{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T18:03:22Z","timestamp":1781546602010,"version":"3.54.5"},"reference-count":10,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2015,12,1]],"date-time":"2015-12-01T00:00:00Z","timestamp":1448928000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>In our institution's pediatric emergency department, adherence to evidence-based asthma guidelines was noted to be suboptimal for patients with asthma exacerbations. We hypothesized that an evidence-based asthma protocol would improve time to treatment and adherence to National Institutes of Health guidelines for patients presenting to the emergency department with status asthmaticus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      Subjects at our institution were retrospectively identified through an electronic medical record search following institutional review board approval. The asthma protocol was initiated in February 2012. All pediatric subjects who received continuous albuterol in the emergency department before (February 26, 2009, to February 22, 2012,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 193) and after (February 23, 2012, to December 31, 2012,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 68) protocol initiation were analyzed. The post-protocol data were collected as part of routine quality assurance monitoring with a target of 60 post-protocol subjects. Subjects were identified at the end of each month, which resulted in a total of 68 subjects being included. Primary outcomes measured included time to initial treatment with inhaled bronchodilator therapy, time to treatment with systemic corticosteroids, and total number of ipratropium bromide treatments delivered.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Two-hundred sixty-one subjects (7.1 \u00b1 4.6 y of age, 66% male) were included. Demographics were similar in the pre- and post-protocol groups. Compared with the pre-protocol group, more subjects in the post-protocol group received bronchodilators within 30 min (60% vs 77%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02), at least one dose of ipratropium bromide (55% vs 87%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), 3 doses of ipratropium bromide (14% vs 54%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), and corticosteroids within 60 min (62% vs 77%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04). There were no statistically significant differences between the pre- and post-protocol cohorts in the mean time to first bronchodilator treatment (32 \u00b1 41 vs 26 \u00b1 52 min,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .34), mean time to corticosteroid administration (74 \u00b1 68 vs 54 \u00b1 63 min,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .06), or mean emergency department length of stay (342 \u00b1 143 vs 364 \u00b1 183 min,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .31).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>An asthma protocol resulted in improved adherence to National Institutes of Health guidelines in children with status asthmaticus and improved efficiency in the administration of rescue bronchodilator and systemic corticosteroid therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.04011","type":"journal-article","created":{"date-parts":[[2015,6,23]],"date-time":"2015-06-23T21:15:27Z","timestamp":1435094127000},"page":"1759-1764","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["An Asthma Protocol Improved Adherence to Evidence-Based Guidelines for Pediatric Subjects With Status Asthmaticus in the Emergency Department"],"prefix":"10.1177","volume":"60","author":[{"given":"Andrew G","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Respiratory Care Services"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moira E","family":"Breslin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California at Los Angeles, Los Angeles, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie C","family":"Pineda","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James W","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University Medical Center, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,12,1]]},"reference":[{"issue":"94","key":"e_1_3_3_2_2","first-page":"1","article-title":"Trends in asthma prevalence, health care use, and mortality in the United States, 2001-2010","author":"Akinbami LJ","year":"2012","unstructured":"Akinbami LJ, , Moorman JE, , Bailey C, , Zahran HS, , King M, , Johnson CA, et al. Trends in asthma prevalence, health care use, and mortality in the United States, 2001-2010. NCHS Data Brief, 2012;(94):1\u20138.","journal-title":"NCHS Data Brief"},{"issue":"5","key":"e_1_3_3_3_2","first-page":"1","article-title":"Management of acute asthma in the pediatric patient: an evidence-based review","volume":"10","author":"Jones BP","year":"2013","unstructured":"Jones BP, , Paul A. Management of acute asthma in the pediatric patient: an evidence-based review. Pediatr Emerg Med Pract, 2013; 10(5):1\u201323.","journal-title":"Pediatr Emerg Med Pract"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.5863\/1551-6776-18.2.88"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2007.09.029"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.12.027"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-2347"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60987-8"},{"issue":"10","key":"e_1_3_3_9_2","first-page":"1698","article-title":"Continuous albuterol therapy in a pediatric academic emergency department (abstract)","volume":"56","author":"Miller A","year":"2011","unstructured":"Miller A, , Mausert S, , Dunn M, , Eakins K, , Thalman JJ, , Davies J, et al. Continuous albuterol therapy in a pediatric academic emergency department (abstract). Respir Care, 2011; 56(10):1698.","journal-title":"Respir Care"},{"issue":"1","key":"e_1_3_3_10_2","first-page":"CD002178","article-title":"Early emergency department treatment of acute asthma with systemic corticosteroids","author":"Rowe BH","year":"2001","unstructured":"Rowe BH, , Spooner C, , Ducharme FM, , Bretzlaff JA, , Bota GW. Early emergency department treatment of acute asthma with systemic corticosteroids. Cochrane Database Syst Rev, 2001;(1):CD002178.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jen.2009.11.003"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.04011","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.04011","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.04011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:14:46Z","timestamp":1777616086000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.04011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12]]},"references-count":10,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.4187\/respcare.04011"],"URL":"https:\/\/doi.org\/10.4187\/respcare.04011","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2015,12]]}}}