{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:36:36Z","timestamp":1786988196295,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n \n To evaluate adherence to the\n Sydney Children's Hospital Network (SCHN) Asthma\u2010Acute Management Practice Guideline<\/jats:italic>\n in the management of paediatric patients presenting to a metropolitan emergency department (ED).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A cross\u2010sectional retrospective audit of 153 paediatric\n ED<\/jats:styled-content>\n presentations with acute asthma between March 2023 and February 2024 was conducted. Data extracted from electronic medical records included demographics, documented asthma severity, investigations, treatment, length of stay and discharge planning. Asthma severity was inferred retrospectively from documentation, which was often incomplete, limiting interpretation of patient management. Outcomes were compared with\n SCHN<\/jats:styled-content>\n guideline recommendations. Data were analysed descriptively using means and proportions, with subgroup comparisons by admission status and severity classification.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 153 presentations, 56 (36.6%) resulted in admission. Documentation of key severity parameters was frequently incomplete, including speech (78%) and cyanosis (69%). Chest X\u2010rays were performed in 34.6% of cases. Mean bronchodilator burst duration exceeded guideline recommendations (salbutamol 46.7\u2009min; ipratropium 47.7\u2009min). Systemic corticosteroids were administered in 92% of patients, with appropriate dosing in 63%. Among 27 severe\/life\u2010threatening cases, 8 (29.6%) received intravenous magnesium sulphate. Mean\n ED<\/jats:styled-content>\n length of stay was longer in admitted patients than in discharged patients (6.5 vs. 4.3\u2009h).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Variation between local practice and\n SCHN<\/jats:styled-content>\n guideline recommendations was identified in severity assessment, pharmacological management, imaging utilisation and discharge planning. Targeted quality improvement strategies, including implementation of\n ED<\/jats:styled-content>\n short\u2010stay models, structured electronic severity assessment tools and staff education initiatives, may support improved adherence to guideline\u2010based care.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jpc.70446","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T04:20:48Z","timestamp":1779769248000},"page":"1394-1402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Paediatric Acute Asthma in a Metropolitan Emergency Department: A Retrospective Audit"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5974-9653","authenticated-orcid":false,"given":"Yasmine","family":"Toufaili","sequence":"first","affiliation":[{"name":"The Children's Hospital at Westmead Sydney Children's Hospital Network Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nounu","family":"Sarukkali","sequence":"additional","affiliation":[{"name":"The Children's Hospital at Westmead Sydney Children's Hospital Network Sydney Australia"},{"name":"Fairfield Hospital Sydney Children's Hospital Network Sydney Australia"},{"name":"The University of New South Wales Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)33311-1"},{"key":"e_1_2_13_3_1","unstructured":"Australian Institute of Health and Welfare \u201cAustralia's Children AIHW \u201d2022 accessed April 3 2026 https:\/\/www.aihw.gov.au\/reports\/children\u2010youth\/australias\u2010children."},{"key":"e_1_2_13_4_1","unstructured":"Australian Institute of Health and Welfare \u201cAsthma AIHW \u201d2026 accessed April 3 2026 https:\/\/www.aihw.gov.au\/reports\/chronic\u2010respiratory\u2010conditions\/asthma."},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3041-x"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000527268"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2020.12.037"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2021-001137"},{"key":"e_1_2_13_9_1","unstructured":"The Sydney Children's Hospitals Network \u201cAsthma\u2014Acute Management Practice Guideline SCHN \u201d2023 accessed April 3 2026 https:\/\/www.schn.health.nsw.gov.au."},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_13_11_1","unstructured":"The Royal Children's Hospital Melbourne \u201cPreschool Asthma (1\u20135\u2009Years) RCH \u201d2023 accessed April 3 2026 https:\/\/www.rch.org.au\/clinicalguide\/guideline_index\/Preschool_asthma_(1\u20105_years)\/."},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S319105"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/02770903.2021.1957865"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S178927"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja15.01177"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2003.tb05359.x"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.722480"},{"issue":"9","key":"e_1_2_13_18_1","first-page":"CD000052","article-title":"Holding Chambers (Spacers) Versus Nebulisers for Beta\u2010Agonist Treatment of Acute Asthma","volume":"2013","author":"Cates C. J.","year":"2013","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0237620"},{"issue":"1","key":"e_1_2_13_20_1","first-page":"1","article-title":"Limited Knowledge on Asthma and Pressurized Metered\u2010Dose Inhaler Technique Among Health Care Professionals Attending Asthmatic Patients in Dar es Salaam, Tanzania","volume":"33","author":"Shayo G. A.","year":"2020","journal-title":"Journal of Aerosol Medicine and Pulmonary Drug Delivery"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2015.08.001"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2024.01.003"},{"key":"e_1_2_13_23_1","unstructured":"Australian Bureau of Statistics \u201cAsthma ABS \u201d2022 accessed April 3 2026 https:\/\/www.abs.gov.au\/statistics\/health\/health\u2010conditions\u2010and\u2010risks\/asthma\/latest\u2010release."},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-017-0823-7"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.70049"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.3296"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2022-325137"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70446","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.70446","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70446","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:17:39Z","timestamp":1786987059000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.70446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,25]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/jpc.70446"],"URL":"https:\/\/doi.org\/10.1111\/jpc.70446","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,25]]},"assertion":[{"value":"2025-11-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}