closely monitored for objectively measured clinical benefits

“…Likewise, Flores-Gonzalez et al showed a clear decrease in the Wood-Downes scale, as modified by Ferres, when comparing scores obtained at admission with those obtained at discharge. This reflected the good clinical evolution necessary for discharging the patient from the hospital and returning him or her to home care (3).…”

Fenotipos clínicos de bronquiolitis aguda y respuesta al salbutamol inhalado en lactantes atendidos en el Hospital Infantil Napoleón Franco Pareja, Cartagena.

“…Se realiza la evaluación de los pacientes a los 30, 60 y 120 minutos posteriores al inicio del tratamiento con la escala de gravedad Wood-Downes-Ferrés (Tabla 1). Esta escala que fue previamente validada por Flores-González et al (13).…”